Multimorbidity among people with HIV in regional New South Wales, Australia
Natalie Edmiston A E , Erin Passmore B C , David J. Smith A and Kathy Petoumenos D
+ Author Affiliations
- Author Affiliations
A Lismore Sexual Health Service, North Coast Public Health, 4 Shepherd Lane, Lismore, NSW 2480, Australia.
B NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia.
C School of Public Health and Community Medicine, L3 Samuels Building, UNSW Australia, Sydney, NSW 2052, Australia.
D Kirby Institute for Infection and Immunity in Society, UNSW Australia, Sydney, NSW 2052, Australia.
E Corresponding author. Email: Natalie.edmiston@ncahs.health.nsw.gov.au
Sexual Health 12(5) 425-432 https://doi.org/10.1071/SH14070
Submitted: 7 April 2014 Accepted: 28 April 2015 Published: 6 July 2015
Abstract
Background: Multimorbidity is the co-occurrence of more than one chronic health condition in addition to HIV. Higher multimorbidity increases mortality, complexity of care and healthcare costs while decreasing quality of life. The prevalence of and factors associated with multimorbidity among HIV positive patients attending a regional sexual health service are described. Methods: A record review of all HIV positive patients attending the service between 1 July 2011 and 30 June 2012 was conducted. Two medical officers reviewed records for chronic health conditions and to rate multimorbidity using the Cumulative Illness Rating Scale (CIRS). Univariate and multivariate linear regression analyses were used to determine factors associated with a higher CIRS score. Results: One hundred and eighty-nine individuals were included in the study; the mean age was 51.8 years and 92.6% were men. One-quarter (25.4%) had ever been diagnosed with AIDS. Multimorbidity was extremely common, with 54.5% of individuals having two or more chronic health conditions in addition to HIV; the most common being a mental health diagnosis, followed by vascular disease. In multivariate analysis, older age, having ever been diagnosed with AIDS and being on an antiretroviral regimen other than two nucleosides and a non-nucleoside reverse transcriptase inhibitor or protease inhibitor were associated with a higher CIRS score. Conclusion: To the best of our knowledge, this is the first study looking at associations with multimorbidity in the Australian setting. Care models for HIV positive patients should include assessing and managing multimorbidity, particularly in older people and those that have ever been diagnosed with AIDS.
Additional keywords: ageing, AIDS, antiretrovirals, chronic health conditions.
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