دورية أكاديمية
أعرض في EDS

The impact of gender and the social determinants of health on the clinical course of people living with HIV in Myanmar: an observational study.

التفاصيل البيبلوغرافية
العنوان: The impact of gender and the social determinants of health on the clinical course of people living with HIV in Myanmar: an observational study.
المؤلفون: Nyein PP; Mingaladon Specialist Hospital, Mingaladon Township, Yangon, Myanmar.; University of Medicine 2, North Okkalapa Township, Yangon, Myanmar., Aung E; The Kirby Institute, University of New South Wales Sydney, Sydney, Australia., Aung NM; University of Medicine 2, North Okkalapa Township, Yangon, Myanmar.; Insein General Hospital, Insein Township, Yangon, Myanmar., Kyi MM; University of Medicine 2, North Okkalapa Township, Yangon, Myanmar.; Insein General Hospital, Insein Township, Yangon, Myanmar., Boyd M; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia., Lin KS; Mingaladon Specialist Hospital, Mingaladon Township, Yangon, Myanmar., Hanson J; University of Medicine 2, North Okkalapa Township, Yangon, Myanmar. jhanson@kirby.unsw.edu.au.; The Kirby Institute, University of New South Wales Sydney, Sydney, Australia. jhanson@kirby.unsw.edu.au.
المصدر: AIDS research and therapy [AIDS Res Ther] 2021 Aug 09; Vol. 18 (1), pp. 50. Date of Electronic Publication: 2021 Aug 09.
نوع المنشور: Journal Article; Observational Study
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101237921 Publication Model: Electronic Cited Medium: Internet ISSN: 1742-6405 (Electronic) Linking ISSN: 17426405 NLM ISO Abbreviation: AIDS Res Ther Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, 2004-
مواضيع طبية MeSH: HIV Infections*/drug therapy , HIV Infections*/epidemiology , Social Determinants of Health*, CD4 Lymphocyte Count ; Cohort Studies ; Female ; Humans ; Male ; Myanmar/epidemiology ; Viral Load
مستخلص: Background: There is a growing recognition of the impact of gender and the social determinants of health on the clinical course of people living with HIV (PLHIV). However, the relative contribution of these factors to clinical outcomes of PLHIV is incompletely defined in many countries. This study was performed to gain a greater understanding of the non-clinical determinants of prognosis of PLHIV in Myanmar.
Methods: Selected demographic, behavioural and socioeconomic characteristics of outpatients at two specialist HIV hospitals and one general hospital in Yangon, Myanmar were correlated with their subsequent clinical course; a poor outcome was defined as death, hospitalisation, loss to follow-up or a detectable viral load at 6 months of follow-up.
Results: 221 consecutive individuals with advanced HIV commencing anti-retroviral therapy (ART) were enrolled in the study; their median CD4 T-cell count was 92 (44-158) cells/mm 3 , 138 (62.4%) were male. Socioeconomic disadvantage was common: the median (interquartile range (IQR) monthly per-capita income in the cohort was US$48 (31-77); 153 (69.9%) had not completed high school. However, in a multivariate analysis that considered demographic, behavioural, clinical factors and social determinants of health, male gender was the only predictor of a poor outcome: odds ratio (95% confidence interval): 2.33 (1.26-4.32, p = 0.007). All eight of the deaths and hospitalisations in the cohort occurred in males (p = 0.03).
Conclusions: Men starting ART in Myanmar have a poorer prognosis than women. Expanded implementation of gender-specific management strategies is likely to be necessary to improve outcomes.
(© 2021. The Author(s).)
References: Br J Nurs. 2019 Jun 13;28(11):721-722. (PMID: 31188657)
BMC Public Health. 2021 Jan 25;21(1):211. (PMID: 33494730)
J Int AIDS Soc. 2017 Sep 25;20(1):21902. (PMID: 28953328)
J Int AIDS Soc. 2020 Feb;23(2):e25454. (PMID: 32112538)
BMC Med. 2017 Aug 4;15(1):145. (PMID: 28774293)
Med J Aust. 2015 Jun 1;202(10):529-31. (PMID: 26021364)
Bull World Health Organ. 2014 Aug 1;92(8):618-20. (PMID: 25197149)
Lancet. 2008 Nov 8;372(9650):1661-9. (PMID: 18994664)
BMC Public Health. 2019 Jan 14;19(1):63. (PMID: 30642303)
PLoS One. 2020 Jan 15;15(1):e0227623. (PMID: 31940422)
PLoS One. 2016 Nov 9;11(11):e0165528. (PMID: 27829033)
Lancet HIV. 2019 Mar;6(3):e191-e200. (PMID: 30777726)
AIDS. 2017 Jan 14;31(2):253-262. (PMID: 27662557)
PLoS Med. 2020 May 13;17(5):e1003107. (PMID: 32401797)
PLoS One. 2020 Feb 21;15(2):e0229329. (PMID: 32084226)
AIDS Res Ther. 2017 Mar 4;14(1):10. (PMID: 28257647)
JAMA Netw Open. 2020 Oct 1;3(10):e2016852. (PMID: 33119102)
PLoS Med. 2015 Nov 24;12(11):e1001906. (PMID: 26599825)
J Acquir Immune Defic Syndr. 2012 Mar 1;59(3):e28-34. (PMID: 22173039)
J Gastroenterol Hepatol. 2020 Apr;35(4):617-623. (PMID: 31758571)
PLoS One. 2018 Sep 25;13(9):e0204550. (PMID: 30252904)
PLoS One. 2018 Jul 11;13(7):e0200505. (PMID: 29995957)
PLoS Med. 2020 Sep 16;17(9):e1003325. (PMID: 32936795)
فهرسة مساهمة: Keywords: Acquired immunodeficiency syndrome; Gender; HIV; Myanmar; Social determinants of health
تواريخ الأحداث: Date Created: 20210810 Date Completed: 20210917 Latest Revision: 20240814
رمز التحديث: 20240814
مُعرف محوري في PubMed: PMC8350926
DOI: 10.1186/s12981-021-00364-w
PMID: 34372879
قاعدة البيانات: MEDLINE
الوصف
تدمد:1742-6405
DOI:10.1186/s12981-021-00364-w