Author ORCID Identifier

0000-0002-7838-0707

Date of Award

Fall 1-7-2022

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Ike Okosun

Second Advisor

Barbara Yankey

Abstract

ABSTRACT

INTRODUCTION: Over the past years, there has been intense and sustained research interest in diabetes and its relationships with different health conditions and factors. Diabetes is defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Without appropriate intervention, elevated blood glucose levels can cause several metabolic abnormalities and disabling complications such as cardiovascular disease, eye disease, neuropathy, and kidney failure. This study is particularly critical as the United States is among the highest diabetes prevalent nations among developed countries. The concentration of HIV and diabetes in the same subjects makes it essential to examine the magnitude of the burden and the predictors of diabetes among persons living with HIV. Nevertheless, the prevalence of type 2 diabetes among Persons Living With HIV (PLWHIV) and its predictors is not well understood.

AIM: This research was done to determine:

  1. the prevalence of diabetes mellitus among PLWHIV,
  2. odds of Diabetes Mellitus among PLWHIV,
  3. predictors of diabetes among PLWHIV.

METHODS: Participants included 170 HIV-infected cases and 329 controls HIV uninfected. This cross-sectional study utilized the 1999–2018 data from the U.S. National Health and Nutrition Examination Surveys (NHANES).

ANALYSIS: Bivariate and multivariate logistic regression was performed to determine the association between diabetes mellitus and HIV status and estimate predictors of diabetes mellitus among PLWHIV. In the regression model, statistical adjustments were made for socio-demographic factors (age, sex, education, marital status, race/ethnicity, and family income), behavioral factors (smoking, physical activity, and alcohol use), metabolic and clinical factors (cholesterol, body mass index, and high blood pressure).

RESULTS: The mean age of HIV-infected participants was 40.8±9.8 years. HIV-infected subjects were older, male, non-Hispanic blacks, never married, had some college or associate degree, and family income to poverty ratio <5 compared with HIV uninfected controls. Apart from alcohol use, there were significant differences in behavioral factors by HIV status. The prevalence of diabetes mellitus was 7.19% in the HIV-infected group and 4.59% in the control group, but there was no statistically significant difference between those two groups (p-value=0.2294). Controlling for age, gender, race, marital status, family income to poverty ratio, education, smoking at least 100 cigarettes in his life, monthly alcohol use, cholesterol level, obesity, and high blood pressure in the model, those who are HIV positive had a non-significant increased odds of having diabetes than their counterparts (Adjusted Odd Ratio: 1.24, p-value = 0,715, 95% CI: 0.39, 3.90). In this study, increasing age, being married, hypertension, and obesity appear to be predictors of diabetes among persons living with HIV.

CONCLUSION: Overall, the findings showed that the prevalence of type 2 diabetes was higher among PLWHIV compared to HIV uninfected controls, but the difference was not statistically significant. Being infected with HIV was not associated with increased odds of type 2 diabetes. Increasing age, being married, having hypertension, and obesity were found to be predictors of type 2 diabetes among PLWHIV.

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