Longitudinal Analysis of Overlapping Psychosocial Factors Predicting Incident Hospitalization Among Mixed HIV Serostatus Men who have Sex with Men in the Multicenter AIDS Cohort Study.

HIV Hospitalization Men who have sex with men Psychosocial factors

Journal

AIDS and behavior
ISSN: 1573-3254
Titre abrégé: AIDS Behav
Pays: United States
ID NLM: 9712133

Informations de publication

Date de publication:
04 May 2024
Historique:
accepted: 22 04 2024
medline: 5 5 2024
pubmed: 5 5 2024
entrez: 4 5 2024
Statut: aheadofprint

Résumé

Men who have sex with men (MSM) are at increased risk for certain types of chronic diseases and mental health problems. Despite having extended survival in the highly active antiretroviral therapy (HAART) era, MSM living with HIV contend with aging-related diseases and complications with treatment. Consequent hospitalizations incur high costs, fear, low quality of life, and frailty. Unlike heterosexual men, MSM experience more structural violence and "syndemics" of psychosocial factors that not only accelerate HIV acquisition and transmission risk but also may increase morbidity, leading to greater rates of hospitalization. We aim to examine the impact of "syndemic" psychosocial factors on the incidence of hospitalization among geographically diverse MSM in the US. Participants were 1760 MSM from the Multicenter AIDS Cohort Study (MACS) between 2004 and 2019. We examined the relationship between six psychosocial factors (depression, stimulant use, smoking, heroin use, childhood sexual abuse, and intimate partner violence) and incident hospitalization (admission to a hospital for treatment). We found a positive dose-response relationship between the number of syndemic factors and hospitalization. MSM reporting five or more syndemic factors had over twice the risk of hospitalization compared to MSM without syndemic factors [aRR = 2.14 (95% CI = 1.56, 2.94)]. Psychosocial factors synergistically increased hospitalizations over time. The positive dose-response relationship between the number of syndemic factors and hospitalization and the synergistic effects of these factors underscore the need for interventions that disentangle the syndemics to reduce hospitalization and related costs and improve the quality of life among MSM.

Identifiants

DOI: 10.1007/s10461-024-04356-5 PMID: 38703339
pubmed: 38703339
doi: 10.1007/s10461-024-04356-5
pii: 10.1007/s10461-024-04356-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : NHLBI NIH HHS
ID : U01-HL146333
Pays : United States
Organisme : NHLBI NIH HHS
ID : U01-HL146333
Pays : United States

