Table 2. Factors Associated With Stages of COVID-19 Diagnosis, Hospitalization, and In-Hospital Death Among Persons Living With Diagnosed HIV Infection—New York State, March 1 to June 7, 2020a.
| Characteristic | Population sizeb | Diagnosed | Hospitalized | In-hospital death | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No. | Rate per 1000 PLWDH | Rate ratio (95% CI) | No. | Rate per 1000 diagnoses | Rate ratio (95% CI) | No. | Rate per 1000 hospitalized | Unadjusted rate ratio (95% CI) | ||||
| Unadjusted | Adjustedc | Unadjusted | Adjustedc | |||||||||
| Age, y | ||||||||||||
| <40 | 27 154 | 492 | 18.12 | 1 [Reference] | 1 [Reference] | 62 | 133.50 | 1 [Reference] | 1 [Reference] | 5 | 80.65 | 1 [Reference] |
| 40 to <60 | 53 632 | 1400 | 26.10 | 1.44 (1.30-1.60) | 1.39 (1.24-1.54) | 356 | 253.30 | 2.02 (1.54-2.64) | 1.86 (1.40-2.46) | 68 | 191.01 | 2.92 (1.06-7.99) |
| ≥60 | 27 274 | 1096 | 40.18 | 2.22 (1.99-2.47) | 2.09 (1.86-2.35) | 478 | 441.80 | 3.46 (2.66-4.51) | 3.09 (2.33-4.09) | 134 | 280.33 | 4.41 (1.63-11.92) |
| Sex | ||||||||||||
| Female | 30 331 | 879 | 28.98 | 1.07 (0.99-1.16) | NA | 265 | 300.00 | 1.01 (0.87-1.16) | NA | 66 | 249.06 | 1.12 (0.84-1.50) |
| Male | 77 731 | 2109 | 27.13 | 1 [Reference] | NA | 631 | 299.20 | 1 [Reference] | NA | 141 | 223.45 | 1 [Reference] |
| Region of residence at diagnosis | ||||||||||||
| Long Island | 5709 | 252 | 44.27 | 1.54 (1.36-1.76) | 1.63 (1.42-1.86) | 53 | 212.80 | 0.66 (0.49-0.87) | 0.74 (0.56-0.99) | 13 | 245.28 | 1.02 (0.58-1.78) |
| Mid-Hudson | 6142 | 228 | 37.24 | 1.30 (1.13-1.49) | 1.28 (1.11-1.47) | 46 | 206.70 | 0.63 (0.47-0.85) | 0.65 (0.47-0.89) | 5 | 108.70 | 0.45 (0.19-1.09) |
| New York City | 84 284 | 2409 | 28.58 | 1 [Reference] | 1 [Reference] | 771 | 317.90 | 1 [Reference] | 1 [Reference] | 186 | 241.25 | 1 [Reference] |
| Rest of New York State | 11 916 | 88 | 7.37 | 0.26 (0.21-0.32) | 0.27 (0.22-0.34) | 25 | 270.30 | 0.89 (0.60-1.32) | 0.99 (0.65-1.51) | 3 | 120.00 | 0.50 (0.16-1.56) |
| Race/ethnicity | ||||||||||||
| Non-Hispanic | ||||||||||||
| White | 20 563 | 337 | 16.39 | 1 [Reference] | 1 [Reference] | 86 | 255.20 | 1 [Reference] | 1 [Reference] | 20 | 232.56 | 1 [Reference] |
| Black | 43 143 | 1146 | 26.56 | 1.62 (1.44-1.83) | 1.59 (1.40-1.81) | 364 | 317.60 | 1.25 (0.98-1.57) | 1.15 (0.89-1.48) | 85 | 233.52 | 1.00 (0.62-1.63) |
| Hispanic | 35 914 | 1256 | 34.97 | 2.13 (1.89-2.41) | 2.08 (1.83-2.37) | 371 | 295.40 | 1.16 (0.92-1.46) | 1.11 (0.87-1.43) | 92 | 247.98 | 1.07 (0.66-1.72) |
| Not listed aboved | 8329 | 246 | 29.54 | 1.80 (1.53-2.12) | 1.86 (1.57-2.20) | 75 | 304.90 | 1.20 (0.88-1.63) | 1.20 (0.87-1.66) | 10 | 133.33 | 0.57 (0.27-1.23) |
| HIV transmission risk | ||||||||||||
| Heterosexual | 30 578 | 913 | 29.86 | 1.32 (1.21-1.44) | 1.01 (0.92-1.12) | 257 | 281.50 | 1.19 (1.00-1.42) | 0.98 (0.82-1.16) | 62 | 241.25 | 1.12 (0.78-1.61) |
| IDU | 11 432 | 439 | 38.40 | 1.70 (1.52-1.89) | 1.12 (0.99-1.26) | 190 | 432.80 | 1.83 (1.52-2.21) | 1.13 (0.93-1.37) | 55 | 289.47 | 1.34 (0.92-1.95) |
| MSM | 46 741 | 1059 | 22.66 | 1 [Reference] | 1 [Reference] | 250 | 236.10 | 1 [Reference] | 1 [Reference] | 54 | 216.00 | 1 [Reference] |
| MSM and IDU | 4118 | 130 | 31.57 | 1.39 (1.16-1.67) | 1.16 (0.96-1.39) | 48 | 369.20 | 1.56 (1.15-2.13) | 1.13 (0.83-1.53) | 7 | 145.83 | 0.68 (0.31-1.48) |
| Other | 2324 | 27 | 11.62 | 0.51 (0.35-0.75) | 0.57 (0.39-0.85) | 4 | 148.10 | 0.63 (0.23-1.69) | 0.89 (0.33-2.41) | NA | 0.00 | NA |
| Unknown | 12 869 | 420 | 32.64 | NA | NA | 147 | 350.00 | NA | NA | 29 | 197.28 | NA |
| Receipt of HIV care, previous 12 moe | ||||||||||||
| Yes | 93 704 | 2834 | 30.24 | 1 [Reference] | NA | 844 | 297.80 | 1 [Reference] | NA | 196 | 232.23 | 1 [Reference] |
