County-Level Socioeconomic Status and Survival After HIV Diagnosis, United States

Socioeconomic Status and Survival of People with Human Immunodeficiency Virus Infection before and after the Introduction of Highly Active Antiretroviral Therapy: A Systematic Literature Review

“…Most of the studies included in the review used more than one of the common determinants to measure SES. Nine reports [34,35,71,75,76,80,81,84,85] presented one arbitrarily selected measure to quantify the association between SES and mortality among people with HIV/AIDS. Education was the most frequently used measure of SES followed by income, and employment status ( Table 1).…”

“…Four studies examined effects of SES on mortality with HIV/AIDS in the years of pre-HAART period [70][71][72][73]. Fifteen studies provided an assessment of SES in relation to survival in HIV-infected patients during the years of commercial availability of HAART [74][75][76][77][78][79][80][81][82][83][84][85][86][87][88]. Two studies [34,35] evaluated the impact of SES on survival with HIV/AIDS in both periods.…”

“…Poverty as the area-level SES factor was positively associated with an increased risk of death in HIV-infected patients even after adjustments for age, clinical and treatment variables [83,84]. The only study that examined the effect of social context on survival of HIVinfected children found that maternal unemployment was associated with lower survival after adjustment for baseline AIDS diagnosis [78].…”

“…Included in the review, 15 reports of post-HAART period examined relationships between SES and all-cause mortality and HIV/ AIDS-related mortality among HIV-infected patients with the mean age ranging from 11 to 42.5 years and the median follow-up ranging from 12 months to 8.6 years [74][75][76][77][78][79][80][81][82][83][84][85][86][87][88]. The composite index of one of these studies was based on the variables of availability of stable income, owned residential property, the need to receive social support, and the effective availability of this support in the past and at the time of interview [82].…”

Trends and Differences among Three New Indicators of HIV Infection Progression

“…These studies have focused on individuals diagnosed in a certain time period and have examined the differences in time from HIV diagnoses to AIDS and death (i.e., the number of months/years from HIV diagnosis to AIDS or death) using survival analyses, including Kaplan-Meier survival curves, the Cox proportional hazard model, or the standardized relative risk. [6][7][8] However, previous studies have not assessed the risks of progression to AIDS and death among all people living with HIV, and have not reported the trends in these outcomes.…”