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AIDS Res Hum Retroviruses. 2019 Jun 18. doi: 10.1089/AID.2018.0296. [Epub ahead of print]

Racial Differences in Change in Physical Functioning in Older Male Veterans with HIV.

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1 Division of Infectious Diseases, Department of Medicine, Duke University, Durham, North Carolina.
2 Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina.
3 Department of Internal Medicine, Salem Veterans Affairs Medical Center, Salem, Virginia.
4 Department of Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia.
5 Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey.
6 Department of Internal Medicine, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
7 Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
8 Department of Medicine, University of Washington School of Medicine, Seattle, Washington.
9 Washington DC Veterans Affairs Medical Center, Washington, District of Columbia.
10 George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
11 Department of Psychology, George Washington University, Washington, District of Columbia.
12 Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut.
13 Yale School of Nursing, New Haven, Connecticut.
14 Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, North Carolina.


Little is known about longitudinal change in physical functioning of older African American/Black and White HIV-infected persons. We examined up to 10 years of data on African American (N = 1,157) and White (N = 400) men with HIV infection and comparable HIV-negative men (n = 1,137 and 530, respectively), age 50-91 years from the Veterans Aging Cohort Study Survey sample. Physical functioning was assessed using the SF-12 (12-Item Short Form Health Survey) physical component summary (PCS) score. Mixed-effects models examined association of demographics, health conditions, health behaviors, and selected interactions with PCS score; HIV biomarkers were evaluated for HIV-infected persons. PCS scores were approximately one standard deviation below that of the general U.S. population of similar age. Across the four HIV/race groups, over time and through ages 65-75 years, PCS scores were maintained; differences were not clinically significant. PCS score was not associated with race or with interactions among age, race, and HIV status. CD4 and viral load counts of African American and White HIV-infected men were similar. Older age, low socioeconomic status, chronic health conditions and depression, lower body mass index, and smoking were associated with poorer PCS score in both groups. Exercising and, counterintuitively, being HIV infected were associated with better PCS score. Among these older African American and White male veterans, neither race nor HIV status was associated with PCS score, which remained relatively stable over time. Chronic disease, depression, and lack of exercise were associated with lower PCS score. To maintain independence in this population, attention should be paid to controlling chronic conditions, and emphasizing good health behaviors.


African American; HIV; VACS study; longitudinal study; physical functioning; race


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