Poor HIV-related outcomes in older adults newly diagnosed with HIV: A 4-year retrospective analysis from a single site in Asia

Wong, Hoi Yee and Wong, Pui Li and Bador, Maria Kahar and Chong, Meng Li and Shenoi, Sheela and Rozanova, Julia and Syed Omar, Sharifah Faridah and Neelamegam, Malinee and Lee, Yew Kong and Rajasuriar, Reena (2023) Poor HIV-related outcomes in older adults newly diagnosed with HIV: A 4-year retrospective analysis from a single site in Asia. Journal of Acquired Immune Deficiency Syndromes, 93 (1). pp. 64-72. ISSN 1525-4135, DOI https://doi.org/10.1097/QAI.0000000000003169.

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Background:In resource-limited settings, HIV-related services are often targeted to younger key populations, although increasing reports have found that adults >= 50 years now account for among the highest increase in new HIV diagnosis. We assessed the proportion of new HIV infections among older adults (>= 50 years) and compared their sociodemographics, risk behaviors, and HIV-related outcomes to newly diagnosed younger adults (<50 years).Methods:This retrospective analysis included all new HIV diagnosis from 2016 to 2019 at the University of Malaya Medical Centre, Malaysia. Trends of HIV diagnosis was assessed using join point regression analysis, and characteristics between the older and younger adults were compared using chi(2) test or Mann-Whitney U test. Kaplan-Meier analysis and log-rank test were used to compare the survival probability in both age groups.Results:From a total of 594 new HIV diagnosis between 2016 and 2019, 11.5% (N = 68) were among older adults with an annual percent increase of 5.50%. Older adults were more likely ethnic Indians (P < 0.001), acquired HIV through heterosexual contact (P = 0.001), had late presentation to care (P = 0.003), and multimorbidity (P < 0.001). Immunological responses after 12 months on antiretroviral therapy were comparable in both the groups. Older adults had a higher probability of death compared with younger adults (adjusted hazard ratio 1.81, 95% confidence interval: 1.02 to 3.23, P = 0.043) after adjusting for sex, mode of HIV transmission, late presentation to care, antiretroviral therapy initiation, and multimorbidity.Conclusion:Older adults diagnosed with HIV were associated with late care presentation and increased mortality. There is an urgent need to enhance uptake of HIV testing and linkage to care among older individuals in our setting.

Item Type: Article
Funders: None
Uncontrolled Keywords: HIV; AIDS; New diagnosis; Older adults; Aging population; Asia
Subjects: H Social Sciences > HQ The family. Marriage. Woman
H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine
Faculty of Medicine > Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 27 Nov 2023 08:32
Last Modified: 03 Dec 2023 01:40
URI: http://eprints.um.edu.my/id/eprint/38260

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