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Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada
BACKGROUND: Women living with HIV (WLWH) continue to experience poorer outcomes across the HIV care cascade and overall health, an appreciable proportion of which may not be disease-related but due to socio-structural barriers that impact health. We compared socio-structural determinants of health a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428327/ https://www.ncbi.nlm.nih.gov/pubmed/30897144 http://dx.doi.org/10.1371/journal.pone.0213901 |
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author | Shokoohi, Mostafa Bauer, Greta R. Kaida, Angela Lacombe-Duncan, Ashley Kazemi, Mina Gagnier, Brenda de Pokomandy, Alexandra Loutfy, Mona |
author_facet | Shokoohi, Mostafa Bauer, Greta R. Kaida, Angela Lacombe-Duncan, Ashley Kazemi, Mina Gagnier, Brenda de Pokomandy, Alexandra Loutfy, Mona |
author_sort | Shokoohi, Mostafa |
collection | PubMed |
description | BACKGROUND: Women living with HIV (WLWH) continue to experience poorer outcomes across the HIV care cascade and overall health, an appreciable proportion of which may not be disease-related but due to socio-structural barriers that impact health. We compared socio-structural determinants of health and self-rated health between WLWH and expected general population values. METHODS: Prevalences of socio-structural determinants and self-rated health were estimated from 1,422 WLWH aged 16+ in the 2013–2015 Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS). Prevalences were also estimated from 46,831 general population women (assumed HIV-negative) in the 2013–2014 Canadian Community Health Survey (CCHS), standardized to the age/ethnoracial group distribution of WLWH. Standardized prevalence differences (SPDs) and 95% confidence intervals (CI) were reported. RESULTS: Compared to general population women, a higher proportion of WLWH reported annual personal income <$20,000 (SPD 42.2%; 95% CI: 39.1, 45.2), indicating that 42.2% of WLWH experienced this low income, in excess of what would be expected of Canadian women of similar ages/ethnoracial backgrounds. A higher proportion of WLWH reported severe food insecurity (SPD 43.9%; 40.2, 47.5), poor perceived social support (SPD 27.4%; 22.2, 33.0), frequent racial (SPD 36.8%; 31.9, 41.8) and gender (SPD 46.0%; 42.6, 51.6) discrimination, and poor/fair self-rated health (SPD 12.2%; 9.4, 15.0). CONCLUSIONS: Significant socio-structural inequalities and lower self-rated health were found among WLWH compared to general population women. Such inequities support the integration of a social-determinants approach, social service delivery, and programming into HIV care, with additional resource allocation tailored to the particular needs of WLWH. |
format | Online Article Text |
id | pubmed-6428327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-64283272019-04-02 Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada Shokoohi, Mostafa Bauer, Greta R. Kaida, Angela Lacombe-Duncan, Ashley Kazemi, Mina Gagnier, Brenda de Pokomandy, Alexandra Loutfy, Mona PLoS One Research Article BACKGROUND: Women living with HIV (WLWH) continue to experience poorer outcomes across the HIV care cascade and overall health, an appreciable proportion of which may not be disease-related but due to socio-structural barriers that impact health. We compared socio-structural determinants of health and self-rated health between WLWH and expected general population values. METHODS: Prevalences of socio-structural determinants and self-rated health were estimated from 1,422 WLWH aged 16+ in the 2013–2015 Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS). Prevalences were also estimated from 46,831 general population women (assumed HIV-negative) in the 2013–2014 Canadian Community Health Survey (CCHS), standardized to the age/ethnoracial group distribution of WLWH. Standardized prevalence differences (SPDs) and 95% confidence intervals (CI) were reported. RESULTS: Compared to general population women, a higher proportion of WLWH reported annual personal income <$20,000 (SPD 42.2%; 95% CI: 39.1, 45.2), indicating that 42.2% of WLWH experienced this low income, in excess of what would be expected of Canadian women of similar ages/ethnoracial backgrounds. A higher proportion of WLWH reported severe food insecurity (SPD 43.9%; 40.2, 47.5), poor perceived social support (SPD 27.4%; 22.2, 33.0), frequent racial (SPD 36.8%; 31.9, 41.8) and gender (SPD 46.0%; 42.6, 51.6) discrimination, and poor/fair self-rated health (SPD 12.2%; 9.4, 15.0). CONCLUSIONS: Significant socio-structural inequalities and lower self-rated health were found among WLWH compared to general population women. Such inequities support the integration of a social-determinants approach, social service delivery, and programming into HIV care, with additional resource allocation tailored to the particular needs of WLWH. Public Library of Science 2019-03-21 /pmc/articles/PMC6428327/ /pubmed/30897144 http://dx.doi.org/10.1371/journal.pone.0213901 Text en © 2019 Shokoohi 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 Shokoohi, Mostafa Bauer, Greta R. Kaida, Angela Lacombe-Duncan, Ashley Kazemi, Mina Gagnier, Brenda de Pokomandy, Alexandra Loutfy, Mona Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada |
title | Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada |
title_full | Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada |
title_fullStr | Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada |
title_full_unstemmed | Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada |
title_short | Social determinants of health and self-rated health status: A comparison between women with HIV and women without HIV from the general population in Canada |
title_sort | social determinants of health and self-rated health status: a comparison between women with hiv and women without hiv from the general population in canada |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428327/ https://www.ncbi.nlm.nih.gov/pubmed/30897144 http://dx.doi.org/10.1371/journal.pone.0213901 |
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