Differential socioeconomic, psychosocial, and behavioral factors associated with psychological distress and uncontrolled blood pressure among women with and without HIV in the US

TL;DR

The study finds that socioeconomic and psychosocial factors are linked to uncontrolled blood pressure in women with and without HIV in the US.

Contribution

The study compares how socioeconomic and psychosocial factors affect blood pressure differently in women with and without HIV.

Findings

Socioeconomic and psychosocial factors explained 3% of blood pressure variance in women with HIV.

These factors explained 10% of blood pressure variance in women without HIV.

Health risk behaviors and medication use had weak to moderate impacts on blood pressure.

Abstract

Women with HIV (WWH) have a higher risk of hypertension compared to women without HIV (WWoH). Exposure to adverse socioeconomic (e.g., area level deprivation) and psychosocial factors (e.g., stigma, inadequate social support) may contribute to inequities in hypertension through their influence on health behaviors (e.g., substance use, diet, physical activity) and psychophysiological (e.g., stress) responses.

We examined the association between socioeconomic and psychosocial factors, psychological distress, and current uncontrolled blood pressure among WWH (n=998) and WWoH (n=353) enrolled in the Women’s Interagency HIV Study (WIHS) at a single visit between April and September 2019.

Socioeconomic and psychosocial factors were similar among WWH and WWoH. Among WWH and WWOH, 50.2% had current uncontrolled blood pressure, defined as a systolic blood pressure ≥130 mmHg or diastolic pressure ≥ 80 mmHg at the time of the study visit. Among WWH, socioeconomic, psychosocial, and behavioral factors explained 3% of the variance in blood pressure with self-reported health risk behaviors (r=0.15), and use of antihypertensive medication (r=0.09) had weak to moderate impact. Among WWoH, socioeconomic, psychosocial, and behavioral factors explained 10% of the variance in blood pressure, with self-reported health risk behaviors (r=0.19), use of antihypertensive medication (r=0.19), area-level social vulnerability (r=-0.17), and social support (r=0.16) demonstrating weak to moderate impacts.

Tailored interventions that address socioeconomic and psychosocial stressors at the individual and societal levels may improve outcomes and reduce disparities in uncontrolled blood pressure.

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