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Identifying Subgroups of People Living With HIV in British Columbia, Canada Based on Sexually Transmitted and
Amanda M Yonkman1,2, Scott D Emerson1, Paul Sereda1
1BC Center for Excellence in HIV/AIDS Vancouver Canada.
Insights
Latent Class Analysis identified four distinct groups of people living with HIV (PLWH) based on sexually transmitted and blood-borne infection (STBBI) testing and diagnosis patterns. These findings will help tailor interventions for STBBIs in PLWH.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Combination antiretroviral therapy has improved outcomes for people living with HIV (PLWH).
- However, the prevalence of other sexually transmitted and blood-borne infections (STBBIs) is increasing among PLWH.
- Targeted interventions are needed to address rising STBBI rates in this population.
Purpose of the Study:
- To identify distinct subpopulations of PLWH based on their patterns of STBBI lab testing and diagnosis.
- To inform the development of targeted STBBI interventions for PLWH in British Columbia, Canada.
Main Methods:
- Latent Class Analysis was used to analyze lab testing and diagnostic data for gonorrhea, chlamydia, syphilis, hepatitis C virus (HCV), and hepatitis B virus (HBV).
- The study included 9,328 people living with HIV (PLWH) in British Columbia between 2003 and 2020.
- Two-tailed logistic regression was used to compare the demographic compositions of identified classes.
Main Results:
- Four distinct classes of PLWH were identified based on STBBI testing and diagnostic patterns.
- Class 4 exhibited higher testing and diagnosis rates for all studied STBBIs, with a higher proportion of men who have sex with men.
- Demographic compositions varied significantly across the four classes.
Conclusions:
- Latent Class Analysis successfully identified key subpopulations of PLWH with different STBBI testing and diagnosis profiles.
- Understanding these patterns is crucial for informing public health strategies and guiding targeted STBBI interventions.
- A holistic approach to analyzing STBBI data can enhance the effectiveness of interventions for PLWH.
Background And Aims:
Although combination antiretroviral therapy has decreased morbidity and mortality in people living with HIV (PLWH), the prevalence of other sexually transmitted and blood-borne infections (STBBIs) is rising within this population. We used Latent Class Analysis to examine the diverse lab testing and diagnostic patterns of PLWH in British Columbia (BC), Canada to identify subpopulations of PLWH for targeted STBBI interventions.
Methods:
Our study population included all known PLWH with at least one STBBI lab test or diagnosis in BC between December 2003 and March 2020. Lab data were sourced from the BC Center for Excellence in HIV/AIDS Drug Treatment Program. We used Latent Class Analysis to group study participants based on lab testing and diagnostic data for gonorrhea, chlamydia, syphilis, hepatitis C virus (HCV), and hepatitis B virus (HBV). To compare the demographic compositions of each class, we used two-tailed logistic regression.
Results:
We assigned 9,328 study participants to one of four classes. The 2029 participants assigned to Class 1 (21.7% of our study population) tested for syphilis and HCV, with few diagnoses. Those in Class 2 (n = 2868; 30.7%) tested for HBV, HCV, and syphilis, with some being diagnosed with HCV and HBV. Class 3, the largest group (n = 3154; 33.8%), tested for all STBBIs but had few diagnoses. Finally, Class 4 (n = 1279; 13.7%) had higher testing and diagnoses for all STBBIs. Demographic composition varied significantly between classes; for example, participants in Class 4 had 7.42 times greater odds of being men who have sex with men compared to those in Class 1 (95% CI: 6.20-8.89).
Conclusions:
We identified key subpopulations of PLWH based on STBBI testing and diagnosis. By taking a holistic approach and studying overall patterns in STBBI lab data, this work will help inform public health efforts and guide interventions targeting STBBIs.
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