High risk of obesity and weight gain for HIV-infected uninsured minorities.

Autor:	Taylor BS; Division of Infectious Diseases, Department of Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX; †Research to Advance Community Health (ReACH), University of Texas Health Science Center San Antonio, San Antonio, TX; ‡University of Texas School of Public Health, San Antonio Regional Campus, San Antonio, TX; §Department of Epidemiology and Biostatistics, University of Texas Health Science Center San Antonio, San Antonio, TX; ‖Division of Infectious Diseases, Department of Medicine, South Texas Veterans Health Care System, San Antonio, TX; and ¶Department of Family & Community Health Systems, School of Nursing, University of Texas Health Science Center San Antonio, San Antonio, TX., Liang Y, Garduño LS, Walter EA, Gerardi MB, Anstead GM, Bullock D, Turner BJ
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2014 Feb 01; Vol. 65 (2), pp. e33-40.
DOI:	10.1097/QAI.0000000000000010
Abstrakt:	Background: Obesity and HIV disproportionately affect minorities and have significant health risks, but few studies have examined disparities in weight change in HIV-seropositive (HIV+) cohorts. Objective: To determine racial and health insurance disparities in significant weight gain in a predominately Hispanic HIV+ cohort. Methods: Our observational cohort study of 1214 nonunderweight HIV+ adults from 2007 to 2010 had significant weight gain [≥3% annual body mass index (BMI) increase] as the primary outcome. The secondary outcome was continuous BMI over time. A 4-level race-ethnicity/insurance predictor reflected the interaction between race-ethnicity and insurance: insured white (non-Hispanic), uninsured white, insured minority (Hispanic or black), or uninsured minority. Logistic and mixed-effects models adjusted for baseline BMI, age, gender, household income, HIV transmission category, antiretroviral therapy type, CD4 count, plasma HIV-1 RNA, observation months, and visit frequency. Results: The cohort was 63% Hispanic and 14% black; 13.3% were insured white, 10.0% uninsured white, 40.9% insured minority, and 35.7% uninsured minority. At baseline, 37.5% were overweight, 22.1% obese. Median observation was 3.25 years. Twenty-four percent of the cohort had significant weight gain, which was more likely for uninsured minority patients than insured whites [adjusted odds ratio = 2.85, 95% confidence intervals (CIs): 1.66 to 4.90]. The rate of BMI increase in mixed-effects models was greatest for uninsured minorities. Of 455 overweight at baseline, 29% were projected to become obese in 4 years. Conclusions and Relevance: In this majority Hispanic HIV+ cohort, 60% were overweight or obese at baseline, and uninsured minority patients gained weight more rapidly. These data should prompt greater attention by HIV providers for prevention of obesity.
Databáze:	MEDLINE
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