Abstract #143  -  HCV infection as an aggravating factor for PLWHA: Results from the AIDES & toi survey
Authors:   Presenting Author:   ms Daniela Rojas - Association AIDES
Additional Authors:  Mr. Christian Andreo, Mr. Jean-Marie Le Gall, Ms. Joanne Otis, Mr. Martin Blais, Mr. Bruno Spire, Mr. Vincent Pelletier,
Aim: Quality of life in PLWHA is a major concern for AIDES, the largest HIV French community-based organization. We hypothesized that co-infected people (HIV/HCV) are more likely to report poor quality of life than mono-infected people. Therefore, we compared several variables in mono-infected versus co-infected people who are catered for at AIDES using the results of the AIDES et toi survey.
Method / Issue: A cross-sectional nation-wide survey, filled out by 2434 respondents, was carried out in May 2007. During one week, a self-administered questionnaire was systematically offered to every person in contact with AIDES. The questionnaire includes standardized items concerning socio-demographics, health status and quality of life, sexuality, use of the organization and HIV stigma and disclosure. Statistical comparisons were made between groups using independent Student-t-tests and Chi-square tests.
Results / Comments: Regarding socio-demographic variables, 979 HIV-positive people fulfilled the survey, 229 (23.4%) were co-infected. Mono-infected people were significantly younger than co-infected (44.8 vs. 43.4 years old; p<0.05). No gender differences were found (64.2% of co-infected were men vs. 68.1% of mono-infected). However, for the sexual orientation, it was found that there were significantly less MSM co-infected than mono-infected (13% vs. 48%; p<0.001). In comparison to mono-infected people, co-infected were more likely to be French (80.9% vs. 71.5%; p=0.003), unemployed (52.4% vs. 28.1%; p<0.001) and to receive a disability benefit (60.2% vs. 26.8%; p<0.001). As to their health, co-infected people were more likely to be also infected by HBV (25.6% vs. 6.9%; p<0.001) and to have <200 CD4 cell counts (19.2% vs. 13%; p<0.05). However, they were more likely to receive antiretroviral treatment than mono-infected (89.4% vs. 83.1%; p<0.05). When asked about a drug maintenance treatment, 39.5% of respondents reported taking these treatments (42.7% buprenorphine, 39% methadone, 13.4% morphine sulphate). Concerning discrimination, co-infected people reported significantly more discrimination than mono-infected in the last two years (58.3% vs. 47.9%; p<0.005). In fact, they were also more likely to report having been discriminated against because of their HIV positive status than mono-infected (84.6% vs. 74.7%; p<0.05). The settings where discrimination was greater for co-infected than for mono-infected were health care settings (48.5% vs. 31.8%; p<0.001) and daily life settings (62.5% vs. 50.8%; p<0.05). However, mono-infected people were more likely to be discriminated against in sexual settings (31.5% vs. 22.8%; p<0.05) and in work settings (32.1% vs. 22.8%; p<0.05). Regarding current drug use, 17.1% of co-infected respondents were current drug users (vs. 7.3% of mono-infected; p<0.001). Finally, co-infected people reported being more dissatisfied with their sexual life (46.7% vs. 36.8%; p<0.05), with their health status (39.1% vs. 22.7%; p<0.001) and with their quality of life (23.5% vs. 17.8%; p<0.001).
Discussion: Co-infected people seem to face more social and health-related difficulties than mono-infected. As suggested by the research literature, drug use could explain this situation. Particularly interesting is the greater discrimination related to HIV status as well as discrimination experienced in the health care settings reported by co-infected people. These results reflect the need for advocacy and community-based interventions targeted towards co-infected people.
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