Cohort Profile: The Women’s Interagency HIV Study (WIHS)

Adimora, Adaora A.; Ramirez, Catalina; Benning, Lorie; Greenblatt, Ruth M.; Kempf, Mirjam Colette; Tien, Phyllis C.; Kassaye, Seble; Anastos, Kathryn; Cohen, Mardge H.; Minkoff, Howard; Wingood, Gina M.; Ofotokun, Igho; Fischl, Margaret A.; Gange, Stephen J.

doi:10.1093/ije/dyy021

Cited by 239 publications

(232 citation statements)

References 28 publications

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“…Our study was a cross-sectional analysis of data from the WIHS, a prospective cohort study of HIV-seropositive women and demographically similar HIV-seronegative women in the USA. Cohort recruitment, demographics and retention are described elsewhere (Barkan et al, 1998;Bacon et al, 2005;Hessol et al, 2009;Adimora et al, 2018). WIHS participants undergo structured interviews and physical examinations every 6 months at nine sites across the USA and have blood and other biological samples taken.…”

Section: Study Design and Populationmentioning

confidence: 99%

Associations between food insecurity and psychotropic medication use among women living with HIV in the United States

Whittle

Wolfe

Sheira³

et al. 2020

Epidemiol Psychiatr Sci

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Aims Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. Methods We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score). Results Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose–response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36–3.13) and 1.99 (p < 0.01; 95% CI = 1.26–3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16–3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19–0.96). Conclusions Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.

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Section: Study Design and Populationmentioning

confidence: 99%

Associations between food insecurity and psychotropic medication use among women living with HIV in the United States

Whittle

Wolfe

Sheira³

et al. 2020

Epidemiol Psychiatr Sci

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show abstract

“…This investigation was part of the WIHS, the ongoing US multicenter prospective cohort investigation of HIV infection and related health conditions among HIV seropositive women and demographically similar seronegative comparison women. The protocols, recruitment processes, procedures, and baseline results of the WIHS have been described [10][11][12]. Enrollment began prior to the widespread introduction of cART with 2623 women (2056 with HIV and 569 without) in 1994-1995 at six study consortia (Bronx, Brooklyn, Chicago, Los Angeles, San Francisco, and Washington, DC).…”

Section: Methodsmentioning

confidence: 99%

Longitudinal assessment of abnormal Papanicolaou test rates among women with HIV

Massad

Xie

Minkoff

et al. 2020

Aids

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“…Women were enrolled based on having a known HIV‐seropositive (prior diagnosis) or HIV‐seronegative status with a history of sexually transmitted infections (STIS) or demographic and behavioural characteristics that increased their susceptibility to HIV acquisition. Details of the study population and recruitment strategies have been previously described [19‐21]. Participants were not deliberately matched on any characteristics prior to enrolment into the study.…”

Section: Methodsmentioning

confidence: 99%

“…Participants were interviewed and examined semiannually using structured questionnaires administered by trained research staff, and laboratory testing was conducted to assess HIV‐related outcomes [19‐21]. This analysis included all 3626 WLWH who self‐reported on country of birth.…”

Section: Methodsmentioning

confidence: 99%

“…The Women’s Interagency HIV Study (WIHS) is a long‐standing cohort of WLWH and otherwise similarly HIV‐negative women recruited to be representative of the populations of women living with HIV in the US [19‐21]. No study has examined how foreign‐born WIHS participants, who are often grouped into “Black/African‐American, Latina or Asian” despite the heterogeneity and diversity of these population groups, compare with their US born counterparts in terms of long‐term HIV outcomes, especially mortality.…”

Section: Introductionmentioning

confidence: 99%

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Women from afar: an observational study of demographic characteristics and mortality among foreign‐born women living with HIV in the Women’s Interagency HIV Study (WIHS) in the United States 1994‐2016

et al. 2020

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Introduction Foreign‐born persons comprise ~13% of the US population. Immigrants, especially women, often face a complex set of social and structural factors that negatively impact health outcomes including greater risk of HIV infection. We described socio‐demographic, clinical and immunological characteristics and AIDs and non‐AIDS death among foreign‐born women living with HIV (FBWLWH) participating in the US Women’s Interagency HIV Study (WIHS) in the US from 1994 to 2016. We hypothesized that FBW will experience higher AIDS‐related mortality compared to US‐born women (USBW). Methods The WIHS is a multicenter prospective observational cohort study of mostly women living with HIV (WLWH). The primary exposure in this analysis, which focused on 3626 WLWH, was self‐reported country of birth collapsed into foreign‐born and US born. We assessed the association of birthplace with categorized demographic, clinical and immunological characteristics, and AIDS/non‐AIDS mortality of WLWH, using chi‐squared tests. Proportional hazard models examined the association of birthplace with time from enrolment to AIDS and non‐AIDS death. Results Of the 628 FBW, 13% were born in Africa, 29% in the Caribbean and 49% in Latin America. We observed significant differences by HIV status in socio‐demographic, clinical and immunological characteristics and mortality. For both AIDS and non‐AIDS caused deaths FBW WLWH had lower rates of death. Adjusting for year of study enrolment and other demographic/clinical characteristics mitigated FBW’s statistical survival advantage in AIDS deaths Relative Hazard (RH = 0.91 p = 0.53), but did not substantively change the survival advantage in non‐AIDS deaths RH = 0.33, p < 0.0001). Conclusion Foreign‐born WLWH exhibited demographic, clinical and immunological characteristics that are significantly different compared with women born in the US or US territory. After adjusting for these characteristics, the FB WLWH had a significantly lower hazard of non‐AIDS but not AIDS mortality compared to women born in the US or a US territory. These findings of non‐increased mortality can help inform models of care to optimize treatment outcomes among FBWLWH in the United States.

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Cohort Profile: The Women’s Interagency HIV Study (WIHS)

Cited by 239 publications

References 28 publications

Associations between food insecurity and psychotropic medication use among women living with HIV in the United States

Associations between food insecurity and psychotropic medication use among women living with HIV in the United States

Longitudinal assessment of abnormal Papanicolaou test rates among women with HIV

Women from afar: an observational study of demographic characteristics and mortality among foreign‐born women living with HIV in the Women’s Interagency HIV Study (WIHS) in the United States 1994‐2016

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