Socioeconomic Background Research Articles

Global perspectives to enhance strategies for advancing women in healthcare and STEMM leadership.

The discourse surrounding gender equity has intensified recently, amplified by the impacts of the COVID-19 pandemic, highlighting the critical underrepresentation of women in leadership roles across various sectors including the media and healthcare. In medical research, this disparity is particularly pronounced, with women often excluded from senior positions despite their substantial presence in the workforce. This review seeks to explore the multifaceted issue of gender inequity in medical research leadership, examining the systemic barriers that women face, the socioeconomic factors that compound these challenges and the global variations in leadership representation of women. Diverse leadership teams are essential for fostering medical innovation, improving patient outcomes and ensuring that clinical trials and medical research are effective, inclusive and representative. The underrepresentation of women in leadership roles is not merely a matter of gender bias; it is intricately linked to socioeconomic factors that hinder their advancement. Women from lower socioeconomic backgrounds face additional obstacles, such as limited access to education and professional networks, which further exacerbate their underrepresentation in leadership positions. Moreover, cultural and societal norms play a significant role in shaping the career trajectories of women. As a group of immunologists, including representatives of the International Union of Immunological Sciences (IUIS) Gender Equity Committee, we review the causes of these inequities. We examine the impact of gender-diverse leadership on pre-clinical and medical research, emphasizing the need for inclusive leadership to drive progress in medical research and resulting healthcare. Finally, the review proposes strategies for improving gender equity in medical research leadership, including policy changes, organizational initiatives and societal shifts. By addressing these critical issues, this review contributes to the ongoing efforts to promote gender equity in medical research, ultimately enhancing the quality and inclusiveness of scientific inquiry and its impact on healthcare delivery.

Factors Influencing Students’ Performance in University Mathematics Courses: A Structural Equation Modelling Approach

This study examined the predictive relationships between Grade 12 National Senior Certificate (NSC) Mathematics results (representing students’ academic preparation at the secondary school level), university mathematics credits (indicating students’ progress in mathematics-related university courses), gender, and socioeconomic status (SES, measured by school quintile and family income) on student performance in specific university mathematics courses. The endogenous construct, student performance in university mathematics courses, was assessed using final grades from three courses representing progressive levels of mathematical complexity. Previous research had often evaluated these factors in isolation, leaving gaps in understanding how they collectively influenced academic success in South African higher education. Participants were selected using stratified random sampling to ensure representation across diverse socioeconomic backgrounds and genders. Data collection relied on institutional records for NSC Mathematics results, university mathematics credits, and course grades. SES information was gathered using surveys capturing school quintile and family income data. Structural equation modelling (SEM), specifically the covariance-Based SEM approach, was employed to analyse these variables’ direct and indirect effects on student performance. The analysis was conducted using the lavaan package in R, enabling the simultaneous assessment of multiple variables and offering a comprehensive understanding of their interrelationships. Results indicated that NSC Mathematics results and university mathematics credits were significant predictors of student success. Additionally, gender and SES were found to moderate these relationships, with performance disparities observed. The findings emphasised the need for a multi-dimensional approach to predicting and supporting student success in university mathematics. Recommendations included the implementation of targeted interventions, such as academic assistance programmes and policy initiatives, to ensure that all students have equitable access to resources and opportunities.

An Evaluation of the Attainment Gaps in State Schools in England: Evidence from Next Steps’ Age 25 Sweep Dataset

