Room for improvement

The HIV-diabetes care continuum over 15 years in the women's interagency HIV study

Jonathan Colasanti, Karla I. Galaviz, C. Christina Mehta, Kartika Palar, Michael F. Schneider, Phyllis Tien, Adaora A. Adimora, Maria L Alcaide, Mardge H. Cohen, Deborah Gustafson, Roksana Karim, Daniel Merenstein, Anjali Sharma, Gina Wingood, Vincent C. Marconi, Ighovwerha Ofotokun, Mohammed K. Ali

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background. Gains in life expectancy through optimal control of HIV infection with antiretroviral therapy (ART) may be threatened if other comorbidities, such as diabetes, are not optimally managed. Methods. We analyzed cross-sectional data of the Women's Interagency HIV Study (WIHS) from 2001, 2006, and 2015. We estimated the proportions of HIV-positive and HIV-negative women with diabetes who were engaged in care and achieved treatment goals (hemoglobin A1c [A1c] <7.0%, blood pressure [BP] <140/90 mmHg, low-density lipoprotein [LDL] cholesterol <100 mg/dL, not smoking) and viral suppression. Repeated-measures models were used to estimate the adjusted prevalence of achieving each diabetes treatment goal at each time point, by HIV status. Results. We included 486 HIV-positive and 258 HIV-negative women with diabetes. In 2001, 91.8% visited a health care provider, 60.7% achieved the A1c target, 70.5% achieved the BP target, 38.5% achieved the LDL cholesterol target, 49.2% were nonsmokers, 23.3% achieved combined ABC targets (A1c, BP, and cholesterol), and 10.9% met combined ABC targets and did not smoke. There were no differences by HIV status, and patterns were similar in 2006 and 2015. Among HIV-positive women, viral suppression increased from 41% in 2001 to 87% in 2015 compared with 8% and 13% achieving the ABC goals and not smoking. Viral suppression was not associated with achievement of diabetes care goals. Conclusions. Successful management of HIV is outpacing that of diabetes. Future studies are needed to identify factors associated with gaps in the HIV-diabetes care continuum and design interventions to better integrate effective diabetes management into HIV care.

Original languageEnglish (US)
JournalOpen Forum Infectious Diseases
Volume5
Issue number6
DOIs
StatePublished - Jan 1 2018

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Continuity of Patient Care
HIV
Blood Pressure
LDL Cholesterol
Smoking
Life Expectancy
Smoke
Health Personnel
HIV Infections
Comorbidity
Hemoglobins
Therapeutics
Cholesterol

Keywords

  • Care continuum
  • Diabetes
  • HIV
  • Quality

ASJC Scopus subject areas

  • Oncology
  • Clinical Neurology

Cite this

Colasanti, J., Galaviz, K. I., Christina Mehta, C., Palar, K., Schneider, M. F., Tien, P., ... Ali, M. K. (2018). Room for improvement: The HIV-diabetes care continuum over 15 years in the women's interagency HIV study. Open Forum Infectious Diseases, 5(6). https://doi.org/10.1093/ofid/ofy121

Room for improvement : The HIV-diabetes care continuum over 15 years in the women's interagency HIV study. / Colasanti, Jonathan; Galaviz, Karla I.; Christina Mehta, C.; Palar, Kartika; Schneider, Michael F.; Tien, Phyllis; Adimora, Adaora A.; Alcaide, Maria L; Cohen, Mardge H.; Gustafson, Deborah; Karim, Roksana; Merenstein, Daniel; Sharma, Anjali; Wingood, Gina; Marconi, Vincent C.; Ofotokun, Ighovwerha; Ali, Mohammed K.

In: Open Forum Infectious Diseases, Vol. 5, No. 6, 01.01.2018.

