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Priscilla Lee Chu, DrPH , MPH San Francisco Department of Public Health XIX International AIDS Conference July 23, 2012 Washington, DC. Impact of Syndemics on People Living with HIV/AIDS in San Francisco. Introduction: PCSI.

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Priscilla Lee Chu, DrPH, MPH

San Francisco Department of Public Health

XIX International AIDS Conference

July 23, 2012

Washington, DC

Impact of Syndemics on People Living with HIV/AIDS in San Francisco

introduction pcsi
Introduction: PCSI
  • Program Collaboration and Service Integration (PCSI) has prioritized the integrated monitoring of syndemicsamong four communicable disease registries:
    • HIV
    • Tuberculosis
    • Viral Hepatitis
    • STDs
introduction syndemics
Introduction: Syndemics
  • Syndemics are the presence of two or more diseases interacting synergistically to exacerbate health outcomes within a population
introduction purpose
Introduction: Purpose
  • To assess the prevalence of co-occurring infections within the four registries and their impact on persons living with HIV/AIDS (PLWHA)
methods 1 2
Methods 1/2
  • HIV/AIDS cases were matched against seven diseases from three other registries
methods 2 2
Methods 2/2
  • Chi-square, t-test, and Kruskal-Wallis tests were used to assess differences between those with HIV only versus HIV plus at least one co-infection by:
    • Demographics
    • Health status
    • Neighborhood
results syndemics with hiv
Results: Syndemics with HIV
  • HIV N=15,056
  • N=2,050 (14%) with one or more infection in addition to HIV
  • Syndemic rate 13,616 per 100,000 HIV cases
  • Highest co-morbidities: HCV, HBV, Chlamydia, and latent TB
conclusion 1 3
Conclusion 1/3
  • Syndemics are associated with poorer HIV health outcomes among PLWHA
    • Significant “dose-response relationship” between the number of co-infections and mean VLs
conclusion 2 3
Conclusion 2/3
  • In addition to numbers of co-infections, particular demographic subgroups, and certain geo-clusters were also associated with poorer health outcomes, underscoring the need to address multiple conditions in tandem in an integrated health system
thanks acknowledgements
Thanks & Acknowledgements

Glenn-Milo Santos

Annie Vu

Israel Nieves-Rivera

Grant Colfax

Jennifer Grinsdale

Sandra Huang

Susan Philip

Susan Scheer

Tomas Aragon