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Epidemiology/health services research
Is diabetes prevalence higher among HIV-infected individuals compared with the general population? Evidence from MMP and NHANES 2009–2010
  1. Alfonso C Hernandez-Romieu1,
  2. Shikha Garg2,3,
  3. Eli S Rosenberg1,
  4. Angela M Thompson-Paul4,
  5. Jacek Skarbinski2,3
  1. 1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
  2. 2Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, Georgia, USA
  3. 3Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  4. 4Division of Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
  1. Correspondence to Dr Alfonso C Hernandez-Romieu; alfonso.claudio.hernandez{at}emory.edu

Abstract

Background Nationally representative estimates of diabetes mellitus (DM) prevalence among HIV-infected adults in the USA are lacking, and whether HIV-infected adults are at increased risk of DM compared with the general adult population remains controversial.

Methods We used nationally representative survey (2009–2010) data from the Medical Monitoring Project (n=8610 HIV-infected adults) and the National Health and Nutrition Examination Survey (n=5604 general population adults) and fit logistic regression models to determine and compare weighted prevalences of DM between the two populations, and examine factors associated with DM among HIV-infected adults.

Results DM prevalence among HIV-infected adults was 10.3% (95% CI 9.2% to 11.5%). DM prevalence was 3.8% (CI 1.8% to 5.8%) higher in HIV-infected adults compared with general population adults. HIV-infected subgroups, including women (prevalence difference 5.0%, CI 2.3% to 7.7%), individuals aged 20–44 (4.1%, CI 2.7% to 5.5%), and non-obese individuals (3.5%, CI 1.4% to 5.6%), had increased DM prevalence compared with general population adults. Factors associated with DM among HIV-infected adults included age, duration of HIV infection, geometric mean CD4 cell count, and obesity.

Conclusions 1 in 10 HIV-infected adults receiving medical care had DM. Although obesity contributes to DM risk among HIV-infected adults, comparisons to the general adult population suggest that DM among HIV-infected persons may develop at earlier ages and in the absence of obesity.

  • HIV/Aids
  • Health Disparities
  • National Health Surveys
  • Type 2 Diabetes

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000304

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    Footnotes

    • Contributors ACH-R, SG, and JS had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. ACH-R, SG, ESR, and JS are responsible for study concept and design, analysis and interpretation of data, drafting of the manuscript, and statistical analysis. ACH-R, SG, and JS are responsible for acquisition of data. All authors contributed to critical revision of the manuscript for important intellectual content. JS obtained funding. SG and JS are responsible for administrative, technical, and material support and study supervision.

    • Funding This work was supported and funded by CDC through a Cooperative Agreement (PS09-937) with MMP participating areas.

    • Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement NHANES additional data include biometric, social, and demographic characteristics, and data sets are available to the general public through the Centers for Disease Control and Prevention website. MMP additional data include biometric, social, behavioral, and demographic data and are only available to Centers for Disease Control and Prevention employed in the Clinical and Behavioral Branches of domestic HIV surveillance.