Research output: Contribution to journalArticle

Colasanti, J, Galaviz, KI, Christina Mehta, C, Palar, K, Schneider, MF, Tien, P, Adimora, AA, Alcaide, ML, Cohen, MH, Gustafson, D, Karim, R, Merenstein, D, Sharma, A, Wingood, G, Marconi, VC, Ofotokun, I & Ali, MK 2018, 'Room for improvement: The HIV-diabetes care continuum over 15 years in the women's interagency HIV study', Open Forum Infectious Diseases, vol. 5, no. 6. https://doi.org/10.1093/ofid/ofy121
Colasanti, Jonathan ; Galaviz, Karla I. ; Christina Mehta, C. ; Palar, Kartika ; Schneider, Michael F. ; Tien, Phyllis ; Adimora, Adaora A. ; Alcaide, Maria L ; Cohen, Mardge H. ; Gustafson, Deborah ; Karim, Roksana ; Merenstein, Daniel ; Sharma, Anjali ; Wingood, Gina ; Marconi, Vincent C. ; Ofotokun, Ighovwerha ; Ali, Mohammed K. / Room for improvement : The HIV-diabetes care continuum over 15 years in the women's interagency HIV study. In: Open Forum Infectious Diseases. 2018 ; Vol. 5, No. 6.
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abstract = "Background. Gains in life expectancy through optimal control of HIV infection with antiretroviral therapy (ART) may be threatened if other comorbidities, such as diabetes, are not optimally managed. Methods. We analyzed cross-sectional data of the Women's Interagency HIV Study (WIHS) from 2001, 2006, and 2015. We estimated the proportions of HIV-positive and HIV-negative women with diabetes who were engaged in care and achieved treatment goals (hemoglobin A1c [A1c] <7.0{\%}, blood pressure [BP] <140/90 mmHg, low-density lipoprotein [LDL] cholesterol <100 mg/dL, not smoking) and viral suppression. Repeated-measures models were used to estimate the adjusted prevalence of achieving each diabetes treatment goal at each time point, by HIV status. Results. We included 486 HIV-positive and 258 HIV-negative women with diabetes. In 2001, 91.8{\%} visited a health care provider, 60.7{\%} achieved the A1c target, 70.5{\%} achieved the BP target, 38.5{\%} achieved the LDL cholesterol target, 49.2{\%} were nonsmokers, 23.3{\%} achieved combined ABC targets (A1c, BP, and cholesterol), and 10.9{\%} met combined ABC targets and did not smoke. There were no differences by HIV status, and patterns were similar in 2006 and 2015. Among HIV-positive women, viral suppression increased from 41{\%} in 2001 to 87{\%} in 2015 compared with 8{\%} and 13{\%} achieving the ABC goals and not smoking. Viral suppression was not associated with achievement of diabetes care goals. Conclusions. Successful management of HIV is outpacing that of diabetes. Future studies are needed to identify factors associated with gaps in the HIV-diabetes care continuum and design interventions to better integrate effective diabetes management into HIV care.",
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T2 - The HIV-diabetes care continuum over 15 years in the women's interagency HIV study

AU - Colasanti, Jonathan

AU - Galaviz, Karla I.

AU - Christina Mehta, C.

AU - Palar, Kartika

AU - Schneider, Michael F.

AU - Tien, Phyllis

AU - Adimora, Adaora A.

AU - Alcaide, Maria L

AU - Cohen, Mardge H.

AU - Gustafson, Deborah

AU - Karim, Roksana

AU - Merenstein, Daniel

AU - Sharma, Anjali

AU - Wingood, Gina

AU - Marconi, Vincent C.

AU - Ofotokun, Ighovwerha

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N2 - Background. Gains in life expectancy through optimal control of HIV infection with antiretroviral therapy (ART) may be threatened if other comorbidities, such as diabetes, are not optimally managed. Methods. We analyzed cross-sectional data of the Women's Interagency HIV Study (WIHS) from 2001, 2006, and 2015. We estimated the proportions of HIV-positive and HIV-negative women with diabetes who were engaged in care and achieved treatment goals (hemoglobin A1c [A1c] <7.0%, blood pressure [BP] <140/90 mmHg, low-density lipoprotein [LDL] cholesterol <100 mg/dL, not smoking) and viral suppression. Repeated-measures models were used to estimate the adjusted prevalence of achieving each diabetes treatment goal at each time point, by HIV status. Results. We included 486 HIV-positive and 258 HIV-negative women with diabetes. In 2001, 91.8% visited a health care provider, 60.7% achieved the A1c target, 70.5% achieved the BP target, 38.5% achieved the LDL cholesterol target, 49.2% were nonsmokers, 23.3% achieved combined ABC targets (A1c, BP, and cholesterol), and 10.9% met combined ABC targets and did not smoke. There were no differences by HIV status, and patterns were similar in 2006 and 2015. Among HIV-positive women, viral suppression increased from 41% in 2001 to 87% in 2015 compared with 8% and 13% achieving the ABC goals and not smoking. Viral suppression was not associated with achievement of diabetes care goals. Conclusions. Successful management of HIV is outpacing that of diabetes. Future studies are needed to identify factors associated with gaps in the HIV-diabetes care continuum and design interventions to better integrate effective diabetes management into HIV care.

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KW - HIV

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