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 in | Public health reports (1974) Vol. 125; no. 4_suppl; pp. 43 - 50 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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Los Angeles, CA
Association of Schools of Public Health
01.07.2010
SAGE Publications SAGE PUBLICATIONS, INC |
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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. |
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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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CitedBy_id | crossref_primary_10_1007_s11904_015_0285_5 crossref_primary_10_1007_s11904_011_0093_5 crossref_primary_10_2105_AJPH_2013_301746 crossref_primary_10_1177_2380084419871904 crossref_primary_10_1007_s10461_018_2372_2 crossref_primary_10_1007_s10461_021_03551_y crossref_primary_10_1177_00333549101250S401 crossref_primary_10_1080_19359705_2021_1913462 crossref_primary_10_1186_s13722_017_0088_7 crossref_primary_10_1186_s12889_015_2084_8 crossref_primary_10_1177_0033354920970947 crossref_primary_10_2188_jea_JE20110058 crossref_primary_10_1007_s10461_015_1023_0 crossref_primary_10_1016_j_amepre_2022_03_023 |
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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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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 |
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