Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun;26(6):962-969.
doi: 10.1111/hiv.70031. Epub 2025 Apr 14.

Longitudinal associations between social determinants of health and well-being among women living with HIV in Canada: A latent class analysis

Zerihun Admassu  1 , Carmen H Logie  1   2   3 , Luissa Vahedi  1 , Angela Underhill  2 , Logan Kennedy  2 , Kath Webster  2 , Brenda Gagnier  2 , Angela Kaida  4 , Alexandra de Pokomandy  5   6 , Mona R Loutfy  2   7   8
Affiliations

Longitudinal associations between social determinants of health and well-being among women living with HIV in Canada: A latent class analysis

Zerihun Admassu et al. HIV Med. 2025 Jun.

Abstract

Background: Social determinants of health (SDoH) can significantly impact overall well-being. While existing research has explored SDoH as predictors of well-being among women living with HIV, longitudinal studies examining these relationships over time remain limited. We examined SDoH typologies among women living with HIV in Canada and longitudinal associations with well-being.

Methods: Using longitudinal survey data collected at three time points from women living with HIV in Canada (2013-2018), we conducted latent class analysis (LCA) to identify subgroups of SDoH indicators, including income, experiences of violence, food security, substance use, housing stability, HIV-related stigma and social support at baseline (Time-1). Multivariable linear and logistic regression examined associations between SDoH classes and well-being (depression, discrimination [gender, racial] and HIV clinical outcomes [viral load, adherence, HIV care barriers]) at Time-3.

Results: We identified three distinct SDoH classes among participants (n = 1422, mean age = 42.8): high (n = 435; 30.6%), medium (n = 377; 26.5%) and low SDoH adversity (n = 610; 42.9%). In multivariate regression analyses, the high SDoH adversity class had lower odds of achieving an undetectable viral load (adjusted Odds Ratio [aOR] = 0.46; 95% CI: 0.21, 1.01; p = 0.050) and higher probability of facing barriers to accessing care (aβ = 0.32; 95% CI: 0.19, 0.45; p < 0.001), depression (aOR = 2.52; 95% CI: 1.71, 3.71; p < 0.001), racial discrimination (aβ = 3.42; 95% CI: 1.72, 5.12; p < 0.001) and gender discrimination (aβ = 3.14; 95% CI: 1.42, 4.87; p < 0.001), compared with the low SDoH adversity class at 5-year follow-up.

Conclusions: SDoH adversities were associated with poor wellbeing among women living with HIV in Canada. Integrated, comprehensive person-centred care approaches that address SDoH are needed to improve health and wellbeing.

Keywords: HIV; social determinants of health; well‐being; women.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests.

Similar articles

See all similar articles

References

    1. Logie CH, Wang Y, Marcus N, et al. Factors associated with the separate and concurrent experiences of food and housing insecurity among women living with HIV in Canada. AIDS Behav. 2018;22(9):3100‐3110. doi:10.1007/s10461-018-2119-0 - DOI - PubMed
    1. Logie CH, Sokolovic N, Kazemi M, et al. Does resource insecurity drive HIV‐related stigma? Associations between Food and Housing Insecurity with HIV‐Related Stigma in Cohort of Women Living with HIV in Canada. J Int AIDS Soc. 2022;25 Suppl 1(Suppl 1):11‐14. doi:10.1002/jia2.25913 - DOI - PMC - PubMed
    1. Canada.ca . Canada PHA of HIV in Canada: 2022 Surveillance Highlights. https://www.canada.ca/en/public‐health/services/publications/diseases‐co...
    1. Canada.ca . Canada PHA of HIV in Canada: 2023 Surveillance Highlights. https://www.canada.ca/en/public‐health/services/publications/diseases‐co...
    1. Logie CH, Marcus N, Wang Y, et al. A longitudinal study of associations between HIV‐related stigma, recent violence and depression among women living with HIV in a Canadian cohort study. J Intern AIDS Soc. 2019;22(7):e25341. doi:10.1002/jia2.25341 - DOI - PMC - PubMed