Longitudinal associations between social determinants of health and well-being among women living with HIV in Canada: A latent class analysis.

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2025-04-14 DOI:10.1111/hiv.70031

Zerihun Admassu, Carmen H Logie, Luissa Vahedi, Angela Underhill, Logan Kennedy, Kath Webster, Brenda Gagnier, Angela Kaida, Alexandra de Pokomandy, Mona R Loutfy

{"title":"Longitudinal associations between social determinants of health and well-being among women living with HIV in Canada: A latent class analysis.","authors":"Zerihun Admassu, Carmen H Logie, Luissa Vahedi, Angela Underhill, Logan Kennedy, Kath Webster, Brenda Gagnier, Angela Kaida, Alexandra de Pokomandy, Mona R Loutfy","doi":"10.1111/hiv.70031","DOIUrl":null,"url":null,"abstract":"Background: Social determinants of health (SDoH) can significantly impact overall well-being. While existing research has explored SDoH as predictors of well-being among women living with HIV, longitudinal studies examining these relationships over time remain limited. We examined SDoH typologies among women living with HIV in Canada and longitudinal associations with well-being.Methods: Using longitudinal survey data collected at three time points from women living with HIV in Canada (2013-2018), we conducted latent class analysis (LCA) to identify subgroups of SDoH indicators, including income, experiences of violence, food security, substance use, housing stability, HIV-related stigma and social support at baseline (Time-1). Multivariable linear and logistic regression examined associations between SDoH classes and well-being (depression, discrimination [gender, racial] and HIV clinical outcomes [viral load, adherence, HIV care barriers]) at Time-3.Results: We identified three distinct SDoH classes among participants (n = 1422, mean age = 42.8): high (n = 435; 30.6%), medium (n = 377; 26.5%) and low SDoH adversity (n = 610; 42.9%). In multivariate regression analyses, the high SDoH adversity class had lower odds of achieving an undetectable viral load (adjusted Odds Ratio [aOR] = 0.46; 95% CI: 0.21, 1.01; p = 0.050) and higher probability of facing barriers to accessing care (aβ = 0.32; 95% CI: 0.19, 0.45; p < 0.001), depression (aOR = 2.52; 95% CI: 1.71, 3.71; p < 0.001), racial discrimination (aβ = 3.42; 95% CI: 1.72, 5.12; p < 0.001) and gender discrimination (aβ = 3.14; 95% CI: 1.42, 4.87; p < 0.001), compared with the low SDoH adversity class at 5-year follow-up.Conclusions: SDoH adversities were associated with poor wellbeing among women living with HIV in Canada. Integrated, comprehensive person-centred care approaches that address SDoH are needed to improve health and wellbeing.","PeriodicalId":13176,"journal":{"name":"HIV Medicine","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HIV Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/hiv.70031","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Social determinants of health (SDoH) can significantly impact overall well-being. While existing research has explored SDoH as predictors of well-being among women living with HIV, longitudinal studies examining these relationships over time remain limited. We examined SDoH typologies among women living with HIV in Canada and longitudinal associations with well-being.

Methods: Using longitudinal survey data collected at three time points from women living with HIV in Canada (2013-2018), we conducted latent class analysis (LCA) to identify subgroups of SDoH indicators, including income, experiences of violence, food security, substance use, housing stability, HIV-related stigma and social support at baseline (Time-1). Multivariable linear and logistic regression examined associations between SDoH classes and well-being (depression, discrimination [gender, racial] and HIV clinical outcomes [viral load, adherence, HIV care barriers]) at Time-3.

Results: We identified three distinct SDoH classes among participants (n = 1422, mean age = 42.8): high (n = 435; 30.6%), medium (n = 377; 26.5%) and low SDoH adversity (n = 610; 42.9%). In multivariate regression analyses, the high SDoH adversity class had lower odds of achieving an undetectable viral load (adjusted Odds Ratio [aOR] = 0.46; 95% CI: 0.21, 1.01; p = 0.050) and higher probability of facing barriers to accessing care (aβ = 0.32; 95% CI: 0.19, 0.45; p < 0.001), depression (aOR = 2.52; 95% CI: 1.71, 3.71; p < 0.001), racial discrimination (aβ = 3.42; 95% CI: 1.72, 5.12; p < 0.001) and gender discrimination (aβ = 3.14; 95% CI: 1.42, 4.87; p < 0.001), compared with the low SDoH adversity class at 5-year follow-up.

Conclusions: SDoH adversities were associated with poor wellbeing among women living with HIV in Canada. Integrated, comprehensive person-centred care approaches that address SDoH are needed to improve health and wellbeing.

查看原文本刊更多论文

加拿大感染艾滋病毒的妇女健康和福祉的社会决定因素之间的纵向关联：潜在阶层分析。

背景：健康的社会决定因素（SDoH）可以显著影响整体福祉。虽然现有的研究已经探索了SDoH作为艾滋病毒感染妇女幸福感的预测因素，但随着时间的推移，对这些关系的纵向研究仍然有限。我们研究了加拿大感染艾滋病毒的妇女的SDoH类型以及与幸福感的纵向关联。方法：利用从加拿大艾滋病毒感染者（2013-2018）中收集的三个时间点的纵向调查数据，我们进行了潜在类分析（LCA），以确定SDoH指标的亚组，包括收入，暴力经历，食品安全，物质使用，住房稳定性，艾滋病毒相关的耻辱和基线（time -1）的社会支持。多变量线性回归和逻辑回归检验了SDoH类别与幸福感（抑郁、歧视[性别、种族]和HIV临床结果[病毒载量、依从性、HIV护理障碍]）之间的关系。结果：我们在参与者中确定了三个不同的SDoH类别（n = 1422，平均年龄= 42.8）：高(n = 435；30.6%)，中(n = 377；26.5%)和低SDoH逆境(n = 610；42.9%)。在多变量回归分析中，高SDoH逆境类别实现无法检测到病毒载量的几率较低(调整优势比[aOR] = 0.46；95% ci: 0.21, 1.01；P = 0.050)，面临获得护理障碍的可能性更高(aβ = 0.32；95% ci: 0.19, 0.45；p结论：SDoH逆境与加拿大感染艾滋病毒的妇女的健康状况不佳有关。为改善健康和福祉，需要采取以人为本的综合综合护理办法，解决健康和健康问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.