This paper evaluates the higher education (HE) admissions policy by examining the educational attainment gaps in state schools of young people from different socio-economic backgrounds in England. We analysed data for a cohort of 5192 state-educated young people from the large-scale nationally representative longitudinal Next Steps dataset from 2004 to 2015, linked to the robust administrative National Pupil Database (NPD) for England. The analytical methods used include effect sizes and correlations. The results show a clear pattern of the socio-economic stratification of young people’s educational attainment. Pupil deprivation is a key indicator which is consistently associated with lower educational attainment. While this is not surprising, our study also suggests that there are other factors besides the family backgrounds which are associated with young people’s educational outcomes. Pupils’ enjoyment of school, their educational aspirations, and their parent’s aspirations for their children are found to have a positive correlation with attainment at school, suggesting that educational aspirations and positive school experiences might contribute to a narrowing of deprivation-related gaps. As the analyses also suggest that young people who went to university and those in professional occupations consistently achieved higher academic performance than their peers, the findings have policy implications for improving social mobility. While it is not possible to alter parents’ socioeconomic backgrounds, raising children’s aspirations and making school enjoyable are amenable to policies and interventions. The common practice of using academic attainment as a selection criterion for admission to HE is likely to disadvantage children from low socioeconomic families, with implications for social mobility. The contextualised admission (CA) policy should lead to fairer approaches, which could be used for admissions to HE.

Developing a Green-BIM team to improve the construction of green buildings in Sri Lanka

Purpose The purpose of the paper is to propose a novel Green-BIM team (GBT) through a framework that would be essential in mitigating barriers to Green-BIM integration.Design/methodology/approach An interpretive stance is adopted for this study. Through a qualitative survey, 25 experts with proficiency in green building construction and building information modelling (BIM) implementation were interviewed. Code-based content analysis was carried out using NVivo12.Findings The findings of this study signified the need for a GBT and proposed architect, client, Green consultant, designer (mechanical, electrical and plumbing [MEP], structural), BIM coordinator, engineer (MEP, structural), project manager, quantity surveyor and facilities manager to be involved in the team representing design phase, construction phase and operational phase.Research limitations/implications The experts were limited to the Sri Lankan context; however, the findings can also benefit countries with socio-economic and cultural backgrounds similar to Sri Lanka.Practical implications Findings will be beneficial for policymakers and industry professionals to promote a BIM-enabled green building environment. The proposed GBT model extends existing theoretical frameworks, emphasising the need for a multi-disciplinary team throughout the entire lifecycle of a green building.Social implications The proposed GBT model aligns with broader societal goals related to sustainable development. This approach provides a sustainable pathway to achieve economic goals for all stakeholders in the construction sector.Originality/value There is a dearth of literature on a GBT to improve the construction of green buildings in Sri Lanka. Thus, the developed model is unique as it presents a novel GBT for the Sri Lankan construction sector. Further, it elaborates roles and responsibilities of team members with comprehensive details on how to mitigate the barriers to Green-BIM integration.

Leveling up Learning: Enhancing Self-Directed Learning in Computer Applications Technology with Classcraft

This study explores how gamification can be incorporated when facilitating theoretical content in Computer Applications Technology (CAT) to promote self-directed learning of Generation Z learners. The CAT curriculum consists of practical and theoretical content, and Generation Z learners tend to perceive theoretical content as less engaging and less stimulating. The dynamic nature of CAT, however, requires CAT learners to be self-directed learners who take ownership of their learning and are motivated and engaged in learning both the practical and theoretical components. A basic interpretive study, within an interpretivist paradigm, was applied as the research design. Purposive sampling was utilized, and 106 CAT learners at a South African high school participated in the research. A traditional teacher-centered approach was first followed to facilitate theoretical content. Thereafter, gamification with Classcraft was applied as an intervention. Data collection was performed by implementing post-open-ended questionnaires and focus group interviews. Results indicate that Generation Z learners crave instant gratification and lack skills such as self-motivation and critical thinking. A teacher-centered approach was found unsuitable for facilitating theoretical content to Generation Z learners. Gamification has the potential to entice Generation Z learners from different socioeconomical and cultural backgrounds to experience theoretical content in a more engaging and enjoyable manner and foster self-directed learning.

