Risk Factors for HIV Disease Progression in a Rural Southwest American Indian Population

Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (Als) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural Al community. Methods. From January 20...

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Published inPublic health reports (1974) Vol. 125; no. 4_suppl; pp. 43 - 50
Main Authors Iralu, Jonathan, Duran, Bonnie, Pearson, Cynthia R., Jiang, Yizhou, Foley, Kevin, Harrison, Melvin
Format Journal Article
LanguageEnglish
Published Los Angeles, CA Association of Schools of Public Health 01.07.2010
SAGE Publications
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Abstract Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (Als) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural Al community. Methods. From January 2004 through December 2006, we interviewed 36 HIV-positive Als regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Results. Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of <$ 1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p< 0.05), household income of <$1,000/month(p<0.05), and provider-assessed alcohol abuse (p<0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p<0.05) and use of traditional medicine (p<0.05). Conclusions. Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural Al population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.
AbstractList Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural AI community. Methods. From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4–cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Results. Participant characteristics included being male (58.3%), being trans-gender (13.9%), having ever been incarcerated (63.9%), having a household income of <$1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p<0.05), household income of <$1,000/month (p<0.05), and provider-assessed alcohol abuse (p<0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p<0.05) and use of traditional medicine (p<0.05). Conclusions. Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.
Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural Al community. From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of $1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p0.05), household income of $1,000/month (p0.05), and provider-assessed alcohol abuse (p0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p0.05) and use of traditional medicine (p0.05). Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners. [PUBLICATION ABSTRACT]
Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural AI community. From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of < $1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p < 0.05), household income of < $1,000/month (p < 0.05), and provider-assessed alcohol abuse (p < 0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p < 0.05) and use of traditional medicine (p < 0.05). Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.
Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural Al community. From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of <$1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p<0.05), household income of <$1,000/month (p<0.05), and provider-assessed alcohol abuse (p<0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p<0.05) and use of traditional medicine (p<0.05). Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners. [PUBLICATION ABSTRACT]
Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (Als) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural Al community. Methods. From January 2004 through December 2006, we interviewed 36 HIV-positive Als regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Results. Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of <$ 1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p< 0.05), household income of <$1,000/month(p<0.05), and provider-assessed alcohol abuse (p<0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p<0.05) and use of traditional medicine (p<0.05). Conclusions. Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural Al population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.
Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural AI community. Methods. From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome. Results. Participant characteristics included being male (58.3%), being trans-gender (13.9%), having ever been incarcerated (63.9%), having a household income of <$1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p <0.05), household income of <$1,000/month (p <0.05), and provider-assessed alcohol abuse (p <0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p <0.05) and use of traditional medicine (p <0.05). Conclusions. Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.
Author Iralu, Jonathan
Foley, Kevin
Harrison, Melvin
Jiang, Yizhou
Pearson, Cynthia R.
Duran, Bonnie
AuthorAffiliation b Division of Global Health Equity, Brigham Women's Hospital/Harvard Medical School, Boston, MA
a Gallup Indian Medical Center, Navajo Area Indian Health Service, Gallup, NM
d Indigenous Wellness Research Institute, School of Social Work, University of Washington, Seattle, WA
e Department of Mathematics and Statistics, University of New Mexico, Albuquerque, NM
f Na'nizhoozhi Center, Inc., Gallup, NM
c School of Public Health, University of Washington, Seattle, WA
g Navajo AIDS Network, Inc., Chinle, AZ
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bibr14-00333549101250S408
bibr9-00333549101250S408
Maruschak LM (bibr20-00333549101250S408) 2004
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(bibr2-00333549101250S408) 1994; 43
Rowell R (bibr5-00333549101250S408) 2002
bibr21-00333549101250S408
Schneider E (bibr17-00333549101250S408) 2008; 57
bibr22-00333549101250S408
Berman BM (bibr30-00333549101250S408) 1995; 8
bibr23-00333549101250S408
bibr4-00333549101250S408
bibr1-00333549101250S408
National Alliance of State and Territorial AIDS Directors (bibr8-00333549101250S408) 2004
bibr29-00333549101250S408
Freeman C (bibr13-00333549101250S408) 2005
Middleton AE (bibr28-00333549101250S408) 1922; 19
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Snippet Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (Als) have been poorly characterized. We assessed...
Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed...
Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of...
Objectives. Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed...
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StartPage 43
SubjectTerms Adhesion
AIDS
Alcohol
Alcohol abuse
Alcoholic beverages
Alcoholism
American Indians
Bivariate analysis
CD4 antigen
CD4 Lymphocyte Count
Collaboration
Criminal punishment
Data collection
Data processing
Disease Progression
Drug abuse
Economic factors
Family income
Female
Folk medicine
Gender
Healing
HIV
HIV Infections - economics
HIV Infections - ethnology
HIV Infections - therapy
Household income
Human immunodeficiency virus
Human immunodeficiency virus 1
Humans
Imprisonment
Income
Indians, North American
Male
Mathematical models
Medication Adherence
Medicine
Medicine, Traditional - utilization
Native Americans
Native North Americans
Prisoners
Public health
Regression analysis
Risk analysis
Risk assessment
Risk Factors
Rural areas
Rural communities
Rural Population
Social factors
Socioeconomic factors
Southwestern United States
Traditional medicine
Viral Load
Viruses
Title Risk Factors for HIV Disease Progression in a Rural Southwest American Indian Population
URI https://www.jstor.org/stable/41434919
https://journals.sagepub.com/doi/full/10.1177/00333549101250S408
https://www.ncbi.nlm.nih.gov/pubmed/20626192
https://www.proquest.com/docview/1905536494
https://www.proquest.com/docview/577577436
https://search.proquest.com/docview/888097388
https://pubmed.ncbi.nlm.nih.gov/PMC2882974
Volume 125
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