| No | 14 243 | 154 | 10.81 | 0.36 (0.30-0.42) | NA | 52 | 337.70 | 1.13 (0.86-1.50) | NA | 11 | 211.54 | 0.91 (0.50-1.67) |
| Stage of HIV Infection, at last testf | ||||||||||||
| Stage 1 | 63 712 | 1774 | 27.84 | 1 [Reference] | 1 [Reference] | 437 | 246.30 | 1 [Reference] | 1 [Reference] | 94 | 215.10 | 1 [Reference] |
| Stage 2 | 27 905 | 843 | 30.21 | 1.08 (0.99-1.18) | 1.02 (0.94-1.11) | 298 | 353.50 | 1.44 (1.24-1.66) | 1.29 (1.11-1.49) | 71 | 238.26 | 1.11 (0.81-1.51) |
| Stage 3 | 7498 | 270 | 36.01 | 1.29 (1.14-1.47) | 1.22 (1.07-1.38) | 126 | 466.70 | 1.89 (1.55-2.31) | 1.69 (1.38-2.07) | 34 | 269.84 | 1.26 (0.85-1.86) |
| Other | 8947 | 101 | 11.29 | NA | NA | 35 | 346.50 | NA | NA | 8 | 228.57 | NA |
| Viral suppression, at last testf | ||||||||||||
| Yes | 87 480 | 2628 | 30.04 | 1 [Reference] | NA | 756 | 287.70 | 1 [Reference] | NA | 180 | 238.10 | 1 [Reference] |
| No | 12 027 | 267 | 22.20 | 0.74 (0.65-0.84) | NA | 105 | 393.30 | 1.37 (1.11-1.68) | NA | 21 | 200.00 | 0.84 (0.54-1.32) |
| Other | 8555 | 93 | 10.87 | NA | NA | 35 | 376.30 | NA | NA | 6 | 171.43 | NA |
| Total | 108 062 | 2988 | 27.65 | NA | NA | 896 | 299.87 | NA | NA | 207 | 231.03 | NA |
Abbreviations: COVID-19, coronavirus disease 2019; IDU, injection drug use; MSM, men who have sex with men; NA, not applicable.
Persons with a diagnosis of COVID-19 through June 7, 2020, hospitalized through June 15, 2020.
Persons living with HIV infection diagnosed as of the end of December 2019, per data as of July 2020. Two persons had unknown age, 11 were living in New York State at the time of HIV diagnosis but living out of state at COVID-19 diagnosis, classifying them as out of state for region of residence, 113 had unknown race/ethnicity, 115 had unknown receipt of care status (New York City cases not linkable to the statewide HIV registry). Individuals younger than 18 years are included in the group who are younger than 40 years.
Model adjusted for age, region of residence, race/ethnicity, HIV transmission risk (other includes pediatric, blood products), and stage at last test in the 3 years before March 1, 2020. Viral suppression is not included in multivariable models with stage of HIV infection, since viral suppression is a likely mediator of the association between HIV stage and COVID-19 outcomes.
Includes individuals who identify as Asian, Pacific Islander, Native American, or multiracial. There were insufficient data available to present analyses separately for each group.
Receipt of care status is based on any laboratory report received by the New York State HIV surveillance registry in the 12 months prior to March 1, 2020.
Stage and viral suppression are based on most recent test received by the New York State HIV surveillance registry in the 36 months prior to the study period. Stage of HIV infection was based on the Centers for Disease Control and Prevention case definition for adults and children, where stage 1 is CD4 of 500 cells/mm3 or more or 26% or more of total lymphocytes (aged ≥6 years) or CD4 of 1000 cells/mm3 or more or 30% or more of total lymphocytes (aged 1-5 years); stage 2 is CD4 of 200 to 499 cells/mm3 or 14% to 25% of total lymphocytes (aged ≥6 years) or CD4 of 500 to 999 cells/mm3 or 22% to 29% of total lymphocytes (age 1-5 years); and stage 3 is CD4 less than 200 cells/mm3 or less than 14% of total lymphocytes (aged ≥6 years) and CD4 less than 500 cells/mm3 or less than 22% of total lymphocytes (aged 1-5 years).25 Persons classified as “other” include those out of care for more than 36 months, who have moved out of state, and who have not moved but are receiving care out of state.