Effects of early AP coursetaking on high school outcomes and college enrollment for less academically prepared students

The expansion of Advanced Placement (AP) programs to include students from underrepresented racial and ethnic minorities and those from less advantaged socioeconomic backgrounds has made it crucial to assess how effective AP courses and exams are for these groups. As AP programs become more popular, more high school students–especially freshmen and sophomores–are signing up for AP courses. Despite this growing trend, there’s still not enough research on how early AP participation affects these particular students. This study fills this research gap by exploring the benefits of early AP involvement for students considered academically underprepared based on prior test scores. We find that early AP course participation leads to higher scores on state exit exams, greater enrollment in early college credit courses, and increased college attendance and completion rates, particularly at four-year institutions. These findings challenge the reliance on prior test scores as the sole predictor of AP success and future academic achievements, suggesting a need for a more comprehensive approach to evaluating students’ readiness for the rigors of AP coursework.

Engaging Disadvantaged Young Adults Through Collaborative Game Development

Abstract Disadvantaged young people face disproportionate challenges in accessing education and employment. Higher education serves as an aspirational destination and recommended route to entry for certain industries, yet young people from lower socioeconomic backgrounds are less likely to apply and enrol in higher education programmes. Disadvantaged young people may also be underrepresented within the workforce of certain sectors, compounding barriers to entering desired industries. Solutions to reduce barriers into education and employment are required. The paper presents a postmortem from a collaborative game development project with aims of addressing social inequalities and positive destinations towards the games industry. The project involved a third sector social enterprise delivering economic regeneration and community-based support, an eight-person interdisciplinary team of game development students, and a practice-based research group exploring multiple themes of game-based research practice. The paper captures the experiences of student developers, young people, and engagement officers in reviewing the value and impact of the project. The intention of this paper is to present a case study of collaborative practice which shows positive impact on addressing community support outcomes for young adults within its service, with the potential to apply similar practices to wider initiatives related to outreach, engagement, and employability pathways.

Long-acting family planning uptake and associated factors among women in the reproductive age group in East Africa: multilevel analysis

IntroductionThe campaign to encourage sexually active women to utilize family planning is one of the primary initiatives being undertaken globally to reduce unintended pregnancies and fertility rates. Evidence suggests that family planning measures can lower this maternal mortality ratio by nearly 25%. According to our literature search, there is no known study that has reported on the study area to assess utilization and factors associated with the use of long-acting contraceptive methods (LACMs) among women of reproductive age. Therefore, this study aimed to assess long-acting contraceptive method uptake and its associated factors among women of reproductive age in East Africa.MethodsA weighted total of 50,525 women of reproductive age were included in this study. A community-based cross-sectional study was conducted on the most recent Demographic and Health Surveys in 12 East African countries. The pooled prevalence of long-acting contraceptive uptake with a 95% confidence interval (CI) was reported and presented in a forest plot for East African countries using STATA version 14.1. Intraclass correlation coefficient, likelihood ratio (LR) test, median odds ratio, and deviance (−2 log-likelihood) values were used for model comparison and fitness. Adjusted odds ratios (AOR) with a 95% CI and p-value ≤0.05 in the multilevel logistic model were used to declare significant factors associated with long-acting contraceptive uptake.ResultsThe overall prevalence of long-acting contraceptive methods in East African countries was 19.41% (95% CI 19.07%–19.76%). In the multilevel logistic regression analysis, women in the age group of 35–49 years (AOR 1.09, 95% CI 1.06–1.17), women who were married (AOR 1.31, 95% CI 1.10–1.56), and women who were exposed to media (AOR 1.06, 95% CI 1.00–1.13) were significantly associated with LACM uptake. Moreover, living in urban areas (AOR 1.23, 95% CI 1.14–1.32) and living in the highest household wealth index (AOR 1.09, 95% CI 1.01–1.17) were also significantly associated with long-acting contraceptive uptake.ConclusionThe overall utilization of acting contraceptive methods was low. Therefore, future interventions should be planned to target women in younger age groups, with lower socioeconomic backgrounds, and those living in rural areas to improve LACM uptake.

