Healthcare services utilization of HIV-positive persons in BC

Project number: 
09-013
Approval date: 
Wednesday, September 28, 2011
Principal Investigator: 
Hogg,Robert
Institution: 
Simon Fraser University (SFU)
Funding Agency: 
Canadian Institutes of Health Research(CIHR),Canadian Institutes of Health Research(CIHR)
Datasets requested: 
bc cancer
Deaths (BC Vital Statistics Agency)
Hospital Separations (BC Ministry of Health)
Consolidation registry (Ministry of Health)
PharmaCare (BC Ministry of Health)
consolidation - census geocodes
PharmaNet
Mental Health (BC Ministry of Health)
Medical Services Plan (BC Ministry of Health)
Consolidation - demographic (Ministry of Health)
Research objective: 

The proposed study has seven objectives:

1. To determine the proportion and clinical and socio-demographic profile of HIV-positive persons accessing and not accessing HAART over the study period; we hypothesize that proportion accessing therapy will increase over the study period.

2. To determine rates of disease progression (defined as AIDS related event and/or death) among persons accessing and not accessing HAART over the study period; we hypothesize that rates of disease progression will be highest amongst those not accessing HAART.

3. To evaluate the use of healthcare services and their direct costs (e.g. physician, laboratory, continuing care, mental health, hospital and pharmacy) of HIV-positive persons accessing and not accessing HAART over the study period; we hypothesize that healthcare service use and costs will be highest amongst those not accessing HAART.

4. To evaluate if healthcare utilization and costs associated with HIV/AIDS have been reduced once an individual starts and remains on HAART over the study period; we hypothesize that those who continue on HAART without interruption will have lower healthcare service use and costs than those who do not.

5. To evaluate the spectrum of medical conditions (e.g. cancer) associated with physician visits and hospitalizations for HIV positive individuals comparing those who are receiving antiretroviral therapy with those who are not on HAART/the general population over the study period; we hypothesize that those not accessing HAART will have greater spectrum of medical conditions associated with physician and hospital visits.

6. To evaluate the socio-demographic profile, the utilization and direct costs of healthcare services, as well as frequency distribution of medical conditions (e.g. cancer) seen among HIV positive individuals when compared with general population; we hypothesize that HIV-positive individuals will have different socio-demographic profile and types of medical conditions, along with higher healthcare service use and higher associated costs than those people in the general population.

7. To evaluate the burden of liver disease in HIV-mono-infected, hepatitis C (HCV)-mono-infected and co-infected individuals, and compared to the general population; we hypothesize that liver disease will represent an important cause of morbidity and mortality among co-infected individuals compared to the general population.

Publications: 

Journal Publication

Academic thesis or dissertation

  • Gali, Brent. HIV AND AGING: AGE-ASSOCIATED CHRONIC COMORBIDITIES AMONG HIV-POSITIVE INDIVIDUALS ON HIGHLY ACTIVE ANTIRETROVIRAL THERAPY IN BRITISH COLUMBIA, CANADA. Thesis. UBC, 2015.

Presentation of research material (poster/seminar/lecture etc.)

  • Raymakers AJN, Marra CA, Sadatsafavi M, FitzGerald JM, Sin DD , Lynd LD. Inhaled corticosteroid (ICS) use in Chronic Obstructive Pulmonary Disease and Lung Cancer diagnosis. Institute for Heart and Lung Health FEST 2014. Vancouver, British Columbia (2014, 7 February). (Poster presentation)

