Prevalence of chronic conditions, quality of life, and medical care utilization in a cohort of persons with HIV/AIDS

Background: As HIV infected individuals (PLWHA) age, they become increasingly vulnerable to a broad spectrum of non-HIV chronic health conditions. There is relatively limited information on the prevalence of chronic conditions among PLWHA and associated changes in quality of life and utilization of medical services.

Methods: Self-reported information on 9 chronic conditions, quality of life and medical care utilization was obtained from four rounds of in-person interviews conducted between 2001 and 2008 for the CHAIN project, a cohort study of PLWHA residing in New York City (N=693) and three counties north of NYC (N=484). A count of the lifetime occurrence of the 9 conditions was tabulated for each cohort member. Regression analysis was used to estimate the volume of inpatient days and outpatient and emergency visits associated with the cohort's experience with these chronic conditions.

Results: Among study participants, 93% reported being diagnosed with at least one of the 9 conditions and 66% reported 3 or more. Declines in physical and mental health status were associated with each additional chronic condition. Increasing medical care utilization associated with each additional chronic condition translated into approximately 10% more outpatient visits, 29% more emergency room visits, and 35% more inpatient stays than would have been expected in the absence of all nine non-HIV chronic conditions.

Conclusion: Multiple non-HIV chronic conditions requiring medical attention were common in the study cohort. These results underscore the importance of coordinating HIV medical care with care for chronic disease conditions common in an aging population.