CROI 2025 Abstract eBook

Abstract eBook

Poster Abstracts

Methods: Retrospective observational study of the results obtained after an assessment of stigma using a validated 30-item HIV-stigma questionnaire (four-point Likert-type scale) in PHIV attended in a tertiary hospital. As part of routine care, 2,270 PHIV were invited to complete (online) the questionnaire from 2019 to 2024, through an application of the center itself, integrated into the electronic medical record. A multivariate analysis was performed to assess the four dimensions of stigma: personalized stigma, concerns about disclosure, negative self-image, and concerns regarding public attitudes. Results: 1,296 PHIV completed the questionnaire, most of them were men (1,261 - 97%) with a mean age of 46.7 ± 10.4 years (range 25 - 81); 34.4% of them were > 50 years old. The highest degree of stigma was observed in relation to concerns about disclosure and concerns about public attitudes (table 1), with scores on several items ranging from 70% to 90%. In these stigma domains, we could observe statistically significant differences between PHIV >50 years old versus people <=50 years old on several concerns (losing their jobs when employers learn that they have HIV, telling someone about they have HIV is risky, worry that people may judge them when they learn about their HIV status). Regarding personalized stigma and negative self-image, several items have rates ranging from 20 to 46%. In these domains we also see significant differences between PHIV >50 years old versus people <=50 years old (feeling guilty or feeling as if their body were dirty because they have HIV, feeling hurt by how people react to learning I have HIV). Conclusions: Assessing stigma in routine follow-up can be a useful strategy to measure the needs of PHIV and determine how concerns about disclosure and public attitudes are the main concerns of PHIV. Its implementation through digital tools can facilitate its use, although it requires strategies to achieve results in underrepresented groups such as women or older adults.

Results: The overall cohort was predominantly male (71.9%), White (46.5%) or Black (37.0%), and had a mean age of 71.3 (SD=5.36). LCA identified five comorbidity profile classes, which we named as: Cardiometabolic (12.3% – of study cohort), Pre-Cardiometabolic (39.5%), Substance-Hepatic (8.4%), Neuro Psychiatric (7.5%), and Minimal (32.3% – reference). Compared to the other classes, the Cardiometabolic class was characterized by a high prevalence of hypertension, ischemic heart disease, anemia, and hyperlipidemia. The Pre Cardiometabolic class exhibited a similar profile. The Substance-Hepatic class had elevated prevalence of tobacco use and drug use disorder and viral hepatitis. The Neuro-Psychiatric class was characterized by the highest prevalence of depression, dementia, and Alzheimer’s disease. The Minimal class had the lowest prevalence of most conditions relative to the others. Beneficiaries with HIV had significantly increased odds of belonging to the Pre-Cardiometabolic (OR=1.06, 95% CI [1.01; 1.11]), Cardiometabolic (OR=1.61, 95% CI [1.51; 1.72]), and Substance-Hepatic (OR=2.43, 95% CI [2.27; 2.61) classes compared to their matched HIV- counterparts (Figure 1). Conclusions: The findings demonstrate that older PWH (≥65 years) have specific comorbidity patterns compared to their HIV- counterparts. These results offer a valuable analytic tool for defining clinically meaningful subgroups and their associated treatments and outcomes, which may inform efforts on prevention, screening, and comprehensive management of comorbidities for older PWH in the U.S.

Poster Abstracts

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Multimorbidity and Quality of Life Among Older People Living With HIV in Urban Tanzania Theresia A. Ottaru 1 , Christopher H. Mbotwa 1 , Joan Rugemalia 1 , Sylvia Kaaya 1 , Lisa R. Hirschhorn 2 , Pilly Chillo 1 , Dannielle Grayer 2 , Edith Tarimo 1 , Mary C. Masters 3 , Claudia Hawkins 2 1 Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania, 2 Northwestern University, Chicago, IL, USA, 3 Albert Einstein College of Medicine, Bronx, NY, USA Background: Approximately one-third of Tanzanians living with HIV are aged ≥50. Aging persons living with HIV (PLWH) are at a higher risk of multi morbidities compared to older persons without HIV. Multi-morbidities can have a significant negative impact on quality of life (QOL). This study assessed the distribution of geriatric and medical comorbidities and their association with quality of life in older PLWH in Tanzania. These results are important to understand the growing complexities of care needs in this population and inform future strategies to improve health and well-being. Methods: This cross-sectional study was conducted among PLWH at seven HIV clinics in Dar es Salaam, Tanzania. Participants were included if they were aged ≥50 years, on ART ≥3 years, and in HIV care ≥12 months. Geriatric comorbidity screening included Fried’s Frailty phenotype score (frailty), PHQ-9 (depression), community screening interview for dementia (CSI-D), and WHODAS 2.0 (ADLs). QOL was assessed using the WHOQOL-HIV-BREF. Fasting blood glucose, lipid profile, and serum creatinine were also measured. Multivariable linear regression was used to examine the association between geriatric and medical comorbidities and QOL scores. Results: A total of 400 older PLWH were enrolled [mean age (SD): 58.6 (±6.9) years; 50% female; mean (SD) duration on ART: 11.8 (±1.8) years]. Among these, 86% were on Dolutegravir (DTG)-based ART, and 73% were virally suppressed (<50 copies/mL). The prevalences of geriatric and medical comorbidities are

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Latent Class Analysis Identifies Distinct Comorbidity Profiles in Older (>65 Years) People With HIV Fabrizio Drago 1 , Kylie Getz 1 , Luke Soshnik-Schierling 2 , Stephen Crystal 1 , Chintan V. Dave 1 , Mackey Friedman 1 , Henry F. Raymond 1 , Jason Roy 1 , Markella V. Zanni 3 , Michael T. Yin 4 , Stephanie Shiau 1 1 Rutgers University, Piscataway, NJ, USA, 2 New York University Langone Medical Center, New York, NY, USA, 3 Massachusetts General Hospital, Boston, MA, USA, 4 Columbia University Irving Medical Center, New York, NY, USA Background: Advances in HIV treatment have resulted in a growing population of older (≥65 years) people living with HIV (PWH) in the U.S. However, the health profiles of this aging population have been poorly delineated. Our objective was to characterize comorbidity patterns among older adults comparing PWH to those without HIV (HIV-). Methods: We constructed a cross-sectional cohort (2016) using a sample of older (≥65 years) Medicare beneficiaries in the U.S. Beneficiaries with HIV (n=13,080) were matched to HIV- beneficiaries (n=39,240) using propensity scores based on age, sex, race/ethnicity, state, and dual eligibility status. Latent class analysis (LCA) was used to define comorbidity profile classes using 63 comorbidities, pre-coded using the Chronic Condition Warehouse algorithm. Logistic regression was used to estimate the odds of belonging to each comorbidity profile class comparing matched HIV+ and HIV- beneficiaries.

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