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Références

Marcus JL, Leyden WA, Alexeeff SE, et al. Comparison of overall and comorbidity-free life expectancy between insured adults with and without HIV infection, 2000–2016. JAMA Netw Open. 2020;3(6). https://doi.org/10.1001/jamanetworkopen.2020.7954 .
Samji H, Cescon A, Hogg RS, et al. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS ONE. 2013;8(12). https://doi.org/10.1371/journal.pone.0081355 .
Buchacz K, Baker RK, Moorman AC, et al. Rates of hospitalizations and associated diagnoses in a large multisite cohort of HIV patients in the United States, 1994–2005. AIDS Lond Engl. 2008;22(11):1345–54. https://doi.org/10.1097/QAD.0b013e328304b38b .
doi: 10.1097/QAD.0b013e328304b38b
Berry SA, Fleishman JA, Moore RD et al. Trends in reasons for hospitalization in a multisite United States cohort of persons living with HIV, 2001–2008. J Acquir Immune Defic Syndr 1999. 2012;59(4):368–75. https://doi.org/10.1097/QAI.0b013e318246b862 .
Milliken M. Hospital and surgery costs. https://www.debt.org/medical/hospital-surgery-costs/ . Accessed December 22, 2023.
Winkelman TNA, Admon LK, Jennings L, et al. Evaluation of amphetamine-related hospitalizations and associated clinical outcomes and costs in the United States. JAMA Netw Open. 2018;1(6). https://doi.org/10.1001/jamanetworkopen.2018.3758 .
Sporinova B, Manns B, Tonelli M, et al. Association of mental health disorders with health care utilization and costs among adults with chronic disease. JAMA Netw Open. 2019;2(8). https://doi.org/10.1001/jamanetworkopen.2019.9910 .
Mimiaga MJ, Hughto JMW, Biello KB, et al. Longitudinal analysis of syndemic psychosocial problems predicting HIV risk behavior among a multicity prospective cohort of sexually active young transgender women in the United States. J Acquir Immune Defic Syndr 1999. 2019;81(2):184–92. https://doi.org/10.1097/QAI.0000000000002009 .
doi: 10.1097/QAI.0000000000002009
Blashill AJ, Bedoya CA, Mayer KH, et al. Psychosocial syndemics are additively associated with worse ART adherence in HIV-infected individuals. AIDS Behav. 2015;19(6):981–6. https://doi.org/10.1007/s10461-014-0925-6 .
doi: 10.1007/s10461-014-0925-6 pubmed: 25331267 pmcid: 4405426
Friedman MR, Stall R, Silvestre AJ, et al. Effects of syndemics on HIV viral load and medication adherence in the Multicenter AIDS Cohort Study. AIDS Lond Engl. 2015;29(9):1087–96. https://doi.org/10.1097/QAD.0000000000000657 .
doi: 10.1097/QAD.0000000000000657
Harkness A, Bainter SA, O’Cleirigh C, et al. Longitudinal effects of syndemics on HIV-positive sexual minority men’s sexual health behaviors. Arch Sex Behav. 2019;48(4):1159–70. https://doi.org/10.1007/s10508-018-1329-x .
doi: 10.1007/s10508-018-1329-x pubmed: 30868437 pmcid: 6586562
Safren SA, Blashill AJ, Lee JS, et al. Condom-use self-efficacy as a mediator between syndemics and condomless sex in men who have sex with men (MSM). Health Psychol. 2018;37(9):820–7. https://doi.org/10.1037/hea0000617 .
doi: 10.1037/hea0000617 pubmed: 29927272 pmcid: 6107409
Satyanarayana S, Rogers BG, Bainter SA, et al. Longitudinal associations of syndemic conditions with antiretroviral therapy adherence and HIV viral suppression among HIV-infected patients in primary care. AIDS Patient Care STDs. 2021;35(6):220–30. https://doi.org/10.1089/apc.2021.0004 .
doi: 10.1089/apc.2021.0004 pubmed: 34097465 pmcid: 8336208
Mimiaga MJ, Biello KB, Robertson AM, et al. High prevalence of multiple syndemic conditions associated with sexual risk behavior and HIV infection among a large sample of Spanish- and Portuguese-speaking men who have sex with men in Latin America. Arch Sex Behav. 2015;44(7):1869–78. https://doi.org/10.1007/s10508-015-0488-2 .
doi: 10.1007/s10508-015-0488-2 pubmed: 26159862
Biello KB, Oldenburg CE, Safren SA, et al. Multiple syndemic psychosocial factors are associated with reduced engagement in HIV care among a multinational, online sample of HIV-infected MSM in Latin America. AIDS Care. 2016;28(Suppl 1):84–91. https://doi.org/10.1080/09540121.2016.1146205 .
doi: 10.1080/09540121.2016.1146205 pubmed: 26883009 pmcid: 4828614
Biello K, Colby D, Closson E, et al. The syndemic condition of psychosocial problems and HIV risk among male sex workers in Ho Chi Minh City, Vietnam. AIDS Behav. 2014;18(7):1264–71. https://doi.org/10.1007/s10461-013-0632-8 .
doi: 10.1007/s10461-013-0632-8 pubmed: 24081899 pmcid: 4363106
Safren SA, Reisner SL, Herrick A, et al. Mental health and HIV risk in men who have sex with men. J Acquir Immune Defic Syndr 1999. 2010;55(Suppl 2). https://doi.org/10.1097/QAI.0b013e3181fbc939 .
Ogunbajo A, Oke T, Jin H, et al. A syndemic of psychosocial health problems is associated with increased HIV sexual risk among Nigerian gay, bisexual, and other men who have sex with men (GBMSM). AIDS Care. 2020;32(3):337–42. https://doi.org/10.1080/09540121.2019.1678722 .
doi: 10.1080/09540121.2019.1678722 pubmed: 31608657
Dyer TV, Turpin RE, Stall R, et al. Latent profile analysis of a syndemic of vulnerability factors on incident sexually transmitted infection in a cohort of Black men who have sex with men only and Black men who have sex with men and women in the HIV Prevention Trials Network 061 Study. Sex Transm Dis. 2020;47(9):571–9. https://doi.org/10.1097/OLQ.0000000000001208 .
doi: 10.1097/OLQ.0000000000001208 pubmed: 32496390 pmcid: 7442627
Mimiaga MJ, Hughto JMW, Klasko-Foster L et al. Substance use, mental health problems, and physical and sexual violence additively increase HIV risk between male sex workers and their male clients in Northeastern United States. J Acquir Immune Defic Syndr. 1999. 2021;86(3):305–312. https://doi.org/10.1097/QAI.0000000000002563 .