Young People’s Views of and Responses to Socioeconomic Inequality: Self-Oriented Accommodation, Sceptical Resistance and Knowing Resignation

Abstract To date, sociological research has rarely foregrounded young people’s views of the causes of socioeconomic inequality, either for interpreting their understanding of the underlying processes involved or for exploring how these may influence the choices that help shape their own future socioeconomic outcomes. To address this gap, this paper uses questionnaire and interview data from 77 UK secondary school students concerning the relationships between their views of the causes of wealth and poverty and their occupational aspirations. In particular, the paper looks at how holding a ‘critical’ view of inequality—i.e. one which sees structural factors as its main cause—impacts their attitudes toward achieving their aspirations. While most participants gave more than one kind of cause for both wealth and poverty, a minority gave only structural factors as the main cause. Among the participants who held such a critical view, I identify three types of response to inequality concerning their aspirations: self-oriented accommodation (endorsing meritocratic beliefs regarding their own career success), sceptical resistance (seeking upward mobility while simultaneously doubting its likelihood) and knowing resignation (an acceptance of the prospect of failing to achieve one’s aspirations). I then discuss how the potential transitions between these response types, especially for students from lower socioeconomic backgrounds, may contribute to the reproduction of inequality despite such a critical awareness. I conclude by highlighting the benefits of foregrounding young people’s views of the causes of inequality for understanding the mechanisms that underlie their choices and the subsequent socioeconomic outcomes.

MICRO FINANCING AND RURAL WOMEN EMPOWERMENT THROUGH SELF HELP GROUPS

Himachal Pradesh has emerged as a pioneer in many fields. Per capita income of state has zoomed from ₹240 in 1948 to more than ₹2, 35,199 in 2023-2024. State is developing in the case of women's empowerment, employment generation and environmental conservation. Agriculture, Horticulture and Animal Husbandry are sources of livelihood for about 70 per cent of population. Constitution of India guarantees no discrimination on the grounds of gender. But in reality, however rural women have harder lives and are often discriminated in the case of socio – economic empowerment. Self help group is a small voluntary association of poor people, preferably from same socio-economic background. They come together for the purpose of solving their common problems through self help groups and mutual help. Self help groups are generally facilitated by NGOs, and increasingly advice and their members in a variety of on and off farm income generating activities. These self help groups also promotes small savings among member and are provided needed access from the local financial institutions.

Anti-Politics Behaviour among Young Malaysian Chinese

Objective: The study investigated the anti-politics behaviour of Chinese youth in Malaysia. Method: Semi-structured interviews were conducted with 21 Chinese participants aged 18 to 40 in Malaysia. They were from lower socio-economic backgrounds. The interview questions included frequency of reading newspapers, and having political conversations with friends, parents and educators. They were also asked about their interest in political speeches, and political involvement. Thematic analysis was conducted for the 85,000-word interview transcript. Results: The interview results revealed that the participants read newspaper articles and social media postings to confirm their pre-existing opinions on political issues. All the participants read Chinese newspapers because they were Chinese-educated, but only three participants were politically informed. The agents of political socialisation were their parents rather than peers and educators. Only one-third of the young Chinese participants read political news, and engaged in political conversations. They were likely to vote, hope for change, and believe that politics is a force for food. On the other hand, two-thirds of the participants were not interested in politics. The anti-politics behaviour was due to the politicians’ negative behaviour and observations of dirty tactics in politics. Most of the participants exhibited non-participation without democracy, and there were few participants in the political participation category, whether negative evaluation or positive evaluation. Conclusion: The study indicates that information black-out contributed to apathy of Chinese youth towards political participation and the disengagement may limit Chinese representation in the political structures of Malaysia in the future.

Teacher Personality and the Perceived Socioeconomic Gap in Student Outcomes

We randomly assign student profiles to teachers and elicit teachers’ beliefs about the student's likelihood of success in alternative high school tracks. We document a large and statistically significant gradient in teachers’ beliefs about students’ high school prospects with respect to students’ socioeconomic background (SEB), ceteris paribus. We find that this gradient varies with teacher's personality, a hard-to-observe and understudied teacher trait. Specifically, higher levels of teacher's extraversion and openness are associated with a steeper negative SEB gradient in teachers’ beliefs about students’ success prospects in an academic track. Conversely, more conscientious and agreeable teachers assign to low-SEB students, on average, a higher probability of success in a vocational track. We discuss some policy implications of our findings.

