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

Details

Serval ID
serval:BIB_ED32B2E637BD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Neighbourhood socio-economic position, late presentation and outcomes in people living with HIV in Switzerland.
Journal
Aids
Author(s)
Gueler A., Schoeni-Affolter F., Moser A., Bertisch B., Bucher H.C., Calmy A., Cavassini M., Ledergerber B., Wandeler G., Egger M.
Working group(s)
Swiss HIV Cohort Study Swiss National Cohort
ISSN
1473-5571 (Electronic)
ISSN-L
0269-9370
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
29
Number
2
Pages
231-238
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
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.
Pubmed
Web of science
Create date
29/01/2015 20:13
Last modification date
20/08/2019 16:15
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