Prevalence and risk factors of comorbidities among Chinese older people living with HIV/AIDS: a cross-sectional study

Abstract

With population aging among people living with HIV/AIDS (PLWHA), comorbidity has become a prominent challenge for long-term care. However, evidence on its prevalence and associated factors in Chinese community settings remains limited. We conducted a cross-sectional study among PLWHA aged ≥ 50 years receiving routine follow-up care in Wenjiang District, Chengdu, China, from May 1 to December 31, 2024. Comorbidity was defined as at least one non-HIV chronic condition, ascertained by integrating self-reported physician diagnoses with routinely collected data. Primary data from questionnaires and physical examinations were supplemented with routinely collected data, including health insurance claims and HIV follow-up records. Comorbidity prevalence was estimated, and multivariable logistic regression was used to identify associated factors. Among 206 participants, the mean age was 61.9 years and 72.3% were male. Overall, 82 participants (39.8%) had at least one comorbidity and 32 (15.5%) had two or more. Hypertension and diabetes were the most common conditions. Among participants with elevated blood pressure, 73.2% had no prior hypertension diagnosis. Older age (adjusted odds ratio [aOR] 1.09, 95% CI 1.04 to 1.14), abdominal obesity (aOR 3.30, 95% CI 1.60 to 7.03), and anxiety symptoms (aOR 21.55, 95% CI 3.36 to 218.24) were independently associated with higher odds of comorbidity. By integrating self-reported diagnoses with health insurance claims, this study identified nearly 40% of older PLWHA in community settings had comorbidity. These findings highlight the value of routine data linkage for comorbidity ascertainment in HIV follow-up systems and support integrating non-communicable disease screening into HIV management for this population.