HIV/AIDS has been associated with a number of social comorbidities, including substance use, mental illness, and unstable housing. This study examined the epidemiology of these social comorbidities among a longitudinal cohort of HIV-positive adults in New York City, and the relationship of these comorbidities to specific health outcomes and service characteristics. The longitudinal cohort, known as the CHAIN study, is composed of 700 HIV-positive adults recruited in 1994-1995 and an additional 268 individuals recruited in 1998. The cohort is broadly representative of HIV-positive adults in New York City's health and social service system. Six rounds of interview data, representing 2,360 individual observations, were included in this analysis. Personal interviews were conducted at six to twelve month intervals, and topics included sociodemographic characteristics, service needs and utilization, and self-reported data on CD4+ and viral load counts, experiences of opportunistic infections (including TB and STDs), and use of and adherence to antiretroviral therapies. This study examined how health outcomes such as having appropriate medical care, in-patient hospitalization, and length-of-stay varied by comorbid groupings. We distinguished three groups: individuals without a specific comorbidity, individuals with a comorbidity who were receiving treatment for that comorbidity, and individuals with a comorbidity who were not receiving treatment for that comorbidity. Our fundamental research hypothesis, generally confirmed by the data, was that individuals treated for a comorbidity will experience health outcomes at approximately the same rate as individuals without the comorbidity. This analysis suggests that treating social comorbidities has a positive effect on specific health service outcomes.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. describe survey research strategies for measuring social comorbidities; 2. articulate the methods for linking self-reported treatment to subjectively or objectively expressed need; 3. describe the apparent improvement in selected health service outcomes by treating social comorbidites in an HIv-positive population.
Keywords: HIV/AIDS, Outcomes Research
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.