Associations between drug and alcohol use, smoking, and frailty among people with HIV across the United States in the current era of antiretroviral treatment

Crane, Heidi M.; Ruderman, Stephanie A; Whitney, Bridget M; Nance, Robin M.; Drumright, Lydia N; Webel, Allison R.; Willig, Amanda L.; Saag, Michael S.; Christopoulos, Katerina; Greene, Meredith; Hahn, Abigail; Eron, Joseph J.; Napravnik, Sonia; Mathews, W. Christopher; Chander, Geetanjali; McCaul, Mary E.; Mayer, Kenneth H.; Landay, Alan; Austad, Steven N.; Ma, Jimmy; Kritchevsky, Stephen B.; Pandya, Chintan; Achenbach, Chad; Cartujano-Barrera, Francisco; Kitahata, Mari M.; Delaney, Joseph; Kamen, Charles

doi:10.1016/j.drugalcdep.2022.109649

Cited by 7 publications

(9 citation statements)

References 70 publications

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“…A rate of 60.7% smoking was reported by participants with poor treatment adherence in the similar population [31]. In a population with different characteristics in United States, 30% smoking and 50% non-hazardous alcohol consumption was reported while 44% smoking in Spain, 24.7% in Italy were reported [29,32,33], which was significantly higher than the current study.…”

Section: Risky Behavioral Factorscontrasting

confidence: 69%

Factors Associated with Treatment Outcomes among Patients Living with HIV and Hypertension Comorbidity in the Eastern Cape Province, South Africa

Faleni¹,

Mabunda²,

Ziphelele³

et al. 2022

Preprint

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Globally, non-communicable diseases like hypertension are on the rise, existing concurrently with the human immunodeficiency virus (HIV) in populations, especially those in low- to middle-income countries. The introduction of antiretroviral treatment (ART) for people living with HIV was welcomed with great enthu-siasm across populations. A cross-sectional study of 100 purposively selected adult participants on an-tiretroviral treatment living in the OR Tambo district was conducted to determine factors associated with treatment outcomes among patients living with HIV and hypertension comorbidity. The data was analyzed using the Statistical Package for Social Sciences, with a p-value of 0.05 considered significant. A total of 86% of the female population, with a mean age of 39.76, was studied. Participants with improved viral load and CD4 cell count after initiation of ART increased from 63% to 68% and 74% to 90%, respectively whilst viral load suppression increased from 45.1% to 90.2%. Hypertension post-ART initiation increased from 9% to 34%, exacerbated by smoking (12%), alcohol (14%), vegetable consumption (39%), skipping breakfast (50%), sugar use (62%), and vigorous physical activity (12%). The onset of hypertension was linked to the start of ART, and risky behaviors influenced treatment outcomes. Primordial prevention, like strong health promotion inter-ventions for risk factors, is needed to improve life expectancy.

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Section: Risky Behavioral Factorscontrasting

confidence: 69%

Factors Associated with Treatment Outcomes among Patients Living with HIV and Hypertension Comorbidity in the Eastern Cape Province, South Africa

Faleni¹,

Mabunda²,

Ziphelele³

et al. 2022

Preprint

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“…The prevalence of frailty among the 522 participants in this study was lower than in all of CNICS-8% on the Mod-FP in this study versus 13% as measured by the Mod-FP across the whole CNICS cohort (Crane et al, 2022). This difference may be due to enrolling PWH who are less likely to have frailty perhaps being more likely to volunteer to participate in the PROSPER-HIV study, which is focused on nutrition and physical activity assessments.…”

