High risk of obesity and weight gain for HIV-infected uninsured minorities

Barbara S. Taylor, Yuanyuan Liang, L. Sergio Garduño, Elizabeth A. Walter, Margit B. Gerardi, Gregory M. Anstead, Delia Bullock, Barbara J. Turner

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Background: Obesity and HIV disproportionately affect minorities and have significant health risks, but few studies have examined disparities in weight change in HIV-seropositive (HIV+) cohorts. Objective: To determine racial and health insurance disparities in significant weight gain in a predominately Hispanic HIV+ cohort. Methods: Our observational cohort study of 1214 nonunderweight HIV+ adults from 2007 to 2010 had significant weight gain [≥3% annual body mass index (BMI) increase] as the primary outcome. The secondary outcome was continuous BMI over time. A 4-level race-ethnicity/insurance predictor reflected the interaction between race-ethnicity and insurance: insured white (non-Hispanic), uninsured white, insured minority (Hispanic or black), or uninsured minority. Logistic and mixed-effects models adjusted for baseline BMI, age, gender, household income, HIV transmission category, antiretroviral therapy type, CD4+ count, plasma HIV-1 RNA, observation months, and visit frequency. Results: The cohort was 63% Hispanic and 14% black; 13.3% were insured white, 10.0% uninsured white, 40.9% insured minority, and 35.7% uninsured minority. At baseline, 37.5% were overweight, 22.1% obese. Median observation was 3.25 years. Twenty-four percent of the cohort had significant weight gain, which was more likely for uninsured minority patients than insured whites [adjusted odds ratio = 2.85, 95% confidence intervals (CIs): 1.66 to 4.90]. The rate of BMI increase in mixed-effects models was greatest for uninsured minorities. Of 455 overweight at baseline, 29% were projected to become obese in 4 years. Conclusions and Relevance: In this majority Hispanic HIV+ cohort, 60% were overweight or obese at baseline, and uninsured minority patients gained weight more rapidly. These data should prompt greater attention by HIV providers for prevention of obesity.

Original languageEnglish (US)
Pages (from-to)e33-e40
JournalJournal of Acquired Immune Deficiency Syndromes
Volume65
Issue number2
DOIs
StatePublished - Jan 1 2014

Keywords

  • HIV
  • Health disparities
  • Obesity
  • Observational cohort
  • Weight gain

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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