TY - JOUR
T1 - Associations of County-Level Social Determinants of Health with COVID-19 Related Hospitalization Among People with HIV
T2 - A Retrospective Analysis of the U.S. National COVID Cohort Collaborative (N3C)
AU - The N3C Consortium
AU - Islam, Jessica Y.
AU - Hurwitz, Eric
AU - Li, Dongmei
AU - Camacho-Rivera, Marlene
AU - Sun, Jing
AU - Safo, Sandra
AU - Ross, Jennifer M.
AU - Wilkins, Kenneth
AU - Hassan, Shukri
AU - Hill, Elaine L.
AU - Nosyk, Bohdan
AU - Varley, Cara
AU - Fadul, Nada
AU - Madlock-Brown, Charisse
AU - Patel, Rena C.
AU - Vedula, Satyanarayana
AU - Saha, Amit
AU - Mattapally, Saidulu
AU - Mariona, Federico
AU - Koraishy, Farrukh M.
AU - Hernandez, Wenndy
AU - Harper, Jeremy Richard
AU - Bramante, Carolyn
AU - Walden, Anita
AU - Volz, Andréa M.
AU - McMurry, Julie A.
AU - Chute, Christopher G.
AU - Suver, Christine
AU - Saltz, Mary Morrison
AU - Qureshi, Nabeel
AU - Manna, Amin
AU - Girvin, Andrew T.
AU - Bradwell, Katie Rebecca
AU - Bissell, Mark M.
AU - Temple-O’Connor, Meredith
AU - Rutter, Joni L.
AU - Michael, Sam G.
AU - Kurilla, Michael G.
AU - Garbarini, Nicole
AU - Deacy, Mariam
AU - Bozzette, Samuel
AU - Austin, Christopher P.
AU - Zampino, Elizabeth
AU - Sheikh, Usman
AU - O’Neil, Shawn T.
AU - Neumann, Andrew J.
AU - Graves, Alexis
AU - Fuentes, Rafael
AU - Francis, Patricia A.
AU - Dillon, Thomas
AU - Dietz, Racquel R.
AU - Dest, Alexandra
AU - Cook, Connor
AU - Chae, Yooree
AU - Walters, Kellie M.
AU - Palchuk, Matvey B.
AU - Morris, Michele
AU - Miller, Robert T.
AU - Lee, Adam M.
AU - Kostka, Kristin
AU - Hong, Stephanie S.
AU - Clark, Marshall
AU - Amor, Benjamin
AU - Pfaff, Emily R.
AU - Zhu, Richard L.
AU - Zhang, Xiaohan Tanner
AU - Moffitt, Richard A.
AU - Lehmann, Harold P.
AU - Gabriel, Davera
AU - Wu, Chunlei
AU - Williams, Andrew E.
AU - Wilcox, Adam B.
AU - Starren, Justin
AU - Spratt, Heidi
AU - Saltz, Joel H.
AU - Robinson, Peter N.
AU - Payne, Philip R.O.
AU - Liu, Hongfang
AU - Kibbe, Warren A.
AU - Guinney, Justin
AU - Eichmann, David A.
AU - Bennett, Tellen D.
AU - Gersing, Kenneth R.
AU - Haendel, Melissa A.
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/10
Y1 - 2024/10
N2 - Individually, the COVID-19 and HIV pandemics have differentially impacted minoritized groups due to the role of social determinants of health (SDoH) in the U.S. Little is known how the collision of these two pandemics may have exacerbated adverse health outcomes. We evaluated county-level SDoH and associations with hospitalization after a COVID-19 diagnosis among people with (PWH) and without HIV (PWOH) by racial/ethnic groups. We used the U.S. National COVID Cohort Collaborative (January 2020-November 2023), a nationally-sampled electronic health record repository, to identify adults who were diagnosed with COVID-19 with HIV (n = 22,491) and without HIV (n = 2,220,660). We aggregated SDoH measures at the county-level and categorized racial/ethnic groups as Non-Hispanic (NH) White, NH-Black, Hispanic/Latinx, NH-Asian and Pacific Islander (AAPI), and NH-American Indian or Alaskan Native (AIAN). To estimate associations of county-level SDoH with hospitalization after a COVID-19 diagnosis, we used multilevel, multivariable logistic regressions, calculating adjusted relative risks (aRR) with 95% confidence intervals (95% CI). COVID-19 related hospitalization occurred among 11% of PWH and 7% of PWOH, with the highest proportion among NH-Black PWH (15%). In evaluating county-level SDoH among PWH, we found higher average household size was associated with lower risk of COVID-19 related hospitalization across racial/ethnic groups. Higher mean commute time (aRR: 1.76; 95% CI 1.10–2.62) and higher proportion of adults without health insurance (aRR: 1.40; 95% CI 1.04–1.84) was associated with a higher risk of COVID-19 hospitalization among NH-Black PWH, however, NH-Black PWOH did not demonstrate these associations. Differences by race and ethnicity exist in associations of adverse county-level SDoH with COVID-19 outcomes among people with and without HIV in the U.S.
AB - Individually, the COVID-19 and HIV pandemics have differentially impacted minoritized groups due to the role of social determinants of health (SDoH) in the U.S. Little is known how the collision of these two pandemics may have exacerbated adverse health outcomes. We evaluated county-level SDoH and associations with hospitalization after a COVID-19 diagnosis among people with (PWH) and without HIV (PWOH) by racial/ethnic groups. We used the U.S. National COVID Cohort Collaborative (January 2020-November 2023), a nationally-sampled electronic health record repository, to identify adults who were diagnosed with COVID-19 with HIV (n = 22,491) and without HIV (n = 2,220,660). We aggregated SDoH measures at the county-level and categorized racial/ethnic groups as Non-Hispanic (NH) White, NH-Black, Hispanic/Latinx, NH-Asian and Pacific Islander (AAPI), and NH-American Indian or Alaskan Native (AIAN). To estimate associations of county-level SDoH with hospitalization after a COVID-19 diagnosis, we used multilevel, multivariable logistic regressions, calculating adjusted relative risks (aRR) with 95% confidence intervals (95% CI). COVID-19 related hospitalization occurred among 11% of PWH and 7% of PWOH, with the highest proportion among NH-Black PWH (15%). In evaluating county-level SDoH among PWH, we found higher average household size was associated with lower risk of COVID-19 related hospitalization across racial/ethnic groups. Higher mean commute time (aRR: 1.76; 95% CI 1.10–2.62) and higher proportion of adults without health insurance (aRR: 1.40; 95% CI 1.04–1.84) was associated with a higher risk of COVID-19 hospitalization among NH-Black PWH, however, NH-Black PWOH did not demonstrate these associations. Differences by race and ethnicity exist in associations of adverse county-level SDoH with COVID-19 outcomes among people with and without HIV in the U.S.
KW - Access to care
KW - Area-level
KW - COVID-19 hospitalization
KW - County-level
KW - HIV
KW - Pandemic
KW - Race and ethnicity
KW - SARS-CoV-2 infection
KW - Social determinants of health
UR - http://www.scopus.com/inward/record.url?scp=85204205373&partnerID=8YFLogxK
U2 - 10.1007/s10461-024-04466-0
DO - 10.1007/s10461-024-04466-0
M3 - Article
C2 - 39292319
AN - SCOPUS:85204205373
SN - 1090-7165
VL - 28
SP - 136
EP - 148
JO - AIDS and Behavior
JF - AIDS and Behavior
IS - Suppl 1
ER -