Matacotta Joshua J, Tran Derek, Yoon Sonyeol
College of Health Sciences, Western University of Health Sciences, Pomona, California, USA.
College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California, USA.
HIV Med. 2024 Aug;25(8):998-1004. doi: 10.1111/hiv.13653. Epub 2024 May 7.
The All of Us (AoU) Research Program is a national-scale effort to build a dataset to help transform the future of health research by equipping researchers with comprehensive health data from diverse populations, especially those underrepresented in biomedical research. Our objectives were to evaluate the burden of HIV and major depressive disorder (MDD) in underrepresented groups and the frequency of the HIV/MDD comorbidity.
We conducted a cross-sectional analysis combining collected survey and electronic health record (EHR) data. We ascertained HIV and MDD cases using Observational Medical Outcomes Partnership codes. We used multivariable logistic regression to obtain the odds ratio of HIV in AoU participants and MDD in AoU participants with HIV.
The latest AoU data release includes 412 211 participants: 254 700 have at least one medical condition concept in their EHR, of whom 5193 (1.3%) had HIV, and 2238 (43%) of those with HIV had a diagnosis of MDD. Black AoU participants had approximately 4.58 times the odds of having an HIV diagnosis compared with the combined odds of all other racial groups. AoU participants with HIV were more likely to have MDD (p = 0.001) than were participants without HIV.
Among AoU participants, Black individuals have a disproportionately high burden of HIV, pointing to underlying factors such as social determinants of health, limited access to healthcare or prevention resources, and potential systemic biases that contribute to these differences. In addition, HIV is a risk factor for mental health issues like MDD. Further data collection from people with HIV will elucidate contributing factors and the need for interventions.
“我们所有人”(AoU)研究计划是一项全国性的努力,旨在构建一个数据集,通过为研究人员提供来自不同人群(特别是在生物医学研究中代表性不足的人群)的全面健康数据,来帮助改变健康研究的未来。我们的目标是评估代表性不足群体中艾滋病毒和重度抑郁症(MDD)的负担以及艾滋病毒/重度抑郁症合并症的发生率。
我们进行了一项横断面分析,结合收集的调查数据和电子健康记录(EHR)数据。我们使用观察性医疗结果合作组织代码确定艾滋病毒和重度抑郁症病例。我们使用多变量逻辑回归来获得AoU参与者中艾滋病毒以及感染艾滋病毒的AoU参与者中重度抑郁症的比值比。
最新的AoU数据发布包括412211名参与者:254700人在其电子健康记录中至少有一个医疗状况概念,其中5193人(1.3%)感染了艾滋病毒,感染艾滋病毒的人中2238人(43%)被诊断患有重度抑郁症。与所有其他种族群体的综合比值相比,黑人AoU参与者被诊断感染艾滋病毒的几率大约是其4.58倍。感染艾滋病毒的AoU参与者比未感染艾滋病毒的参与者更有可能患有重度抑郁症(p = 0.001)。
在AoU参与者中,黑人感染艾滋病毒的负担过高,这表明存在一些潜在因素,如健康的社会决定因素、获得医疗保健或预防资源的机会有限以及可能导致这些差异的潜在系统性偏见。此外,艾滋病毒是导致像重度抑郁症这样的心理健康问题的一个风险因素。从艾滋病毒感染者那里进一步收集数据将阐明促成因素以及干预的必要性。