Exploring the Relationship Between Community-Level Economic Deprivation and HIV Infection Among Hospital Admissions in Washington, DC.

Autor:	Akinyemi OA; Health Policy and Management, University of Maryland School of Public Health, College Park, USA.; Surgery, Howard University, Washington, DC, USA., Omokhodion OV; Obstetrics and Gynecology, University College Hospital, Ibadan, NGA., Fasokun ME; Epidemiology and Public Health, University of Alabama at Birmingham, Birmingham, USA., Makanjuola OE; Medicine and Surgery, University of Ilorin, Ilorin, NGA., Aaron S; Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC, USA., Elleissy Nasef K; Obstetrics and Gynecology, Howard University College of Medicine, Washington, DC, USA., Chidi M; Hospital Medicine, Howard University College of Medicine, Washington, DC, USA., Agboola BO; Institute of Applied Environmental Health, University of Maryland School of Public Health, College Park, USA., Ogungbemi T; Epidemiology, DC Department of Public Health, Washington, DC, USA., Ogundipe T; Community and Family Medicine, Howard University Hospital, Washington, DC, USA., Abiodun O; Family and Community Medicine, Howard University College of Medicine, Washington, DC, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Apr 07; Vol. 15 (4), pp. e37236. Date of Electronic Publication: 2023 Apr 07 (Print Publication: 2023).
DOI:	10.7759/cureus.37236
Abstrakt:	Introduction Human immunodeficiency virus (HIV) infection is a significant health concern in the United States, affecting 38 million Americans. Despite a recent decline in prevalence, social determinants of health remain an important factor driving infections, particularly among minority populations. However, the relationship between community-level economic deprivation indices and HIV infection among hospital admissions has been understudied in the literature. Objectives This study investigated the association between community-level economic deprivation, measured by the Distressed Community Index (DCI), and HIV infection among hospital admissions in Washington, District of Columbia (DC). Methods We utilized data from the State Inpatient Database (SID) for Washington, DC, between 2016 and 2019, identifying all admissions with a history of HIV. The multivariate analysis determined the association between DCI quintiles and HIV infection among hospital admissions. Also included in the multivariate analysis were patients' age, sex, race/ethnicity, insurance type, smoking status, obesity, sexually transmitted infections (STIs), hepatitis B infections, and mental health conditions. Results Of the 213,682 admissions captured in the DCI quintiles, 67.4% were Black, 17.2% were White, and 10.7% were Hispanic. The prevalence of HIV infection in the study population was 4.4%. There was a statistically significant association between the DCI quintiles and HIV infection among hospital admissions. The residents of the richest neighborhoods defined as prosperous quintile (also the reference group) had the lowest odds of HIV infections compared to the other quintiles (comfortable, odds ratio {OR}=1.94 and 95% confidence interval {CI}=1.38-2.74; mid-tier, OR=1.49 and 95% CI=1.04-2.14; at risk, OR=1.75 and 95% CI=1.22-2.49; and distressed, OR=1.97 and 95% CI=1.38-2.82). Other significant predictors of HIV infection were Black race (OR=1.82; 95% CI=1.41-2.33), age between 45 and 65 years (OR=1.55; 95% CI=1.32-1.80), male sex (OR=1.58; 95% CI=1.40-1.77), and depression (OR=1.21; 95% CI=1.03-1.43). Conclusion This study reveals a significant association between increased levels of economic distress and the prevalence of HIV among hospital admissions in Washington, DC. Our findings emphasize the importance of taking social determinants of health into account when addressing HIV prevention and management. Implementing targeted interventions and resources in economically distressed communities may be crucial for reducing HIV prevalence and improving health outcomes for affected populations. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Akinyemi et al.)
Databáze:	MEDLINE
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