Screening for Comorbid Conditions Among People with HIV in Medical Care

BACKGROUND: A significant proportion of morbidity and mortality among people living with HIV (PLWH) is attributable to non-HIV comorbid conditions. Despite the importance of detecting and treating comorbidities among PLWH, screening rates for common comorbidities are often suboptimal and may not correspond with risk factor status. METHODS: Comorbidities screening and other clinical data were obtained from the 2012 New York City (NYC) Medical Monitoring Project (MMP), a multi-site surveillance project comprised of demographically representative cohorts of PLWH receiving medical care. MMP medical record abstraction data were analyzed to determine screening frequencies for potential comorbid conditions, including tuberculosis, hepatitis B and C, type 2 diabetes, and three sexually transmitted infections (STI), and to assess demographic and clinical factors associated with screening in the previous 12 months. RESULTS: In the NYC MMP cohort (N = 439), 18% of patients were screened for hepatitis B, 26% for hepatitis C, 37% for type 2 diabetes, 38% for gonorrhea, 41% for chlamydia, 42% for tuberculosis, and 46% for syphilis in the past year. In multivariate analyses, having three or more medical visits with a CD4 count or viral load test during the year was significantly associated with STI screening (OR = 3.84, 95% CI: 1.94, 7.57) and hepatitis C screening (OR = 3.45, 95% CI: 1.65, 7.21). Hispanic PLWH were more likely to be screened for hepatitis C (OR = 1.72, 95% CI: 1.05, 2.81) and non-Hispanic Whites were less likely to be screened for type 2 diabetes (OR = 0.30, 95% CI: 0.10, 0.88), compared with non-Hispanic Blacks. Self-reported sexual risk behaviors and history of injection drug use were not associated with screening for STI and hepatitis C, respectively. CONCLUSION: We found a range of screening frequencies for comorbid conditions among PLWH in medical care during 2012, indicating a need for improved integration of HIV care with other clinical services. More frequent HIV care was associated with screening for STI and hepatitis C, possibly due to increased opportunity for testing or care related to the screened-for condition. Notably, we found no relationship between established risk factors for STI and hepatitis C and screening for these conditions. DISCLOSURES: All authors: No reported disclosures.