Neighbourhood socio-economic position, late presentation and outcomes in people living with HIV in Switzerland.

Güler, Aysel; Schöni-Affolter, Franziska; Moser, André; Bertisch, Barbara; Bucher, Heiner C; Calmy, Alexandra; Cavassini, Matthias; Ledergerber, Bruno; Wandeler, Gilles; Egger, Matthias (2015). Neighbourhood socio-economic position, late presentation and outcomes in people living with HIV in Switzerland. AIDS, 29(2), pp. 231-238. Lippincott Williams & Wilkins 10.1097/QAD.0000000000000524

[img]
Preview
Text
Gueler AIDS 2015.pdf - Published Version
Available under License Publisher holds Copyright.

Download (291kB) | Preview

OBJECTIVES: Inequalities and inequities in health are an important public health concern. In Switzerland, mortality in the general population varies according to the socio-economic position (SEP) of neighbourhoods. We examined the influence of neighbourhood SEP on presentation and outcomes in HIV-positive individuals in the era of combination antiretroviral therapy (cART). METHODS: The neighbourhood SEP of patients followed in the Swiss HIV Cohort Study (SHCS) 2000-2013 was obtained on the basis of 2000 census data on the 50 nearest households (education and occupation of household head, rent, mean number of persons per room). We used Cox and logistic regression models to examine the probability of late presentation, virologic response to cART, loss to follow-up and death across quintiles of neighbourhood SEP. RESULTS: A total of 4489 SHCS participants were included. Presentation with advanced disease [CD4 cell count <200 cells/μl or AIDS] and with AIDS was less common in neighbourhoods of higher SEP: the age and sex-adjusted odds ratio (OR) comparing the highest with the lowest quintile of SEP was 0.71 [95% confidence interval (95% CI) 0.58-0.87] and 0.59 (95% CI 0.45-0.77), respectively. An undetectable viral load at 6 months of cART was more common in the highest than in the lowest quintile (OR 1.52; 95% CI 1.14-2.04). Loss to follow-up, mortality and causes of death were not associated with neighbourhood SEP. CONCLUSION: Late presentation was more common and virologic response to cART less common in HIV-positive individuals living in neighbourhoods of lower SEP, but in contrast to the general population, there was no clear trend for mortality.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Güler, Aysel; Schöni-Affolter, Franziska; Moser, André; Wandeler, Gilles and Egger, Matthias

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0269-9370

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

03 Dec 2014 16:19

Last Modified:

30 Aug 2017 07:49

Publisher DOI:

10.1097/QAD.0000000000000524

PubMed ID:

25396262

BORIS DOI:

10.7892/boris.60175

URI:

https://boris.unibe.ch/id/eprint/60175

Actions (login required)

Edit item Edit item
Provide Feedback