Meningitis outbreaks in northern Nigeria: a public health crisis

Background: Education is a fundamental right, yet millions of children, particularly orphans and those from low socioeconomic backgrounds, lack access to quality education. These children face systemic challenges such as financial constraints, social stigma, and inadequate educational infrastructure. The resulting educational disparity perpetuates poverty and limits social mobility, underscoring the need for targeted interventions. Methods and Materials: This project employed a mixed-methods approach, combining quantitative data analysis with qualitative insights. Field surveys, interviews, and collaborations with NGOs were conducted to assess the barriers to education for marginalized children. Secondary data from UNESCO, UNICEF, and other reputable sources were analyzed to identify best practices and evaluate policy frameworks. Key actions included community workshops, distribution of educational resources, and partnerships with local organizations. Results: The project positively impacted over 900 children, increasing school enrollment and raising community awareness about the importance of education. Successful interventions included resource distribution, community-based schools, and public-private partnerships. However, systemic challenges such as funding limitations, cultural resistance, and sustainability concerns persisted, emphasizing the need for comprehensive policy advocacy and long-term solutions. Conclusion: Investing in the education of orphans and children from low-income backgrounds is essential for societal progress. This study highlights the transformative potential of education in breaking the cycle of poverty and fostering community development. Collaboration among policymakers, educators, and community leaders is crucial to sustaining and scaling these initiatives for lasting impact.

Importance of Orphan and Low Socioeconomic Backgrounds Education in Society Authors

Background: Education is a fundamental right, yet millions of children, particularly orphans and those from low socioeconomic backgrounds, lack access to quality education. These children face systemic challenges such as financial constraints, social stigma, and inadequate educational infrastructure. The resulting educational disparity perpetuates poverty and limits social mobility, underscoring the need for targeted interventions. Methods and Materials: This project employed a mixed-methods approach, combining quantitative data analysis with qualitative insights. Field surveys, interviews, and collaborations with NGOs were conducted to assess the barriers to education for marginalized children. Secondary data from UNESCO, UNICEF, and other reputable sources were analyzed to identify best practices and evaluate policy frameworks. Key actions included community workshops, distribution of educational resources, and partnerships with local organizations. Results: The project positively impacted over 900 children, increasing school enrollment and raising community awareness about the importance of education. Successful interventions included resource distribution, community-based schools, and public-private partnerships. However, systemic challenges such as funding limitations, cultural resistance, and sustainability concerns persisted, emphasizing the need for comprehensive policy advocacy and long-term solutions. Conclusion: Investing in the education of orphans and children from low-income backgrounds is essential for societal progress. This study highlights the transformative potential of education in breaking the cycle of poverty and fostering community development. Collaboration among policymakers, educators, and community leaders is crucial to sustaining and scaling these initiatives for lasting impact.

Characteristics of older patients undergoing surgery in the UK: SNAP-3, a snapshot observational study.

Frailty and multimorbidity are common in older adults, but the prevalence and interaction of these conditions in surgical patients remain unclear. This study describes the clinical characteristics of a heterogeneous cohort of older UK surgical patients. We conducted a prospective observational cohort study during 5 days in March 2022, aiming to recruit all UK patients aged 60 yr and older undergoing surgery, excluding minor procedures (e.g. cataract surgery). Data were collected on patient characteristics, clinical care, frailty, and multimorbidity measures. A total of 7134 patients from 214 NHS hospitals were recruited, with a mean (sd) age of 72.8 (8.1) yr. Of all operations, 69% (95% confidence interval [CI] 67.9-70.1%) were elective, and 34% (95% CI 32.7-34.8%) were day cases. Of the patients, 19% (95% CI 18.3-20.1%) were living with frailty (Clinical Frailty Score ≥5), and 63.1% (95% CI 62.0-64.3%) were living with multimorbidity (count of ≥2 comorbidities). Those living with frailty, multimorbidity, or both were typically older, were from lower socioeconomic backgrounds, and experienced greater polypharmacy and reduced independence. Patients living with frailty were less likely to undergo elective and day-case surgeries. Four out of five (78.8% [1079/1369]) of those who were living with frailty were also living with multimorbidity; 27.1% (1079/3978) of those who were living with multimorbidity were also living with frailty. In the UK, one in five older patients undergoing surgery is living with frailty, and almost two-thirds of older patients are living with multimorbidity. These data highlight the importance of frailty screening. In addition, they can serve to guide resource allocation and provide comparative estimates for future research.