Section: Discussionmentioning

confidence: 57%

“…Investigators within the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS), a large U.S.-based cohort of PWH (Kitahata et al, 2008), developed a modified Fried phenotype (Mod-FP) based on four self-reported components: unintentional weight loss, low physical activity, fatigue, and poor mobility (Crane et al, 2022). The Mod-FP is similar to other modified phenotypes used among PWH, with the use of self-reported components and exclusion of a weakness/grip strength measure that is not collected at routine appointments in CNICS (Akgun et al, 2014; Desquilbet et al, 2007).…”

mentioning

confidence: 99%

Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States

Ruderman¹,

Webel²,

Willig³

et al. 2023

J Assoc Nurses AIDS Care

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Modifications to Fried's frailty phenotype (FFP) are common. We evaluated a self-reported modified frailty phenotype (Mod-FP) used among people with HIV (PWH). Among 522 PWH engaged in two longitudinal studies, we assessed validity of the four-item Mod-FP compared with the five-item FFP. We compared the phenotypes via receiver operator characteristic curves, agreement in classifying frailty, and criterion validity via association with having experienced falls. Mod-FP classified 8% of PWH as frail, whereas FFP classified 9%. The area under the receiver operator characteristic curve for Mod-FP classifying frailty was 0.93 (95% CI = 0.91–0.96). We observed kappa ranging from 0.64 (unweighted) to 0.75 (weighted) for categorizing frailty status. Both definitions found frailty associated with a greater odds of experiencing a fall; FFP estimated a slightly greater magnitude (i.e., OR) for the association than Mod-FP. The Mod-FP has good performance in measuring frailty among PWH and is reasonable to use when the gold standards of observed assessments (i.e., weakness and slowness) are not feasible.

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“…Among the participants in this research, the prevalence of multimorbidity was higher in women (55.6%) than in men (36.2%), being a risk factor for frailty in both sexes, but with a two‐fold greater odds ratio for women than for men. Smoking is a risk factor for frailty in the general geriatric population and among PLHIV [32]. The global prevalence of active smoking in PLHIV on ART is 36.1% [33] and is increased in higher‐ than in lower‐income countries, and in men than in women [33].…”

Section: Discussionmentioning

confidence: 99%

Frailty in people 50 years or older living with HIV: A sex perspective

Wiechmann,

Tejo,

Inácio

et al. 2023

HIV Medicine

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ObjectiveTo estimate prefrailty and frailty prevalence and associated factors in people living with HIV (PLHIV) from a sex perspective.MethodsCross‐sectional study on PLHIV at specialized public health centres in Brazil. Data were obtained from individuals aged ≥50 years using antiretroviral therapy (ART) and with an undetectable viral load through personal interviews, clinical evaluations and medical records. Frailty and prefrailty were characterized using the Fried Frailty Phenotype tool. Multinomial regression models were performed, and the associated factors were selected through the backward stepwise method.ResultsAmong 670 patients, 373 men and 297 women were included. The prevalence of frailty and prefrailty was significantly higher for women (16.2% and 56.2%, respectively) than for men (11.5% and 46.4%, respectively). Low socioeconomic and educational level, multimorbidity, depression, subjective cognitive complaints, and low scores on the Mini‐Mental State Exam (MMSE) were associated (P < 0.05) with frailty for both sexes. However, in the sex‐specific analysis, while smoking (OR = 3.66, 95% CI: 1.58–8.48) and a history of low adherence to ART (OR = 3.10, 95% CI: 1.33–7.23) were associated with frailty in men, depression (OR = 3.39, 95% CI: 1.36– 8.44) and the absence of functional dentition (OR = 3.77, 95% CI: 1.36– 10.43) were associated with frailty in women.ConclusionsThis study adds self‐reported cognitive complaints as a potential predictor of frailty in both sexes and supports the known deleterious effect of multimorbidity on frailty in adults living with HIV. Furthermore, it suggests that other possible predictors, such as depression, oral health status and adherence to ART, may be sex‐specific.

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Associations between drug and alcohol use, smoking, and frailty among people with HIV across the United States in the current era of antiretroviral treatment

Cited by 7 publications

References 70 publications

Factors Associated with Treatment Outcomes among Patients Living with HIV and Hypertension Comorbidity in the Eastern Cape Province, South Africa

Factors Associated with Treatment Outcomes among Patients Living with HIV and Hypertension Comorbidity in the Eastern Cape Province, South Africa

Validity Properties of a Self-reported Modified Frailty Phenotype Among People With HIV in Clinical Care in the United States

Frailty in people 50 years or older living with HIV: A sex perspective

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