TY - JOUR
T1 - All-cause hospitalisation among people living with HIV according to gender, mode of HIV acquisition, ethnicity, and geographical origin in Europe and North America
T2 - findings from the ART-CC cohort collaboration
AU - Rein, Sophia M.
AU - Lampe, Fiona C.
AU - Ingle, Suzanne M.
AU - Sterne, Jonathan A. C.
AU - Trickey, Adam
AU - Gill, M. John
AU - Papastamopoulos, Vasileios
AU - Wittkop, Linda
AU - van der Valk, Marc
AU - Kitchen, Maria
AU - Guest, Jodie L.
AU - Satre, Derek D.
AU - Wandeler, Gilles
AU - Galindo, Pepa
AU - Castilho, Jessica
AU - Crane, Heidi M.
AU - Smith, Colette J.
N1 - Funding Information: This work was funded by the Royal Free Charity for PhD research and by the US National Institute on Alcohol Abuse and Alcoholism (U01-AA026209) for the ART-CC. We thank all patients participating in the cohorts for their time and effort. Publisher Copyright: © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background: Understanding demographic disparities in hospitalisation is crucial for the identification of vulnerable populations, interventions, and resource planning. Methods: Data were from the Antiretroviral Therapy Cohort Collaboration (ART-CC) on people living with HIV in Europe and North America, followed up between January, 2007 and December, 2020. We investigated differences in all-cause hospitalisation according to gender and mode of HIV acquisition, ethnicity, and combined geographical origin and ethnicity, in people living with HIV on modern combination antiretroviral therapy (cART). Analyses were performed separately for European and North American cohorts. Hospitalisation rates were assessed using negative binomial multilevel regression, adjusted for age, time since cART intitiaion, and calendar year. Findings: Among 23 594 people living with HIV in Europe and 9612 in North America, hospitalisation rates per 100 person-years were 16·2 (95% CI 16·0–16·4) and 13·1 (12·8–13·5). Compared with gay, bisexual, and other men who have sex with men, rates were higher for heterosexual men and women, and much higher for men and women who acquired HIV through injection drug use (adjusted incidence rate ratios ranged from 1·2 to 2·5 in Europe and from 1·2 to 3·3 in North America). In both regions, individuals with geographical origin other than the region of study generally had lower hospitalisation rates compared with those with geographical origin of the study country. In North America, Indigenous people and Black or African American individuals had higher rates than White individuals (adjusted incidence rate ratios 1·9 and 1·2), whereas Asian and Hispanic people living with HIV had somewhat lower rates. In Europe there was a lower rate in Asian individuals compared with White individuals. Interpretation: Substantial disparities exist in all-cause hospitalisation between demographic groups of people living with HIV in the current cART era in high-income settings, highlighting the need for targeted support. Funding: Royal Free Charity and the National Institute on Alcohol Abuse and Alcoholism.
AB - Background: Understanding demographic disparities in hospitalisation is crucial for the identification of vulnerable populations, interventions, and resource planning. Methods: Data were from the Antiretroviral Therapy Cohort Collaboration (ART-CC) on people living with HIV in Europe and North America, followed up between January, 2007 and December, 2020. We investigated differences in all-cause hospitalisation according to gender and mode of HIV acquisition, ethnicity, and combined geographical origin and ethnicity, in people living with HIV on modern combination antiretroviral therapy (cART). Analyses were performed separately for European and North American cohorts. Hospitalisation rates were assessed using negative binomial multilevel regression, adjusted for age, time since cART intitiaion, and calendar year. Findings: Among 23 594 people living with HIV in Europe and 9612 in North America, hospitalisation rates per 100 person-years were 16·2 (95% CI 16·0–16·4) and 13·1 (12·8–13·5). Compared with gay, bisexual, and other men who have sex with men, rates were higher for heterosexual men and women, and much higher for men and women who acquired HIV through injection drug use (adjusted incidence rate ratios ranged from 1·2 to 2·5 in Europe and from 1·2 to 3·3 in North America). In both regions, individuals with geographical origin other than the region of study generally had lower hospitalisation rates compared with those with geographical origin of the study country. In North America, Indigenous people and Black or African American individuals had higher rates than White individuals (adjusted incidence rate ratios 1·9 and 1·2), whereas Asian and Hispanic people living with HIV had somewhat lower rates. In Europe there was a lower rate in Asian individuals compared with White individuals. Interpretation: Substantial disparities exist in all-cause hospitalisation between demographic groups of people living with HIV in the current cART era in high-income settings, highlighting the need for targeted support. Funding: Royal Free Charity and the National Institute on Alcohol Abuse and Alcoholism.
UR - http://www.scopus.com/inward/record.url?scp=85172697066&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S2468-2667(23)00178-0
DO - https://doi.org/10.1016/S2468-2667(23)00178-0
M3 - Article
C2 - 37777287
SN - 2468-2667
VL - 8
SP - e776-e787
JO - The Lancet. Public health
JF - The Lancet. Public health
IS - 10
ER -