Co-morbid Non-communicable Diseases and Associated Health Service Use in African and Caribbean Immigrants with HIV |
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| Authors: | Khatundi-Irene Masindi Nathaniel Jembere Claire E Kendall Sean B Rourke Tony Antoniou |
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| Institution: | 1.Department of Family and Community Medicine,St. Michael’s Hospital,Toronto,Canada;2.Institute for Clinical Evaluative Sciences,Toronto,Canada;3.Department of Family Medicine,University of Ottawa,Ottawa,Canada;4.CT Lamont Primary Health Care Research Centre,Bruyere Research Institute,Ottawa,Canada;5.Ottawa Hospital Research Institute,Ottawa,Canada;6.Dalla Lana School of Public Health,University of Toronto,Toronto,Canada;7.Toronto General Hospital Research Institute,University Health Network,Toronto,Canada;8.Li Ka Shing Knowledge Institute,St. Michael’s Hospital,Toronto,Canada;9.Centre for Urban Health Solutions,St. Michael’s Hospital,Toronto,Canada;10.Institute of Health Policy, Management and Evaluation,University of Toronto,Toronto,Canada;11.Department of Medicine,University of Toronto,Toronto,Canada;12.Women’s College Research Institute,Women’s College Hospital,Toronto,Canada;13.Ontario HIV Treatment Network,Toronto,Canada;14.Department of Psychiatry,University of Toronto,Toronto,Canada |
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| Abstract: | We sought to characterize non-communicable disease (NCD)-related and overall health service use among African and Caribbean immigrants living with HIV between April 1, 2010 and March 31, 2013. We conducted two population-based analyses using Ontario’s linked administrative health databases. We studied 1525 persons with HIV originally from Africa and the Caribbean. Compared with non-immigrants with HIV (n?=?11,931), African and Caribbean immigrants had lower rates of hospital admissions, emergency department visits and non-HIV specific ambulatory care visits, and higher rates of health service use for hypertension and diabetes. Compared with HIV-negative individuals from these regions (n?=?228,925), African and Caribbean immigrants with HIV had higher rates of health service use for chronic obstructive pulmonary disease rate ratio (RR) 1.78; 95% confidence interval (CI) 1.36–2.34] and malignancy (RR 1.20; 95% CI 1.19–1.43), and greater frequency of hospitalizations for mental health illness (RR 3.33; 95% CI 2.44–4.56), diabetes (RR 1.37; 95% CI 1.09–1.71) and hypertension (RR 1.85; 95% CI 1.46–2.34). African and Caribbean immigrants with HIV have higher rates of health service use for certain NCDs than non-immigrants with HIV. The evaluation of health services for African and Caribbean immigrants with HIV should include indicators of NCD care that disproportionately affect this population. |
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