Changing contextual factors from baseline to 9-months post-HIV diagnosis predict 5-year mortality in Durban, South Africa. Bassett, I. V., Xu, A., Giddy, J., Bogart, L. M., Boulle, A., Millham, L., Losina, E., & Parker, R. A. AIDS Care, 33(12):1543–1550, Taylor & Francis, nov, 2021. ![Changing contextual factors from baseline to 9-months post-HIV diagnosis predict 5-year mortality in Durban, South Africa [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper doi abstract bibtex Changes in an individual's contextual factors following HIV diagnosis may influence long-term outcomes. We evaluated how changes to contextual factors between HIV diagnosis and 9-month follow-up predict 5-year mortality among HIV-infected individuals in Durban, South Africa enrolled in the Sizanani Trial (NCT01188941). We used random survival forests to identify 9-month variables and changes from baseline predictive of time to mortality. We incorporated these into a Cox proportional hazards model including age, sex, and starting ART by 9 months a priori, 9-month social support and competing needs, and changes in mental health between baseline and 9 months. Among 1,154 participants with South African ID numbers, 900 (78%) had baseline and 9-month data available of whom 109 (12%) died after 9-month follow-up. Those who reported less social support at 9 months had a 16% higher risk of mortality. Participants who went without basic needs or healthcare at 9 months had a 2.6 times higher hazard of death compared to participants who did not. Low social support and competing needs at 9-month follow-up substantially increase long-term mortality risk. Reassessing contextual factors during follow-up and targeting interventions to increase social support and affordability of care may reduce long-term mortality for HIV-infected individuals in South Africa. ARTICLE HISTORY
@article{Bassett2020,
abstract = {Changes in an individual's contextual factors following HIV diagnosis may influence long-term outcomes. We evaluated how changes to contextual factors between HIV diagnosis and 9-month follow-up predict 5-year mortality among HIV-infected individuals in Durban, South Africa enrolled in the Sizanani Trial (NCT01188941). We used random survival forests to identify 9-month variables and changes from baseline predictive of time to mortality. We incorporated these into a Cox proportional hazards model including age, sex, and starting ART by 9 months a priori, 9-month social support and competing needs, and changes in mental health between baseline and 9 months. Among 1,154 participants with South African ID numbers, 900 (78{\%}) had baseline and 9-month data available of whom 109 (12{\%}) died after 9-month follow-up. Those who reported less social support at 9 months had a 16{\%} higher risk of mortality. Participants who went without basic needs or healthcare at 9 months had a 2.6 times higher hazard of death compared to participants who did not. Low social support and competing needs at 9-month follow-up substantially increase long-term mortality risk. Reassessing contextual factors during follow-up and targeting interventions to increase social support and affordability of care may reduce long-term mortality for HIV-infected individuals in South Africa. ARTICLE HISTORY},
author = {Bassett, Ingrid V. and Xu, Ai and Giddy, Janet and Bogart, Laura M. and Boulle, Andrew and Millham, Lucia and Losina, Elena and Parker, Robert A.},
doi = {10.1080/09540121.2020.1837338},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Bassett et al. - 2021 - Changing contextual factors from baseline to 9-months post-HIV diagnosis predict 5-year mortality in Durban, Sou.pdf:pdf},
issn = {0954-0121},
journal = {AIDS Care},
keywords = {HIV infection,South Africa,fund{\_}not{\_}ack,mortality,original,predictors of mortality},
mendeley-tags = {fund{\_}not{\_}ack,original},
month = {nov},
number = {12},
pages = {1543--1550},
pmid = {33138630},
publisher = {Taylor {\&} Francis},
title = {{Changing contextual factors from baseline to 9-months post-HIV diagnosis predict 5-year mortality in Durban, South Africa}},
url = {https://www.tandfonline.com/doi/full/10.1080/09540121.2020.1837338},
volume = {33},
year = {2021}
}
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We incorporated these into a Cox proportional hazards model including age, sex, and starting ART by 9 months a priori, 9-month social support and competing needs, and changes in mental health between baseline and 9 months. Among 1,154 participants with South African ID numbers, 900 (78%) had baseline and 9-month data available of whom 109 (12%) died after 9-month follow-up. Those who reported less social support at 9 months had a 16% higher risk of mortality. Participants who went without basic needs or healthcare at 9 months had a 2.6 times higher hazard of death compared to participants who did not. Low social support and competing needs at 9-month follow-up substantially increase long-term mortality risk. Reassessing contextual factors during follow-up and targeting interventions to increase social support and affordability of care may reduce long-term mortality for HIV-infected individuals in South Africa. 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