Co-morbid Non-communicable Diseases and Associated Health Service Use in African and Caribbean Immigrants with HIV

Journal of Immigrant and Minority Health
Volume 20, Issue 3, 2018, Pages 536-545

Co-morbid Non-communicable Diseases and Associated Health Service Use in African and Caribbean Immigrants with HIV (Article)

Masindi K.-I. , Jembere N. , Kendall C.E. , Burchell A.N. , Bayoumi A.M. , Loutfy M. , Raboud J. , Rourke S.B. , Luyombya H. , Antoniou T.*

^a Department of Family and Community Medicine, St. Michael’s Hospital, 410 Sherbourne Street, Toronto, ON M4X 1K2, Canada
^b Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
^c Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada, CT Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, ON, Canada, Ottawa Hospital Research Institute, Ottawa, ON, Canada
^d Department of Family and Community Medicine, St. Michael’s Hospital, 410 Sherbourne Street, Toronto, ON M4X 1K2, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
^e Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada, Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
^f Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada, Department of Medicine, University of Toronto, Toronto, ON, Canada, Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada
^g Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada, Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
^h Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada, Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada, Ontario HIV Treatment Network, Toronto, ON, Canada, Department of Psychiatry, University of Toronto, Toronto, ON, Canada
ⁱ Ontario HIV Treatment Network, Toronto, ON, Canada
^j Department of Family and Community Medicine, St. Michael’s Hospital, 410 Sherbourne Street, Toronto, ON M4X 1K2, Canada, Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

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. © 2017, Springer Science+Business Media, LLC, part of Springer Nature.

Author Keywords

Caribbean immigrants Co-morbid disease African Non-communicable diseases HIV

Index Keywords

West Indies HIV Infections Human immunodeficiency virus infection human comorbidity middle aged statistics and numerical data Aged Databases, Factual factual database ethnology Young Adult Humans migrant Adolescent male Emigrants and Immigrants female Africa Ontario adult patient attitude Patient Acceptance of Health Care non communicable disease Noncommunicable Diseases Caribbean Islands

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85037610460&doi=10.1007%2fs10903-017-0681-6&partnerID=40&md5=ce429fa586ef9b9f64ea2f36aee2a25c

DOI: 10.1007/s10903-017-0681-6

ISSN: 15571912

Cited by: 1

Original Language: English