HIV related stigma, perceived social support and risk of premature atherosclerosis in South Asians

摘要

Objective This study sought to determine the association between social support and stigma experienced by HIV-positive patients and presence of subclinical cardiovascular disease. Methods We implemented a cross sectional study in 67 HIV-positive patients and 52 controls from a community health care center in central India. The participants underwent an in-depth survey and a clinical and laboratory assessment of cardiovascular risk. Carotid-intimal thickness (CIMT) was used as a marker of subclinical cardiovascular disease. Results On comparing the HIV and age and sex-matched control population, HIV patients had lower body weight (P=0.001), and lower systolic blood pressures (P ? = ? 0.002). Despite the lack of higher cardiac risk factor prevalence and lower lipid abnormalities, HIV patients had higher right, left and average CIMT values than controls (P ? ? 0.001 for all). HIV patients also showed higher prevalence of abnormal CIMT (≥ 0.9 ? mm) than controls (32% vs. 0%, P ? 25th percentile value (odds ratio:3.84, P ? = ? 0.037) were independent predictors of the abnormal CIMT. Conclusions HIV-positive patients from central India have a higher prevalence of abnormal CIMT as a marker of subclinical cardiovascular disease than the general population. This predisposition to increased cardiovascular risk may be related to complex interactions between HIV disease and stigma-related healthcare inequalities.