Satyanarayana S, Safren SA, Rogers BG, et al. Estimating HIV transmissions in a large U.S. clinic-based sample: effects of time and syndemic conditions. J Int AIDS Soc. 2021;24(3). https://doi.org/10.1002/jia2.25679 .
Mimiaga MJ, O’Cleirigh C, Biello KB et al. The effect of psychosocial syndemic production on 4-year HIV incidence and risk behavior in a large cohort of sexually active men who have sex with men. J Acquir Immune Defic Syndr. 1999. 2015;68(3):329–336. https://doi.org/10.1097/QAI.0000000000000475 .
Zaller N, Yang C, Operario D, et al. Alcohol and cocaine use among Latino and African American MSM in 6 US cities. J Subst Abuse Treat. 2017;80:26–32. https://doi.org/10.1016/j.jsat.2017.06.003 .
doi: 10.1016/j.jsat.2017.06.003 pubmed: 28755769 pmcid: 5839147
Santos GM, Coffin PO, Das M, et al. Dose-response associations between number and frequency of substance use and high-risk sexual behaviors among HIV-negative substance-using men who have sex with men (SUMSM) in San Francisco. J Acquir Immune Defic Syndr 1999. 2013;63(4):540–4. https://doi.org/10.1097/QAI.0b013e318293f10b .
doi: 10.1097/QAI.0b013e318293f10b
Centers for Disease Control and Prevention. HIV risk, prevention, and testing behaviors among men who have sex with men --- National HIV Behavioral Surveillance System, 21 U.S. cities, United States., 2008. https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6014a1.htm . Accessed December 22, 2023.
Hovens JG, Cantwell DP, Kiriakos R. Psychiatric comorbidity in hospitalized adolescent substance abusers. J Am Acad Child Adolesc Psychiatry. 1994;33(4):476–83. https://doi.org/10.1097/00004583-199405000-00005 .
doi: 10.1097/00004583-199405000-00005 pubmed: 8005900
Cox S, Johnson CH, Meikle S, et al. Trends in rates of hospitalization with a diagnosis of substance abuse among reproductive-age women, 1998 to 2003. Women’s Health Issues. 2007;17(2):75–83. https://doi.org/10.1016/j.whi.2007.02.001 .
doi: 10.1016/j.whi.2007.02.001 pubmed: 17403464
Lipsky S, Caetano R, Roy-Byrne P. Racial and ethnic disparities in police-reported intimate partner violence and risk of hospitalization among women. Women’s Health Issues. 2009;19(2):109–18. https://doi.org/10.1016/j.whi.2008.09.005 .
doi: 10.1016/j.whi.2008.09.005 pubmed: 19272561 pmcid: 2757408
Choi SKY, Boyle E, Cairney J, et al. Impact of depression and recreational drug use on emergency department encounters and hospital admissions among people living with HIV in Ontario: a secondary analysis using the OHTN cohort study. PLoS ONE. 2018;13(4). https://doi.org/10.1371/journal.pone.0195185 .
Qian Y, Moore RD, Coburn SB, et al. Association of the VACS Index with hospitalization among people with HIV in the NA-ACCORD. J Acquir Immune Defic Syndr 1999. 2022;89(1):9–18. https://doi.org/10.1097/QAI.0000000000002812 .
doi: 10.1097/QAI.0000000000002812
Akgün KM, Gordon K, Pisani M, et al. Risk factors for hospitalization and medical intensive care unit (MICU) admission among HIV infected veterans. J Acquir Immune Defic Syndr 1999. 2013;62(1):52–9. https://doi.org/10.1097/QAI.0b013e318278f3fa .
doi: 10.1097/QAI.0b013e318278f3fa
Akgün KM, Tate JP, Crothers K, et al. An adapted frailty-related phenotype and the VACS Index as predictors of hospitalization and mortality in HIV-infected and uninfected individuals. J Acquir Immune Defic Syndr 1999. 2014;67(4):397–404. https://doi.org/10.1097/QAI.0000000000000341 .
doi: 10.1097/QAI.0000000000000341
Kaslow RA, Ostrow DG, Detels R, et al. The Multicenter AIDS Cohort Study: rationale, organization, and selected characteristics of the participants. Am J Epidemiol. 1987;126(2):310–8. https://doi.org/10.1093/aje/126.2.310 .
doi: 10.1093/aje/126.2.310 pubmed: 3300281
Herrick AL, Lim SH, Plankey MW, et al. Adversity and syndemic production among men participating in the Multicenter AIDS Cohort Study: a life-course approach. Am J Public Health. 2013;103(1):79–85. https://doi.org/10.2105/AJPH.2012.300810 .
doi: 10.2105/AJPH.2012.300810 pubmed: 23153154 pmcid: 3518355
Lewinsohn PM, Seeley JR, Roberts RE, et al. Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychol Aging. 1997;12(2):277–87. https://doi.org/10.1037//0882-7974.12.2.277 .
doi: 10.1037//0882-7974.12.2.277 pubmed: 9189988
Centers for Disease Control and Prevention. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). https://www.cdc.gov/nchs/icd/icd9cm.htm . Accessed December 22, 2023.
Pantalone DW, Valentine SE, Woodward EN, et al. Syndemic indicators predict poor medication adherence and increased health care utilization for urban HIV-positive men who have sex with men. J Gay Lesbian Ment Health. 2018;22(1):71–87. https://doi.org/10.1080/19359705.2017.1389794 .
doi: 10.1080/19359705.2017.1389794 pubmed: 30976378
St-Jean M, Tafessu H, Closson K, et al. The syndemic effect of HIV/HCV co-infection and mental health disorders on acute care hospitalization rate among people living with HIV/AIDS: a population-based retrospective cohort study. Can J Public Health. 2019;110(6):779–91. https://doi.org/10.17269/s41997-019-00253-w .
doi: 10.17269/s41997-019-00253-w pubmed: 31441005 pmcid: 6964491
Liu Y, Ramos SD, Hanna DB, et al. Psychosocial syndemic classes and longitudinal transition patterns among sexual minority men living with or without HIV in the Multicenter AIDS Cohort Study (MACS). AIDS Behav. 2023;27(12):4094–105. https://doi.org/10.1007/s10461-023-04123-y .

