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France: Unemployment as a Risk Factor for AIDS and Death for HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy

July 17, 2008

In the current study, the researchers sought to assess the association between social situation and disease progression among patients diagnosed as HIV-positive since the advent of highly active antiretroviral therapy (HAART). Late testing was taken into account.

The authors designed a prospective cohort study of adults diagnosed with HIV since 1996 in six large HIV reference centers in France. A Cox regression model was used to assess associations between social situation and death, disease progression, and treatment initiation. Included in the analysis were 5,302 patients (77.9 percent of the sample) for whom the status at HIV diagnosis (late or not late) was known.

Of the patients studied, 134 (2.5 percent) died, and 400 presented with a new AIDS defining event (7.5 percent). In multivariate analysis, probabilities of death (HR 3.75, 95 percent CI 2.11 to 6.66) and disease progression (HR 1.59, 95 percent CI 1.17 to 2.15) were higher for non-working patients and for late testers (HR 9.18, 95 percent CI 4.32 to 19.48 for death) and lower for treated patients (HR 0.18, 95 percent CI 0.08 to 0.41 for death and HR 0.29, 95 percent CI 0.20 to 0.42 for disease progression).

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"The probability of receiving antiretroviral treatment was not associated with employment status but was higher for late testers, for those living in a stable relationship and lower for those diagnosed after 2000," the authors concluded. "Among patients diagnosed for HIV infection in the HAART era, poor social situation is an independent risk factor of mortality and morbidity, and is not explained by delayed access to diagnosis or treatment."

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Adapted from:
Sexually Transmitted Infections
06.01.2008; Vol. 84, No. 3: P. 183-186; C. Delpierre, L. Cuzin, V. Lauwers-Cances, G.D. Datta, L. Berkman, T. Lang


  
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This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.
 
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HIV/AIDS in France
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