Impact of social determinants on antiretroviral therapy access and outcomes entering the era of universal treatment for people living with HIV in Italy

BMC Public Health
A SaracinoIcona Foundation Study Group

Abstract

Social determinants are known to be a driving force of health inequalities, even in high income countries. Aim of our study was to determine if these factors can limit antiretroviral therapy (ART) access, outcome and retention in care of people living with HIV (PLHIV) in Italy. All ART naïve HIV+ patients (pts) of Italian nationality enrolled in the ICONA Cohort from 2002 to 2016 were included. The association of socio-demographic characteristics (age, sex, risk factor for HIV infection, educational level, occupational status and residency area) with time to: ART initiation (from the first positive anti-HIV test), ART regimen discontinuation, and first HIV-RNA < 50 cp/mL, were evaluated by Cox regression analysis, Kaplan Meier method and log-rank test. A total of 8023 HIV+ pts (82% males, median age at first pos anti-HIV test 36 years, IQR: 29-44) were included: 6214 (77.5%) started ART during the study period. Women, people who inject drugs (PWID) and residents in Southern Italy presented the lowest levels of education and the highest rate of unemployment compared to other groups. Females, pts aged > 50 yrs., unemployed vs employed, and people with lower educational levels presented the lowest CD4 count at ART initiation compa...Continue Reading

References

Jul 13, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Monica GandhiRuth M Greenblatt
Jun 29, 2004·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Enrico GirardiUNKNOWN ICoNA Behavioural Epidemiology Study Group
Dec 17, 2010·AIDS Research and Therapy·Keri N AlthoffUNKNOWN North American AIDS Cohort Collaboration on Research and Design
Sep 12, 2012·Lancet·Michael MarmotUNKNOWN Consortium for the European Review of Social Determinants of Health and the Health Divide
Oct 4, 2013·Journal of the International AIDS Society·Mona R LoutfyUNKNOWN Women for Positive Action
Mar 29, 2014·Antiviral Therapy·UNKNOWN Antiretroviral Therapy Cohort Collaboration (ART-CC)
Sep 23, 2014·Family Practice·Denton CallanderRebecca Guy
Nov 15, 2014·AIDS·Aysel GuelerUNKNOWN Swiss HIV Cohort Study, Swiss National Cohort
Oct 2, 2015·The Lancet. HIV·Morna CornellUNKNOWN International Epidemiologic Databases to Evaluate AIDS-Southern Africa Collaboration
Nov 10, 2015·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·A SaracinoUNKNOWN ICONA Foundation Study Group
Jun 9, 2016·Current Opinion in HIV and AIDS·Sophie Abgrall, Julia Del Amo
Sep 24, 2016·AIDS·UNKNOWN Socio-economic Inequalities and HIV Working Group for Collaboration of Observational HIV Epidemiological Research in Europe

❮ Previous
Next ❯

Citations

Nov 2, 2019·International Journal of STD & AIDS·Sevtap ŞenoğluÖzlem A Aydın
Feb 23, 2020·The Journal of the Association of Nurses in AIDS Care : JANAC·Joan N ChukwurahAllison Webel
Jul 16, 2019·HIV Research & Clinical Practice·Agnese ComelliEugenia Quiros-Roldan
Jul 22, 2019·AIDS and Behavior·Elise D RileyAdam W Carrico
Jun 25, 2020·BMC Infectious Diseases·Zelalem G DessieDelia North
Jun 23, 2020·JMIR MHealth and UHealth·Stephen B Lee, Joanne Valerius
Sep 16, 2021·AIDS Patient Care and STDs·Lucia TaramassoUNKNOWN Behalf of the CISAI Study Group

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.