title: Prevalence and Predictors of Hospitalizations Among HIV-Infected and At-Risk HIV-Uninfected Women.
abstract: We evaluated the Veterans Aging Cohort Study (VACS) Index score, an index composed of age, CD4 count, viral load, hemoglobin, Hepatitis C coinfection, Fibrosis Index-4, and estimated glomerular filtration rate, and psychosocial and clinical risk factors for all-cause hospitalization among HIV-infected women on highly active antiretroviral therapy and HIV-uninfected women.
  
  
  
  Data were collected from 2008 to 2014 from 1585 highly active antiretroviral therapy-experienced HIV infected and 692 uninfected women. Cox proportional hazards regression evaluated predictors of first hospitalization over 2 years.
  
  
  
  Among HIV-infected women, VACS Index score (per 5 points) [adjusted hazard ratio (aHR) 1.08; 95% confidence interval (CI): 1.06 to 1.11], Centers for Epidemiologic Studies-Depression (CESD) scores ≥16 (aHR 1.61; 95% CI: 1.30 to 1.99), smoking (aHR 1.26; 95% CI: 1.02 to 1.55), abuse history (aHR 1.52; 95% CI: 1.20 to 1.93), diabetes (aHR 1.63; 95% CI: 1.31 to 2.04), and black race (aHR 1.28; 95% CI: 1.03 to 1.59) increased risk of hospitalization. Among HIV-uninfected women, VACS Index score (aHR 1.08; 95% CI: 1.03 to 1.13), CESD scores ≥16 (aHR 1.38; 95% CI: 1.02 to 1.86), diabetes (aHR 2.15; 95% CI: 1.57 to 2.95), and black race (aHR 1.61; 95% CI: 1.15 to 2.24) predicted subsequent hospitalization.
  
  
  
  Psychosocial and clinical factors were associated with risk of hospitalization independently of the VACS Index score. Additional research on contextual and psychosocial influences on health outcomes among women is needed.
authors.affiliation: *The CORE Center, Cook County Health and Hospitals System, Chicago, IL; †Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL; ‡Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY; §Division of Biostatistics, University of California San Francisco, San Francisco, CA; ‖Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; ¶Downstate Medical Center, State University of New York, Brooklyn, NY; #City of Hope National Medical Center, Duarte, CA and the Keck School of Medicine, University of Southern California, Los Angeles, CA; **Division of Infectious Diseases, Georgetown University Medical Center, Washington, DC; and ††Departments of Medicine, Stroger Hospital and Rush University Medical Center, Chicago, IL.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Hotton
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Weber
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Hershow
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.forename: Peter
authors.initials: P
authors.lastname: Bacchetti
authors.forename: Elizabeth T
authors.initials: ET
authors.lastname: Golub
authors.forename: Deborah
authors.initials: D
authors.lastname: Gustafson
authors.forename: Alexandra M
authors.initials: AM
authors.lastname: Levine
authors.forename: Mary
authors.initials: M
authors.lastname: Young
authors.forename: Mardge H
authors.initials: MH
authors.lastname: Cohen
mesh_terms: D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D009519:New York City / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D016016:Proportional Hazards Models; D019562:Viral Load / Q000187:drug effects*