Implementing behavioural science-informed letter interventions to increase COVID-19 vaccination uptake in London residents. A difference-in-difference study in London, United Kingdom.

The accelerated development of vaccines to mitigate COVID-19 was crucial in the response to the 2020 pandemic. The success of vaccination strategies relies upon adequate uptake across the population. In the United Kingdom, COVID-19 vaccination began in December 2020, with population groups invited in priority groups according to age and clinical vulnerability. By February 2021, uptake rates were lower in North West London than the national average. This study aimed to explore whether behaviourally-informed (BI) letters could increase the rate of first vaccine uptake in previously uncontactable residents. BI letters were designed to invoke a sense of ownership, and highlight the ease of accessing a vaccine. Letters were sent to unvaccinated uncontactable residents in a Central London Borough over a 3-week period. Three neighbouring boroughs in London with similar non-responder data acted as controls. A linear difference in difference (DID) analysis assessed the change in the rate of vaccine uptake across all four boroughs, with percentage point change adjusted for covariates including ethnicity, age, gender and socioeconomic status. In total, 10,161 residents in Central London were eligible to receive our BI letter. All four boroughs demonstrated an increase in vaccination, with an absolute increase of 4.3% in the intervention borough. Our linear DID analysis showed a 14.7% increase in vaccination likelihood in the intervention borough following the intervention on average across all weeks included in the study. Residents with a mixed or multiple ethnic background were less likely to receive a COVID-19 vaccination. Those from a more deprived socioeconomic background demonstrated the largest rate of change. Our study highlights the effectiveness of traditional communication strategies such as letters in those who are uncontactable by other means. Incorporating behavioural science principles into healthcare communication, such as those designed to evoke a sense of ownership can enhance their effectiveness.

UNVEILING THE ROLE OF PARENTAL INVOLVEMENT IN ENHANCING ELEMENTARY SCHOOL STUDENTS' LEARNING OUTCOMES

This study aims to examine the impact of parental involvement on students' learning outcomes, the key factors supporting parental involvement, and the challenges faced by parents. This article employs a Systematic Literature Review (SLR) approach. A total of 25 relevant articles were selected after undergoing a screening process based on inclusion and exclusion criteria. The research process includes gathering information, filtering relevant data, and analyzing the findings. The results indicate that parental involvement plays a crucial role. Supporting factors include the availability of quality time between parents and students, motivation and support provided to students, collaboration between parents and teachers, parents' educational background, family economic status, and the utilization of technology. The implications of these findings highlight the importance of fostering stronger parent-teacher partnerships to enhance student outcomes. Schools should consider implementing programs that educate parents on effective ways to support their children’s learning at home. Additionally, policymakers could prioritize providing resources and support systems for families from diverse socioeconomic backgrounds, enabling equitable access to tools and opportunities that facilitate parental involvement.

