title: Multimorbidity among people with HIV in regional New South Wales, Australia.
abstract: Background Multimorbidity is the co-occurrence of more than one chronic health condition in addition to HIV. Higher multimorbidity increases mortality, complexity of care and healthcare costs while decreasing quality of life. The prevalence of and factors associated with multimorbidity among HIV positive patients attending a regional sexual health service are described.
  
  
  METHODS
  A record review of all HIV positive patients attending the service between 1 July 2011 and 30 June 2012 was conducted. Two medical officers reviewed records for chronic health conditions and to rate multimorbidity using the Cumulative Illness Rating Scale (CIRS). Univariate and multivariate linear regression analyses were used to determine factors associated with a higher CIRS score.
  
  
  RESULTS
  One hundred and eighty-nine individuals were included in the study; the mean age was 51.8 years and 92.6% were men. One-quarter (25.4%) had ever been diagnosed with AIDS. Multimorbidity was extremely common, with 54.5% of individuals having two or more chronic health conditions in addition to HIV; the most common being a mental health diagnosis, followed by vascular disease. In multivariate analysis, older age, having ever been diagnosed with AIDS and being on an antiretroviral regimen other than two nucleosides and a non-nucleoside reverse transcriptase inhibitor or protease inhibitor were associated with a higher CIRS score.
  
  
  CONCLUSIONS
  To the best of our knowledge, this is the first study looking at associations with multimorbidity in the Australian setting. Care models for HIV positive patients should include assessing and managing multimorbidity, particularly in older people and those that have ever been diagnosed with AIDS.
authors.affiliation: Lismore Sexual Health Service, North Coast Public Health, 4 Shepherd Lane, Lismore, NSW 2480, Australia.
authors.forename: Natalie
authors.initials: N
authors.lastname: Edmiston
authors.affiliation: NSW Ministry of Health, 73 Miller Street, North Sydney, NSW 2060, Australia.
authors.forename: Erin
authors.initials: E
authors.lastname: Passmore
authors.affiliation: Lismore Sexual Health Service, North Coast Public Health, 4 Shepherd Lane, Lismore, NSW 2480, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Smith
authors.affiliation: Kirby Institute for Infection and Immunity in Society, UNSW Australia, Sydney, NSW 2052, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Petoumenos