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Author Notes:

Correspondence: J. Colasanti, MD, MSPH, 341 Ponce de Leon Ave NE, Atlanta, GA 30308 (jcolasa@emory.edu).

See publication for full list of author contributions.

See publication for full list of disclosures.

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Research Funding:

This study was funded by the National Institute of Allergy and Infectious Diseases through the WIHS (U01AI103408-04).

M.K.A. was partially supported by the Georgia Center for Diabetes Translation Research (P30DK111024).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Infectious Diseases
  • care continuum
  • diabetes
  • HIV
  • quality
  • UNITED-STATES
  • ANTIRETROVIRAL THERAPY
  • ASSOCIATION
  • MELLITUS
  • QUALITY
  • MANAGEMENT
  • RETENTION
  • TRENDS
  • COHORT
  • SUPPRESSION

Room for Improvement: The HIV-Diabetes Care Continuum Over 15 Years in the Women's Interagency HIV Study

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Journal Title:

Open Forum Infectious Diseases

Volume:

Volume 5, Number 6

Publisher:

, Pages ofy121-ofy121

Type of Work:

Article | Final Publisher PDF

Abstract:

Background: Gains in life expectancy through optimal control of HIV infection with antiretroviral therapy (ART) may be threatened if other comorbidities, such as diabetes, are not optimally managed. Methods: We analyzed cross-sectional data of the Women's Interagency HIV Study (WIHS) from 2001, 2006, and 2015. We estimated the proportions of HIV-positive and HIV-negative women with diabetes who were engaged in care and achieved treatment goals (hemoglobin A1c [A1c] <7.0%, blood pressure [BP] <140/90 mmHg, low-density lipoprotein [LDL] cholesterol <100 mg/dL, not smoking) and viral suppression. Repeated-measures models were used to estimate the adjusted prevalence of achieving each diabetes treatment goal at each time point, by HIV status. Results: We included 486 HIV-positive and 258 HIV-negative women with diabetes. In 2001, 91.8% visited a health care provider, 60.7% achieved the A1c target, 70.5% achieved the BP target, 38.5% achieved the LDL cholesterol target, 49.2% were nonsmokers, 23.3% achieved combined ABC targets (A1c, BP, and cholesterol), and 10.9% met combined ABC targets and did not smoke. There were no differences by HIV status, and patterns were similar in 2006 and 2015. Among HIV-positive women, viral suppression increased from 41% in 2001 to 87% in 2015 compared with 8% and 13% achieving the ABC goals and not smoking. Viral suppression was not associated with achievement of diabetes care goals. Conclusions: Successful management of HIV is outpacing that of diabetes. Future studies are needed to identify factors associated with gaps in the HIV-diabetes care continuum and design interventions to better integrate effective diabetes management into HIV care.

Copyright information:

© The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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