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Hospitalisation Rates and Associated Factors in Community-based Cohorts of HIV-infected and -uninfected Gay and Bisexual Men

Overview
Journal HIV Med
Publisher Wiley
Date 2015 Sep 8
PMID 26344061
Citations 1
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Abstract

Objectives: There is evidence that HIV-positive patients are suffering from a greater burden of morbidity as they age due to nonAIDS-related complications. To date it has been difficult to determine what part of this excess risk is due to the health effects of HIV, its treatment or to lifestyle factors common to gay and bisexual men (GBM). We calculated overall and cause-specific hospitalisation rates and risk factors for hospitalisations in HIV-negative and HIV-positive cohorts of GBM and compare these with rates in the general male population.

Methods: We conducted a record linkage study, linking two cohorts of HIV-negative (n = 1325) and HIV-positive (n = 557) GBM recruited in Sydney, New South Wales (NSW), Australia with the NSW hospital discharge data register. We compared rates of hospitalisation in the two cohorts and risk factors for hospitalisation using random-effects Poisson regression methods. Hospitalisation rates for each cohort were further compared with those in the general male population using indirect standardisation.

Results: We observed 2032 hospitalisations in the HIV-negative cohort during 13,016 person-years (PYs) [crude rate: 15.6/100 PYs (95% CI: 14.9-16.3)] and 2130 hospitalisations in the HIV-positive cohort during 5571 PYs [crude rate: 38.2/100 PYs (95% CI: 36.6-39.9)]. HIV-positive individuals had an increased risk of hospitalisation compared with the HIV-negative individuals [adjusted-IRR: 2.34 (95% CI: 1.91-2.86)] and the general population [SHR: 1.45 (95% CI: 1.33-1.59)]. Hospitalisation rates were lower in the HIV-negative cohort compared with the general population [SHR: 0.72 (95% CI: 0.67-0.78)]. The primary causes of hospitalisation differed between groups.

Conclusions: HIV-positive GBM continue to experience excess morbidity compared with HIV-negative GBM men and the general population. HIV-negative GBM had lower morbidity compared with the general male population suggesting that GBM identity does not confer excess risk.

Citing Articles

Poor record linkage sensitivity biased outcomes in a linked cohort analysis.

Moore C, Gidding H, Law M, Amin J J Clin Epidemiol. 2016; 75:70-7.

PMID: 26836255 PMC: 4916010. DOI: 10.1016/j.jclinepi.2016.01.023.

References
1.
Engels E, Atkinson J, Graubard B, McQuillan G, Gamache C, Mbisa G . Risk factors for human herpesvirus 8 infection among adults in the United States and evidence for sexual transmission. J Infect Dis. 2007; 196(2):199-207. DOI: 10.1086/518791. View

2.
Boehmer U, Miao X, Ozonoff A . Cancer survivorship and sexual orientation. Cancer. 2011; 117(16):3796-804. DOI: 10.1002/cncr.25950. View

3.
Rawstorne P, Fogarty A, Crawford J, Prestage G, Grierson J, Grulich A . Differences between HIV-positive gay men who 'frequently', 'sometimes' or 'never' engage in unprotected anal intercourse with serononconcordant casual partners: positive Health cohort, Australia. AIDS Care. 2007; 19(4):514-22. DOI: 10.1080/09540120701214961. View

4.
Zablotska I, Kippax S, Grulich A, Holt M, Prestage G . Behavioural surveillance among gay men in Australia: methods, findings and policy implications for the prevention of HIV and other sexually transmissible infections. Sex Health. 2011; 8(3):272-9. DOI: 10.1071/SH10125. View

5.
Buchacz K, Baker R, Moorman A, Richardson J, Wood K, Holmberg S . Rates of hospitalizations and associated diagnoses in a large multisite cohort of HIV patients in the United States, 1994-2005. AIDS. 2008; 22(11):1345-54. DOI: 10.1097/QAD.0b013e328304b38b. View