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. 2017 Jun 1;75(2):e27-e35.
doi: 10.1097/QAI.0000000000001278.

Prevalence and Predictors of Hospitalizations Among HIV-Infected and At-Risk HIV-Uninfected Women

Anna L Hotton  1 , Kathleen M Weber, Ronald C Hershow, Kathryn Anastos, Peter Bacchetti, Elizabeth T Golub, Deborah Gustafson, Alexandra M Levine, Mary Young, Mardge H Cohen
Affiliations

Prevalence and Predictors of Hospitalizations Among HIV-Infected and At-Risk HIV-Uninfected Women

Anna L Hotton et al. J Acquir Immune Defic Syndr. .

Abstract

Objectives: We evaluated the Veterans Aging Cohort Study (VACS) Index score, an index composed of age, CD4 count, viral load, hemoglobin, Hepatitis C coinfection, Fibrosis Index-4, and estimated glomerular filtration rate, and psychosocial and clinical risk factors for all-cause hospitalization among HIV-infected women on highly active antiretroviral therapy and HIV-uninfected women.

Methods: Data were collected from 2008 to 2014 from 1585 highly active antiretroviral therapy-experienced HIV infected and 692 uninfected women. Cox proportional hazards regression evaluated predictors of first hospitalization over 2 years.

Results: Among HIV-infected women, VACS Index score (per 5 points) [adjusted hazard ratio (aHR) 1.08; 95% confidence interval (CI): 1.06 to 1.11], Centers for Epidemiologic Studies-Depression (CESD) scores ≥16 (aHR 1.61; 95% CI: 1.30 to 1.99), smoking (aHR 1.26; 95% CI: 1.02 to 1.55), abuse history (aHR 1.52; 95% CI: 1.20 to 1.93), diabetes (aHR 1.63; 95% CI: 1.31 to 2.04), and black race (aHR 1.28; 95% CI: 1.03 to 1.59) increased risk of hospitalization. Among HIV-uninfected women, VACS Index score (aHR 1.08; 95% CI: 1.03 to 1.13), CESD scores ≥16 (aHR 1.38; 95% CI: 1.02 to 1.86), diabetes (aHR 2.15; 95% CI: 1.57 to 2.95), and black race (aHR 1.61; 95% CI: 1.15 to 2.24) predicted subsequent hospitalization.

Conclusions: Psychosocial and clinical factors were associated with risk of hospitalization independently of the VACS Index score. Additional research on contextual and psychosocial influences on health outcomes among women is needed.

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Figures

Figure 1
Figure 1
Trends over Time in All-Cause Hospitalizations Footnote: Across all visits, HIV positive women were more likely to be hospitalized (p<0.001) controlling for time and repeated measures correlation in a generalized estimating equations logistic regression model. Among HIV positive women, hospitalizations declined over time (p for trend <0.001); the trend among HIV negative women was not statistically significant (p>0.2).
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