P-1569. Healthcare Disparities Between Racial, Ethnic, and Socioeconomic Backgrounds in Urinary Tract Infection Patients

Abstract Background Numerous studies have highlighted persistent health disparities: chronic disease rates, access to care, and outcomes across diverse races, ethnicities, and socioeconomic backgrounds. To address underlying healthcare disparities, we explored differences in outcomes of patients with urinary tract infections (UTIs).Table 1Results of Statistical Analysis Methods Patients treated at Cooper University Hospital for UTI between 2019 and 2021 were identified using ICD codes. Inclusion criteria was age over 18, inpatient admissions longer than 48 hours, and diagnosis of UTI. Patient demographics, culture results, treatment, discharge outcomes, and outcomes at 30 and 90 days. Additionally, we collected individual indicators of socioeconomic status, including census tract data associated with American Community Survey, Area Deprivation Index (ADI: ranked on a scale 1 to 10, with 10 being most disadvantaged), and Social Vulnerability Index (SVI: ranked on a scale of 0 to 1, with 1 being most vulnerable). Descriptive statistics, Chi-square, and Kruskal-Wallis tests were performed. Results 495 patients with UTI were analyzed: mean age was 67±19 years, 54% were White, and 20% were Latino. Social Mean state ADI was 8.7±2.0, and mean CDC SVI was 0.63±0.24. Social determinants of health were common among patients with UTI: 60% did not have independent level of function, 19% lived alone, 18% had prior mental health history, 14% did not speak English, 8% had history of substance abuse, 2% had housing insecurity. Statistical analysis showed no meaningful difference in patient outcomes for hospital mortality or mortality at 30- or 60-days post discharge. Readmission at 30 or 60 days was associated with census tract median household income, household income less than 10 thousand dollars, per capita income, education with bachelor’s degree, taking public transportation, not having a car, unemployment, and Medicaid coverage (Table 1). Conclusion We found no differences in mortality outcomes among patients with UTI across various socioeconomic parameters within our institution. However, hospital readmissions were more likely among patients who lived in census tracts with increased hardships. Future studies should evaluate possible interventions to decrease readmission disparities. Disclosures All Authors: No reported disclosures

Adversity as Privilege—Poverty Has Made Me a Better Surgeon

This Viewpoint explores how coming from a lower socioeconomic background has made the author a better surgeon.

P-1450. Impact of Multi-morbidities on Quality of Life Among People Living with HIV at a tertiary care center in India: A cross-sectional study

Abstract Background India is home to an estimated 2.4 million People Living with HIV (PLHIV). The term "multi-morbidity" refers to the simultaneous presence of 2 or more chronic medical conditions in an individual, the prevalence of which is rising. The aim of our study is to assess the impact of multi-morbidities on Quality of Life (QoL) in PLHIV attending the Antiretroviral Therapy (ART) center at a tertiary care hospital in Western Maharashtra, India. Methods This was a cross-sectional study, over 2 months with 285 patients recruited. After ethical clearance was obtained, patients were interviewed to gather comprehensive sociodemographic history, with information on treatment and comorbidities obtained from patient charts. The QoL was measured using the WHOQOL-HIV BREF questionnaire which evaluates QoL across six domains: Physical, Psychological, Independence, Social, Environment, and Spiritual. Results The cohort exhibited an average of 2.2 comorbidities (SD = 1.4), with a notable prevalence of cardiovascular diseases and diabetes. Participants with 3 or more comorbidities demonstrated significantly lower QoL scores in the Physical (mean = 10.4, SD = 1.8, p < 0.01) and Psychological (mean = 11.9, SD = 1.5, p < 0.05) domains compared to those with fewer comorbidities. A longer duration of ART correlated positively with higher scores in the Independence domain (r = 0.26, p < 0.05). Elevated CD4 counts were linked with improvements in the Environmental and Psychological health domains. (p < 0.05) Participants from higher socioeconomic backgrounds reported significantly better scores in the Environmental and Spiritual domains (p < 0.05). Younger patients (< 40 years) reported better Social and Spiritual QoL scores compared to older individuals Gender-specific analysis indicated that females reported higher scores in the Social and Environmental domains. (p < 0.01). Conclusion There is a pressing need for effective management strategies that encompass comprehensive care approaches to address the complex health needs of this population. Enhancing routine screening for comorbidities and educating patients about the implications of multi-morbidities can empower PLHIV to improve QoL. Disclosures All Authors: No reported disclosures