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Clinical HIV outcome trajectories associated with a history of child protective service out-of-home care: Longitudinal cohort findings with women living with HIV in Canada.
Logie, Carmen H; Sokolovic, Nina; Casale, Andrea; Ndung'u, Mary; Kennedy, V Logan; Underhill, Angela; Fallon, Barbara; Cardinal, Claudette; Webster, Kathleen; Cotnam, Jasmine; Kaida, Angela; de Pokomandy, Alexandra; Loutfy, Mona.
Afiliación
  • Logie CH; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
  • Sokolovic N; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
  • Casale A; Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada.
  • Ndung'u M; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
  • Kennedy VL; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
  • Underhill A; Women's Health in Women's Hands Community Health Centre, Toronto, Ontario, Canada.
  • Fallon B; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
  • Cardinal C; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
  • Webster K; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
  • Cotnam J; BC Centre for Excellence in HIV/AIDS (BC-CFE), Vancouver, British Columbia, Canada.
  • Kaida A; Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
  • de Pokomandy A; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
  • Loutfy M; Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada.
HIV Med ; 2024 May 17.
Article en En | MEDLINE | ID: mdl-38757480
ABSTRACT

OBJECTIVES:

Knowledge gaps exist regarding the effects of experiencing child protective services (CPS) out-of-home care (e.g. foster homes) among women with HIV. We examined whether CPS out-of-home care was associated with HIV clinical outcome trajectories among women with HIV in a longitudinal cohort study in Ontario, British Columbia, and Quebec, Canada.

METHODS:

At three timepoints across 5 years (2013-2018), we examined self-reported current antiretroviral therapy (ART) use and viral load (VL) detectability (>50 copies/mL). We used latent class growth analysis (LCGA) to identify trajectories of ART use and VL outcomes across study waves. LCGA identifies subgroups (classes) with similar trajectories within the sample. We assessed whether HIV outcome trajectories could be predicted by CPS history. We then conducted a mediation analysis to test whether a mental health latent construct mediated the association between CPS history and detectable VL.

RESULTS:

Nearly one-fifth (n = 272; 19%) of participants (n = 1422; mean age 42.8 years) reported CPS out-of-home care. Most participants (89%) were in classes that consistently used ART and had an undetectable VL. Individuals with CPS out-of-home care histories were twice as likely to have a consistently detectable VL (ß = 0.72, p = 0.02); there were no differences in ART use trajectories. In mediation analyses, we found an indirect path from CPS history to a consistently detectable VL via baseline mental health status (ß = 0.02, 95% confidence interval 0.005-0.04, p = 0.02), with a significant odds ratio (1.12, z = 2.43, p = 0.02).

CONCLUSION:

Among women with HIV in Canada, experiencing childhood CPS out-of-home care was associated with a reduced likelihood of achieving viral suppression, via poorer mental health.
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Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: HIV Med Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article País de afiliación: Canadá

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: HIV Med Asunto de la revista: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Año: 2024 Tipo del documento: Article País de afiliación: Canadá