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20.03.2018 | Original Paper | Ausgabe 7/2018

AIDS and Behavior 7/2018

Elevated Mortality and Associated Social Determinants of Health in a Community-Based Sample of People Living with HIV in Ontario, Canada: Findings from the Positive Spaces, Healthy Places (PSHP) Study

Zeitschrift:
AIDS and Behavior > Ausgabe 7/2018
Autoren:
Tsegaye Bekele, Jason Globerman, James Watson, Stephen W. Hwang, Keith Hambly, Jay Koornstra, Glen Walker, Jean Bacon, Sean B. Rourke, The Positive Spaces Healthy Places Study Team
Wichtige Hinweise
This article is dedicated to the memory of Marisol Desbiens, Michael Hamilton, Devica Hintzen, Rob Rollins, Jim Truax, and Pius White who were peer research associates with the PSHP study and who have passed away. They played a key role in conducting face-to-face interviews with participants and in presentation of the results. They brought their lived experiences to this study and all were strong advocates of research to identify housing issues in people living with HIV.
A complete list of members of The Positive Spaces Healthy Places Study Team appears in the Acknowledgements.

Abstract

We examined social determinants of health associated with all-cause mortality among 602 people living with HIV/AIDS in Ontario, Canada. Mortality status was verified at 1-, 3-, and 5-year follow-up visits with information obtained from proxies (family members, partners, and friends), obituaries, and local AIDS memorial lists. Of the 454 people for whom mortality information was available, 53 individuals died yielding a crude mortality rate of 22.3 deaths per 1000 person-years, a rate substantially higher than the rate in the general population (6.8 per 1000 population). Experiencing both homelessness and incarceration independently predicted high risk of mortality among men who have sex with men (MSM) while suboptimal self-rated general health at previous visit predicted higher greater risk of mortality in both MSM and women and heterosexual men. Homelessness and incarceration may contribute to HIV disease progression and mortality. Intensive case management that increases retention in care and facilitates linkage to housing services may help to reduce excess deaths among people with HIV.

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