AIDS and Behavior

, Volume 15, Issue 7, pp 1503–1511

Poverty, Hunger, Education, and Residential Status Impact Survival in HIV

  • James McMahon
  • Christine Wanke
  • Norma Terrin
  • Sally Skinner
  • Tamsin Knox
Original Paper

DOI: 10.1007/s10461-010-9759-z

Cite this article as:
McMahon, J., Wanke, C., Terrin, N. et al. AIDS Behav (2011) 15: 1503. doi:10.1007/s10461-010-9759-z

Abstract

Despite combination antiretroviral therapy (ART), HIV infected people have higher mortality than non-infected. Lower socioeconomic status (SES) predicts higher mortality in many chronic illnesses but data in people with HIV is limited. We evaluated 878 HIV infected individuals followed from 1995 to 2005. Cox proportional hazards for all-cause mortality were estimated for SES measures and other factors. Mixed effects analyses examined how SES impacts factors predicting death. The 200 who died were older, had lower CD4 counts, and higher viral loads (VL). Age, transmission category, education, albumin, CD4 counts, VL, hunger, and poverty predicted death in univariate analyses; age, CD4 counts, albumin, VL, and poverty in the multivariable model. Mixed models showed associations between (1) CD4 counts with education and hunger; (2) albumin with education, homelessness, and poverty; and (3) VL with education and hunger. SES contributes to mortality in HIV infected persons directly and indirectly, and should be a target of health policy in this population.

Keywords

HIV Socioeconomic status Mortality 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • James McMahon
    • 1
    • 2
  • Christine Wanke
    • 1
    • 2
  • Norma Terrin
    • 3
  • Sally Skinner
    • 2
  • Tamsin Knox
    • 1
    • 2
  1. 1.Department of MedicineTufts Medical CenterBostonUSA
  2. 2.Nutrition/Infection Unit, Department of Public Health and Community MedicineTufts University School of MedicineBostonUSA
  3. 3.Institute for Clinical Research and Health Policy StudiesTufts Medical CenterBostonUSA

Personalised recommendations