TY - JOUR
T1 - Poor HIV-Related Outcomes in Older Adults Newly Diagnosed with HIV
T2 - A 4-Year Retrospective Analysis from a Single Site in Asia
AU - Wong, Hoi Yee
AU - Wong, Pui Li
AU - Bador, Maria Kahar
AU - Chong, Meng Li
AU - Shenoi, Sheela
AU - Rozanova, Julia
AU - Syed Omar, Sharifah Faridah
AU - Neelamegam, Malinee
AU - Lee, Yew Kong
AU - Rajasuriar, Reena
N1 - Publisher Copyright:
© Copyright 2023 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - Background:In resource-limited settings, HIV-related services are often targeted to younger key populations, although increasing reports have found that adults ≥50 years now account for among the highest increase in new HIV diagnosis. We assessed the proportion of new HIV infections among older adults (≥50 years) and compared their sociodemographics, risk behaviors, and HIV-related outcomes to newly diagnosed younger adults (<50 years).Methods:This retrospective analysis included all new HIV diagnosis from 2016 to 2019 at the University of Malaya Medical Centre, Malaysia. Trends of HIV diagnosis was assessed using join point regression analysis, and characteristics between the older and younger adults were compared using χ2 test or Mann-Whitney U test. Kaplan-Meier analysis and log-rank test were used to compare the survival probability in both age groups.Results:From a total of 594 new HIV diagnosis between 2016 and 2019, 11.5% (N = 68) were among older adults with an annual percent increase of 5.50%. Older adults were more likely ethnic Indians (P < 0.001), acquired HIV through heterosexual contact (P = 0.001), had late presentation to care (P = 0.003), and multimorbidity (P < 0.001). Immunological responses after 12 months on antiretroviral therapy were comparable in both the groups. Older adults had a higher probability of death compared with younger adults (adjusted hazard ratio 1.81, 95% confidence interval: 1.02 to 3.23, P = 0.043) after adjusting for sex, mode of HIV transmission, late presentation to care, antiretroviral therapy initiation, and multimorbidity.Conclusion:Older adults diagnosed with HIV were associated with late care presentation and increased mortality. There is an urgent need to enhance uptake of HIV testing and linkage to care among older individuals in our setting.
AB - Background:In resource-limited settings, HIV-related services are often targeted to younger key populations, although increasing reports have found that adults ≥50 years now account for among the highest increase in new HIV diagnosis. We assessed the proportion of new HIV infections among older adults (≥50 years) and compared their sociodemographics, risk behaviors, and HIV-related outcomes to newly diagnosed younger adults (<50 years).Methods:This retrospective analysis included all new HIV diagnosis from 2016 to 2019 at the University of Malaya Medical Centre, Malaysia. Trends of HIV diagnosis was assessed using join point regression analysis, and characteristics between the older and younger adults were compared using χ2 test or Mann-Whitney U test. Kaplan-Meier analysis and log-rank test were used to compare the survival probability in both age groups.Results:From a total of 594 new HIV diagnosis between 2016 and 2019, 11.5% (N = 68) were among older adults with an annual percent increase of 5.50%. Older adults were more likely ethnic Indians (P < 0.001), acquired HIV through heterosexual contact (P = 0.001), had late presentation to care (P = 0.003), and multimorbidity (P < 0.001). Immunological responses after 12 months on antiretroviral therapy were comparable in both the groups. Older adults had a higher probability of death compared with younger adults (adjusted hazard ratio 1.81, 95% confidence interval: 1.02 to 3.23, P = 0.043) after adjusting for sex, mode of HIV transmission, late presentation to care, antiretroviral therapy initiation, and multimorbidity.Conclusion:Older adults diagnosed with HIV were associated with late care presentation and increased mortality. There is an urgent need to enhance uptake of HIV testing and linkage to care among older individuals in our setting.
KW - AIDS
KW - Asia
KW - HIV
KW - aging population
KW - new diagnosis
KW - older adults
UR - http://www.scopus.com/inward/record.url?scp=85152174457&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000003169
DO - 10.1097/QAI.0000000000003169
M3 - Article
C2 - 36716735
AN - SCOPUS:85152174457
SN - 1525-4135
VL - 93
SP - 64
EP - 72
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 1
ER -