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A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario
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BACKGROUND: As people diagnosed with HIV and receiving combination antiretroviral therapy are now living longer, they are likely to acquire chronic conditions related to normal ageing and the effects of HIV and its treatment. Comordidities for people with HIV have not previously been described from a representative population perspective. METHODS: We used linked health administrative data from Ontario, Canada. We applied a validated algorithm to identify people with HIV among all residents aged 18 years or older between April 1, 1992 and March 31, 2009. We randomly selected 5 Ontario adults who were not identified with HIV for each person with HIV for comparison. Previously validated case definitions were used to identify persons with mental health disorders and any of the following physical chronic diseases: diabetes, congestive heart failure, acute myocardial infarction, stroke, hypertension, asthma, chronic obstructive lung disease, peripheral vascular disease and end-stage renal failure. We examined multimorbidity prevalence as the presence of at least two physical chronic conditions, or as combined physical-mental health multimorbidity. Direct age-sex standardized rates were calculated for both cohorts for comparison. RESULTS: 34.4% (95% confidence interval (CI) 33.6% to 35.2%) of people with HIV had at least one other physical condition. Prevalence was especially high for mental health conditions (38.6%), hypertension (14.9%) and asthma (12.7%). After accounting for age and sex differences, people with HIV had significantly higher prevalence of all chronic conditions except myocardial infarction and hypertension, as well as substantially higher multimorbidity (prevalence ratio 1.30, 95% CI 1.18 to 1.44) and combined physical-mental health multimorbidity (1.79, 95% CI 1.65 to 1.94). Prevalence of multimorbidity among people with HIV increased with age. The difference in prevalence of multimorbidity between the two cohorts was more pronounced among women. CONCLUSION: People living with HIV in Ontario, especially women, had higher prevalence of comorbidity and multimorbidity than the general population. Quantifying this morbidity at the population level can help inform healthcare delivery requirements for this complex population.
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“Οι ψυχικές διαταραχές, πιο συγκεκριμένα, παραμένουν έως και σήμερα οι συχνότερες συννοσηρότητες στη λοίμωξη HIV, με ποσοστά επίπτωσης που έχουν εκτιμηθεί έως και στο 50%, πολύ υψηλότερα σε σχέση με τον γενικό πληθυσμό και με ομάδες ανθρώπων που πάσχουν από άλλα χρόνια νοσήματα. 7-9”
From Clinical presentation and requests for support of people with HIV/AIDS seeking counselling and psychotherapy in Greece (2019) · cites this paper as [8]
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“Σε συμφωνία με την προηγούμενη βιβλιογραφία γύρω από τις ψυχιατρικές εκδηλώσεις στη λοίμωξη HIV, 7-10 στο δείγμα της παρούσας έρευνας βρέθηκε ότι η συχνότητα των αγχωδών διαταραχών, της κατάθλιψης, της προβληματικής χρήσης αλκοόλ και άλλων ψυχοτρόπων ουσιών και της αυτοκτονικής συμπεριφοράς είναι ιδιαίτερα υψηλή μεταξύ των ανθρώπων που ζουν με HIV.”
From Clinical presentation and requests for support of people with HIV/AIDS seeking counselling and psychotherapy in Greece (2019) · cites this paper as [8]
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Metadata
- Authors
- Kendall, C. E., Wong, J., Taljaard, M., Glazier, R. H., Hogg, W., Younger, J., & Manuel, D. G.
- Affiliations
- Bruyère (CA)
- McGill University (CA)
- University of Ottawa (CA)
- University of Toronto (CA)
- Ottawa Hospital Research Institute (CA)
- Corresponding author
- Kendall, Claire E
- Venue
- BMC Public Health
- Published
- 2014-02-13
- Volume
- 14
- Issue
- 1
- Pages
- 161-161
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3933292
- OpenAlex
- W2144007968
- Cited by
- 213
- References
- 45
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 11 · 2023: 20 · 2022: 24 · 2021: 27 · 2020: 22 · 2019: 26 · 2018: 16 · 2017: 14 · 2016: 15 · 2015: 10 · 2014: 6
- FWCI
- 16.06
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- uO Research (University of Ottawa) (submittedVersion, public-domain)
- TSpace (University of Toronto) (submittedVersion)
- Funders
- University of Ottawa
- Ottawa Hospital Research Institute
- Public Health Agency of Canada
- Institute for Clinical Evaluative Sciences
- Ontario Ministry of Health and Long-Term Care
- University of Toronto
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Keywords
- HIV, multimorbidity, comorbidities, chronic disease, mental illness, hypertension, asthma, diabetes mellitus, women living with HIV, age differences, Ontario
- MeSH terms
- Adolescent, Adult, Aged, Aging, Chronic Disease, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Heart Failure, Humans, Hypertension, Kidney Failure, Chronic, Male, Middle Aged, Ontario, Retrospective Studies, Sex Factors, Cohort Studies, HIV Infections, Comorbidity, Prevalence
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