Auteurs

Yuhang Qian (Y)

Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA. yuhang886688@g.ucla.edu.
ORCID: 0000-0002-1595-1381

Roger Detels (R)

Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.
Department of Medicine, UCLA Geffen School of Medicine, Los Angeles, CA, USA.

Warren Scott Comulada (WS)

Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA.
Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.

Marco A Hidalgo (MA)

Department of Medicine, UCLA Geffen School of Medicine, Los Angeles, CA, USA.

Sung-Jae Lee (SJ)

Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.
Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA.

Katie B Biello (KB)

Department of Behavioral and Social Health Sciences, Brown University School of Public Health, Providence, RI, USA.
Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
The Fenway Institute, Fenway Health, Boston, MA, USA.

Elizabeth A Yonko (EA)

Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.

M Reuel Friedman (MR)

School of Public Health, Newark, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA.

Frank J Palella (FJ)

Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Michael W Plankey (MW)

Department of Medicine, Division of General Internal Medicine, Georgetown University, Washington, DC, USA.

Matthew J Mimiaga (MJ)

Department of Epidemiology, UCLA Fielding School of Public Health, 650 Charles E. Young Drive, South Box 951772, 71-254 CHS, Los Angeles, CA, 90095, USA.
Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, CA, USA.
UCLA Center for LGBTQ+ Advocacy, Research & Health, Los Angeles, CA, USA.

Classifications MeSH