Conference abstract/presentation

  • Kremer, Shahab Jabbari, Oghenowede Eyawo, Conrado Franco-Villalobos, Susan Shurgold, Guillaume Colley, Robert S. Hogg, Julio S. Montaner, Mark W. Hull. Rurality is associated with an increased likelihood of readmission to hospital within 30 days among individuals living with HIV Abstract # EPHP13.05. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • Danielle M. Smith, Conrado Franco-Villalobos, Guillaume Colley, Tareq Ahmed, Oghenowede Eyawo, Mark Hull, Robert Hogg. Incidence and Survival of Non-Small-Cell Lung Cancer Among HIV Positive and HIV Negative Individuals in British Columbia, Canada Abstract # EPHP5.07. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • Kalysha Closson, Chuck Osborne, Sarah Kesselring, Shahab Jabbari, Conrado Franco-Villalobos, Danielle Smith, Tareq Ahmed, Oghenowede Eyawo, Thomas Patterson, Mark Hull, Robert Hogg. Factors Associated with Mood Disorder Diagnosis Among HIV-Positive and HIV-Negative Individuals in British Columbia Abstract # EPHP5.03. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • Sarah Kesselring, Shahab Jabbari, Conrado Franco-Villalobos, Oghenowede Eyawo, Tareq Ahmed, Mark Hull, Robert Hogg. Factors Associated with Incidence of Type 2 Diabetes among HIV-Positive and HIV-Negative British Columbians Abstract # EPHP5.02. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • Brent J. Gali, Shahab Jabbari, Huiting Ma, Oghenowede Eyawo, Viviane Lima, Kimberlyn McGrail, Robert Hogg, David Moore. Impact of Expanded Access to Highly Active Antiretroviral Therapy on Chronic Comorbidities among HIV-Positive individuals in British Columbia Abstract # CSP5.07. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • Katherine J. Lepik, Conrado Franco-Villalobos, Shahab Jabbari, Ryan F. Paterson, Mark W. Hull, Oghenowede Eyawo, Robert S. Hogg, Viviane Dias Lima, Julio S. Montaner, Rolando Barrios. Incidence of renal stones in persons treated with atazanavir versus other antiretrovirals: A population-based study. Abstract # CSP4.02. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • M Hull, L Ti, O Eyawo, et al. Incidence of end-stage liver disease and liver-related mortality in HCV mono-infected vs. HIV/HCV coinfected patients in British Columbia. Abstract # EPH3.1. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • RS. Hogg, J Montaner, O Eyawo, et al. The State of Health: The Impact of Select Comorbidities on Life Expectancy. Abstract # CS3.5. 25th Annual Canadian Conference on HIV/AIDS Research, Winnipeg, Manitoba, May 12-15, 2016
  • Gali, B; Chau, W; Zhang, W; Eyawo, O; Samji, H; Lima, V; McGrail, K; Hogg, RS; Moore, D. Trends of non-HIV chronic comorbidities among HIV-positive individuals on highly active antiretrovial therapy in British Columbia. Abstract WEPEB355. 8th IAS Conference on HIV Pathogenesis, Treatment & Prevention July 19-22, 2015; Vancouver, Canada
  • Eyawo, O; Nohpal, A; Sereda, P; Samji, H; Hull, M; Lima, V; Colley, G; Moore, D; Montaner, JS; Hogg, RS. Shifting mortality rates and cause of death in the combination antiretroviral therapy (ART) era among HIV positive individuals: a comparison with the general population. Abstract O104. 24th Annual Canadian Conference on HIV/AIDS Research April 28-May 3, 2015; Toronto, Canada
  • Hasina Samji, Wendy Zhang, Oghenowede Eyawo, Guillaume Colley, Mark Hull, Julio Montaner, Robert S. Hogg. Elevated Rates of Injury among HIV-Positive Individuals in British Columbia and Differences by Sex. International Workshop on HIV Observational Databases (IWHOD), Sicily. March 26-28, 2015
  • Samji H, Shopin D, Zhang W, et al. Elevated rates of injury among HIV-positive individuals in British Columbia. Abstract 1055. Paper presented at: Conference on Retroviruses and Opportunistic Infections (CROI); February 23-26, 2015; Seattle, USA.
  • Eyawo O, Colley G, Cescon A, et al. Cohort profile: the comparative outcomes and service utilization trends (COAST) study - a comparison between HIV- positive individuals and a random sample of the general population of British Columbia, Canada 1996-2010. Abstract WEPE164. Paper presented at: 20th International AIDS Conference; July 20-25, 2014; Melbourne, Australia.
  • O. Eyawo, K. Chan, D. Shopin, A. Cescon, G. Colley, H. Samji, M. Hull, S.A. Lear, J.S. Montaner, R.S. Hogg. Life expectancy of HIV-positive individuals in the HAART era (1996-2010) compared to life expectancy in the general population: a longitudinal analysis of the COAST cohort from British Columbia (BC), Canada. Abstract MOPE091. 20th International AIDS Conference; July 20-25, 2014; Melbourne, Australia
  • M Hull, R Gustafson, A Cescon, D Shopin, W Zhang, G Colley, O Eyawo, H Samji, RS Hogg, JS Montaner. Elevated healthcare utilization rates amongst HIV-positive individuals preceding diagnosis compared to the general population in British Columbia. Abstract P132. 23rd Annual Canadian Conference on HIV/AIDS Research May 1-4, 2014; St. John's, Canada
  • Hull, M; Cescon, A; Shopin, D; Cui, Z; Colley, G; Eyawo, O; Samji, H; Hogg, RS; Montaner, JS. Incidence of chronic obstructive pulmonary disease and bacterial pneumonias are elevated in HIV-positive individuals compared to the general population in British Columbia. Abstract O040. 23rd Annual Canadian Conference on HIV/AIDS Research May 1-4, 2014; St John's, Canada

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