Barcelona 2013
Menu
AIDSImpact.com
Conference Details
Authors
International Committee
Plenary Speakers
Presenting Speakers
Programme
Sessions
Scientific Committee
Acknowledgements
| Abstract #610 - Psychological state | ||||
|
Session: 6.4: Psychological state (Parallel) on Monday @ 11.00-13.00 in Auditorio Chaired by Barbara Hedge, Susannah Allison Authors: Presenting Author: Dr Ineke Stolte - Public Health Service Amsterdam, Netherlands |
||||
| Additional Authors: | ||||
| Aim: People living with HIV (PLWH) are at risk for premature onset of age-associated non-communicable co-morbidity (AANCC), accompanied by declines in physical and mental capacities, compared to the general population. This is likely to negatively affect participation in paid work and the quality of life. Aim of the present study was to investigate the prevalence and determinants of non-participation in paid work among older HIV-1 infected and HIV-uninfected participants. | ||||
| Method / Issue: Data were collected between October 2010 and October 2012 within the ongoing prospective AGEhIV Cohort Study, recruiting HIV-1-infected patients ¡Ý45 years from a tertiary care HIV-outpatient clinic, and concurrently HIV-uninfected attendants of the Public Health Service Amsterdam, comparable regarding age, gender and ethnicity. For this study only participants (N=885) in the working age (45-65 years) were included. Data on socio-demographic characteristics, lifestyle, quality of life (physical and mental), AANCC and work participation were collected, using a self-administered questionnaire and through an extensive medical examination. Univariate and multivariate logistic regression analyses were conducted to answer the research questions. | ||||
| Results / Comments: The majority of the 439 HIV-1 infected and 446 HIV-uninfected subjects was male (87%), Dutch (70%) and men having sex with men (71%). Half of the population was highly educated and the median age was 52 (IQR: 48-57]. Almost all (96%) HIV-1 infected individuals were on cART and 92% had HIV-RNA <50 copies/ml in the year prior to enrolment. The median time since first ART was 10 years [IQR: 4-14], median time since HIV-diagnosis was 12 years (IQR: 6-17] and they had been diagnosed with more AANCC (median 1 [IQR: 0-2]) than HIV-uninfected individuals (median 1 [IQR: 0-1]) (p<.001). Non-participation in paid work was higher among HIV-1 infected participants (36.7%) compared to HIV-uninfected participants (21,3%) (p<0.001), mainly due to the higher prevalence of being 100% unfit for work. The percentage 100% unfit for work strongly increased with age, and more strongly so for HIV-1 infected In multivariate analysis, after correcting for educational level and sexual orientation, being HIV-infected (ORadj 2.3 [95%CI:1.6-3.2]), experiencing three or more AANCC (ORadj 2.2 [95%CI:1.6-4.2]), being unmarried (ORadj 2.0 [95%CI:1.5-2.8]) and older age (ORadj60-65 vs. 45-50yrs: 5.8 [95%CI:3.6-9.5]; ORadj55-60 vs. 45-50yrs: 2.2 [95%CI:1.4-3.5]) were each independently associated with higher levels of non-participation in paid work. Interestingly, the effect of co-morbidity disappeared when mean physical well-being and mean general health were included in the model, both of which were independently associated with non-participation in paid work, [ORadj 0.98 [0.97-0.999] and ORadj 0.98 [0.97-0.99], respectively). | ||||
| Discussion: In conclusion, non-participation in paid work among HIV-1 infected individuals is higher compared to HIV-uninfected individuals, independent of socio-demographic characteristics and experienced AANCC. The effect of experienced AANCC seems to be mediated by physical health status and general health. Apart from these factors, specific HIV-related determinants, such as stage of disease but also experienced stigma, might influence work participation. Additional research is needed among HIV-1 infected individuals to further explore these relationships and identify which co-morbidities are the most relevant for reduced work participation. | ||||
| Go Back | ||||