Disproportionate Vulnerability to and Unique Aggregation Pattern of Non-AIDS Comorbidities Among Women With HIV in China

TL;DR

Women with HIV in China face a higher risk of multiple non-AIDS health issues at younger ages and show a unique pattern of these conditions.

Contribution

This study reveals a unique multimorbidity pattern among women with HIV, highlighting sex-specific differences in non-AIDS comorbidities.

Findings

Women with HIV had a higher prevalence of multimorbidity compared to those without HIV across multiple age groups.

Women with HIV showed a unique clustering of neuropsychiatric and cardiometabolic conditions.

The association between HIV and multimorbidity was stronger in women than in men.

Abstract

Whether and how sex plays differential roles in aging-related multimorbidity among people with HIV (PWH) is poorly characterized.

We included 2479 PWH and 5376 people without HIV from the baseline assessment of the CHART cohort (Comparative HIV and Aging Research in Taizhou). Ten non-AIDS comorbidities were investigated. Multiple logistic regression was used to assess the correlates of multimorbidity, defined as the coexistence of ≥2 non-AIDS comorbidities. Multimorbidity patterns were identified through hierarchical cluster analysis.

The prevalence of multimorbidity was higher in PWH than in people without HIV (74.6% vs 66.9%, P < .001). This difference was particularly pronounced in women in each age group from 18 through 59 years and among men in each age group from 18 through 49 years. A significant interaction between sex and HIV on multimorbidity was identified (P < .001), with the strength of the association between HIV infection and multimorbidity being stronger in women than in men. Women with HIV presented a unique aggregation pattern of multimorbidity, where neuropsychiatric disorders (depression, neurocognitive impairment) clustered with cardiometabolic diseases. In contrast, all men and women without HIV manifested a similar multimorbidity pattern, where depression and neurocognitive impairment were clustered with hematologic abnormalities but not with cardiometabolic diseases.

Earlier onset and higher burden of multimorbidity in PWH, as well as disproportionate vulnerability to and a unique multimorbidity pattern among women with HIV, underscore the urgent need for early and sexually oriented integrative interventions and health services targeting multimorbidity in PWH.

Women with HIV were at a disproportionally high risk of living with multimorbidity at younger ages and manifested a unique multimorbidity pattern with neuropsychiatric disorders or mental health conditions clustered with cardiometabolic diseases.

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