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A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia
BACKGROUND: Co-occurrence of social conditions and infections may affect HIV/HCV disease risk and progression. We examined the changes in relationship of these social conditions and infections on HIV and hepatitis C virus (HCV) infections over time in British Columbia during 1990–2013. METHODS: The...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568727/ https://www.ncbi.nlm.nih.gov/pubmed/28829824 http://dx.doi.org/10.1371/journal.pone.0183609 |
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author | Butt, Zahid Ahmad Shrestha, Nabin Wong, Stanley Kuo, Margot Gesink, Dionne Gilbert, Mark Wong, Jason Yu, Amanda Alvarez, Maria Samji, Hasina Buxton, Jane A. Johnston, James C. Cook, Victoria J. Roth, David Consolacion, Theodora Murti, Michelle Hottes, Travis S. Ogilvie, Gina Balshaw, Robert Tyndall, Mark W. Krajden, Mel Janjua, Naveed Z. |
author_facet | Butt, Zahid Ahmad Shrestha, Nabin Wong, Stanley Kuo, Margot Gesink, Dionne Gilbert, Mark Wong, Jason Yu, Amanda Alvarez, Maria Samji, Hasina Buxton, Jane A. Johnston, James C. Cook, Victoria J. Roth, David Consolacion, Theodora Murti, Michelle Hottes, Travis S. Ogilvie, Gina Balshaw, Robert Tyndall, Mark W. Krajden, Mel Janjua, Naveed Z. |
author_sort | Butt, Zahid Ahmad |
collection | PubMed |
description | BACKGROUND: Co-occurrence of social conditions and infections may affect HIV/HCV disease risk and progression. We examined the changes in relationship of these social conditions and infections on HIV and hepatitis C virus (HCV) infections over time in British Columbia during 1990–2013. METHODS: The BC Hepatitis Testers Cohort (BC-HTC) includes ~1.5 million individuals tested for HIV or HCV, or reported as a case of HCV, HIV, HBV, or tuberculosis linked to administrative healthcare databases. We classified HCV and HIV infection status into five combinations: HIV-/HCV-, HIV+monoinfected, HIV-/HCV+seroconverters, HIV-/HCV+prevalent, and HIV+/HCV+. RESULTS: Of 1.37 million eligible individuals, 4.1% were HIV-/HCV+prevalent, 0.5% HIV+monoinfected, 0.3% HIV+/HCV+ co-infected and 0.5% HIV-/HCV+seroconverters. Overall, HIV+monoinfected individuals lived in urban areas (92%), had low injection drug use (IDU) (4%), problematic alcohol use (4%) and were materially more privileged than other groups. HIV+/HCV+ co-infected and HIV-/HCV+seroconverters were materially most deprived (37%, 32%), had higher IDU (28%, 49%), problematic alcohol use (14%, 17%) and major mental illnesses (12%, 21%). IDU, opioid substitution therapy, and material deprivation increased in HIV-/HCV+seroconverters over time. In multivariable multinomial regression models, over time, the odds of IDU declined among HIV-/HCV+prevalent and HIV+monoinfected individuals but not in HIV-/HCV+seroconverters. Declines in odds of problematic alcohol use were observed in HIV-/HCV+seroconverters and coinfected individuals over time. CONCLUSIONS: These results highlight need for designing prevention, care and support services for HIV and HCV infected populations based on the evolving syndemics of infections and social conditions which vary across groups. |
format | Online Article Text |
id | pubmed-5568727 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-55687272017-09-09 A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia Butt, Zahid Ahmad Shrestha, Nabin Wong, Stanley Kuo, Margot Gesink, Dionne Gilbert, Mark Wong, Jason Yu, Amanda Alvarez, Maria Samji, Hasina Buxton, Jane A. Johnston, James C. Cook, Victoria J. Roth, David Consolacion, Theodora Murti, Michelle Hottes, Travis S. Ogilvie, Gina Balshaw, Robert Tyndall, Mark W. Krajden, Mel Janjua, Naveed Z. PLoS One Research Article BACKGROUND: Co-occurrence of social conditions and infections may affect HIV/HCV disease risk and progression. We examined the changes in relationship of these social conditions and infections on HIV and hepatitis C virus (HCV) infections over time in British Columbia during 1990–2013. METHODS: The BC Hepatitis Testers Cohort (BC-HTC) includes ~1.5 million individuals tested for HIV or HCV, or reported as a case of HCV, HIV, HBV, or tuberculosis linked to administrative healthcare databases. We classified HCV and HIV infection status into five combinations: HIV-/HCV-, HIV+monoinfected, HIV-/HCV+seroconverters, HIV-/HCV+prevalent, and HIV+/HCV+. RESULTS: Of 1.37 million eligible individuals, 4.1% were HIV-/HCV+prevalent, 0.5% HIV+monoinfected, 0.3% HIV+/HCV+ co-infected and 0.5% HIV-/HCV+seroconverters. Overall, HIV+monoinfected individuals lived in urban areas (92%), had low injection drug use (IDU) (4%), problematic alcohol use (4%) and were materially more privileged than other groups. HIV+/HCV+ co-infected and HIV-/HCV+seroconverters were materially most deprived (37%, 32%), had higher IDU (28%, 49%), problematic alcohol use (14%, 17%) and major mental illnesses (12%, 21%). IDU, opioid substitution therapy, and material deprivation increased in HIV-/HCV+seroconverters over time. In multivariable multinomial regression models, over time, the odds of IDU declined among HIV-/HCV+prevalent and HIV+monoinfected individuals but not in HIV-/HCV+seroconverters. Declines in odds of problematic alcohol use were observed in HIV-/HCV+seroconverters and coinfected individuals over time. CONCLUSIONS: These results highlight need for designing prevention, care and support services for HIV and HCV infected populations based on the evolving syndemics of infections and social conditions which vary across groups. Public Library of Science 2017-08-22 /pmc/articles/PMC5568727/ /pubmed/28829824 http://dx.doi.org/10.1371/journal.pone.0183609 Text en © 2017 Butt et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Butt, Zahid Ahmad Shrestha, Nabin Wong, Stanley Kuo, Margot Gesink, Dionne Gilbert, Mark Wong, Jason Yu, Amanda Alvarez, Maria Samji, Hasina Buxton, Jane A. Johnston, James C. Cook, Victoria J. Roth, David Consolacion, Theodora Murti, Michelle Hottes, Travis S. Ogilvie, Gina Balshaw, Robert Tyndall, Mark W. Krajden, Mel Janjua, Naveed Z. A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia |
title | A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia |
title_full | A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia |
title_fullStr | A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia |
title_full_unstemmed | A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia |
title_short | A syndemic approach to assess the effect of substance use and social disparities on the evolution of HIV/HCV infections in British Columbia |
title_sort | syndemic approach to assess the effect of substance use and social disparities on the evolution of hiv/hcv infections in british columbia |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568727/ https://www.ncbi.nlm.nih.gov/pubmed/28829824 http://dx.doi.org/10.1371/journal.pone.0183609 |
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