Table 3.
Hazard Ratios (95% CI) for Interactive Effect of HIV Status and Syndemic Conditions on Mortality
| HIV-Uninfected | HIV-Infected | Pairwise Comparison | |||||
|---|---|---|---|---|---|---|---|
| No. of Concurrent Conditions | HR (95% CI) | P Value | No. of Concurrent Conditions | HR (95% CI) | P Value | HR (95% CI) | P Value |
| Adjusted for VACS Index | |||||||
| HIV-/0 conditions | 1.0 (ref) | — | HIV+/0 conditions | 0.89 (0.56–1.44) | .641 | ||
| HIV-/1 condition | 1.55 (1.05–2.30) | .028 | HIV+/1 condition | 1.50 (1.02–2.20) | .038 | 0.97 (0.78–1.19) | .752 |
| HIV-/2 conditions | 2.14 (1.48–3.11) | <.001 | HIV+/2 conditions | 1.93 (1.33–2.79) | .001 | 0.90 (0.78–1.03) | .126 |
| HIV-/3 conditions | 2.10 (1.40–3.15) | <.001 | HIV+/3 conditions | 2.53 (1.72–3.73) | <.001 | 1.21 (0.95–1.53) | .117 |
| Adjusted for VACS Index and other predictorsa | |||||||
| HIV-/0 conditions | 1.0 (ref) | — | HIV+/0 conditions | 0.95 (0.59–1.53) | .827 | ||
| HIV-/1 condition | 1.39 (0.94–2.06) | .102 | HIV+/1 condition | 1.49 (1.01–2.20) | .043 | 1.08 (0.87–1.33) | .502 |
| HIV-/2 conditions | 1.75 (1.20–2.55) | .004 | HIV+/2 conditions | 1.78 (1.22–2.60) | .003 | 1.02 (0.89–1.18) | .784 |
| HIV-/3 conditions | 1.59 (1.05–2.40) | .029 | HIV+/3 conditions | 2.15 (1.45–3.20) | <.001 | 1.36 (1.07–1.72) | .013 |
“Conditions” refers to unhealthy alcohol use, cigarette smoking, and depressive symptoms. HIV-infected and uninfected people with 2 conditions had 1.78 (95% CI, 1.22–2.60; P < .01) and 1.75 (95% CI, 1.20–2.55; P < .01) times greater mortality risk, respectively, compared with uninfected people with 0 conditions. HIV-infected and -uninfected people with 3 conditions had 2.15 (95% CI, 1.45–3.20; P < .001) and 1.59 (95% CI, 1.05–2.40; P = .029) times greater mortality risk, respectively, compared with uninfected people with 0 conditions. HIV-infected people with 3 conditions had 1.36 times greater mortality risk (95% CI, 1.07–1.72; P = .013) compared with HIV-uninfected people with 3 conditions.
Abbreviations: CI, confidence interval; HIV-, HIV-uninfected; HIV+, HIV-infected; HR, hazard ratio; VACS Index, Veterans Aging Cohort Study index.
a“Other predictors”: race/ethnicity, education, cardiovascular disease risk factors (hypertension, diabetes, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, and obesity), illicit drug use, post-traumatic stress disorder, prevalent chronic obstructive pulmonary disease, and cardiovascular disease.