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- W3009806543 abstract "Aging persons living with HIV (PLWH) are a vulnerable population at higher risk for chronic illnesses such as metabolic alterations, diabetes, cardiovascular disease, and cancer. Community and specifically, neighborhood, factors may play a key role in the development of comorbidities. Availability of healthy food stores, physical activity resources, walking/physical activity environment, and neighborhood socioeconomic status have all been individually associated with a higher odds of having ideal cardiovascular health scores. We hypothesized that exposure concentrated disadvantage at the community level impact cardio metabolic outcomes in PLWH. We examined this hypothesis in a cross-sectional analysis of the N ew O rleans A lcohol use in H IV [NOAH] Study of adult PLWH under care (n=365). Hypertension (HTN) was defined as a mean systolic ≥130-139 or diastolic blood pressure ≥80-89 mmHg. Metabolic syndrome (MS) was defined as having 3 of 5 conditions: HTN, low high-density lipoproteins (≤40 (men)/50 (women)), high triglycerides (≥ 150mg/dl), high glucose (≥100 mg/dl), waist circumference >88(women)/102(men). Multivariable logistic regression and multilevel binomial regression analyses were performed adjusting for age, race, smoking, and viral load. The majority of participants were African American (83.6%) with a mean age 48.2 ±10.4, 68.8% male and 31.2% female. MS was prevalent in 36.1%, HTN 66.0%, diabetes 14%, dyslipidemia 28.2%, and 27.4% were obese. There was substantial clustering of cardiometabolic outcomes by neighborhood, with intra-class correlations (ICC) near or greater than 20% for BMI, diabetes, hypertension, and metabolic syndrome. Neighborhood concentrated disadvantage explained a significant proportion of the variance in diabetes (ICC drop from 18% to 8%) and the likelihood of having diabetes increases by 33% for each unit increase in neighborhood concentrated disadvantage (odds ratio = 1.33, 95% CI=1.02, 1.74). Our results suggest a significant role of environmental factors on cardio metabolic comorbidities among PLWH. There is a critical need for a deeper understanding of the roles that social determinants at the community and interpersonal levels play in chronic comorbidities in PLWH. Neighborhoods and social spaces are important contexts through which social determinants act to shape health and health behavior. (Supported by: NIH P60AA009803)" @default.
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- W3009806543 date "2020-03-03" @default.
- W3009806543 modified "2023-10-05" @default.
- W3009806543 title "Abstract P326: Multilevel Analysis Of Concentrated Neighborhood Disadvantage And Cardiometabolic Factors In People Living With Hiv" @default.
- W3009806543 doi "https://doi.org/10.1161/circ.141.suppl_1.p326" @default.
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