Sandeep Prabhu, MD, MPH, MS, Brigham and Women's Hospital, 800 Huntington Ave, Boston, MA, 02115. Telephone 650-245-7276. Email:
J Frailty Aging. 2024;13(4):552-560. doi: 10.14283/jfa.2024.71.
Social vulnerability reflects deficits in social resources that may disproportionally impact older women with HIV (WWH) in Africa.
To examine the relationship between scores on an adapted Social Vulnerability Index (SVI) and measures of physical frailty and disability.
Cross-sectional study.
293 women (156 HIV-positive, 137 HIV-negative) aged >40 years in Mombasa, Kenya who were recruited from the Mombasa Cohort of women with a history of transactional sex and the general community.
Assessments including an SVI adapted for the Kenyan context (SVI-Kenya), the Clinical Frailty Scale (CFS) and the World Health Organization Disability Assessment (WHODAS) were compared by HIV status. Linear regression was used to determine the relationship between SVI-Kenya score and both CFS and WHODAS, after adjustment for potential confounders. An exploratory analysis identified factors associated with SVI-Kenya score. An age-by-HIV-status interaction term was tested and retained if significant in unadjusted analyses.
Mean SVI-Kenya score was 34.1 (SD, 12.9) and did not differ by HIV status (p=0.49). In adjusted analyses, each increment in SVI-Kenya score was associated with a 1.10-point higher WHODAS score (95%CI:0. 21, 1.99), but not with CFS. In exploratory analysis, factors associated with higher SVI-Kenya score included WHODAS score (adjusted beta=0.20; 95%CI: 0.05,0.35) and Mombasa Cohort recruitment (adjusted beta=5.91; 95%CI: 2.07,9.75). Being married, separated/divorced, or widowed predicted lower SVI-Kenya scores (by 5.52-9.09 points) compared to being single. Age did not predict SVI-Kenya score.
Social vulnerability as measured by the SVI-Kenya score was associated with greater disability but not physical frailty. Social vulnerability was also associated with prior sex work and never having married. Our findings suggest that social vulnerability is a distinct construct from physical frailty among older Kenyan women and not related to HIV status.
社会脆弱性反映了社会资源的不足，这可能会不成比例地影响非洲的老年 HIV 阳性妇女（WWH）。
研究经过调整的社会脆弱性指数（SVI）评分与身体虚弱和残疾测量指标之间的关系。
横断面研究。
293 名年龄在 40 岁以上的妇女（156 名 HIV 阳性，137 名 HIV 阴性），来自肯尼亚蒙巴萨的有过交易性行为史的妇女队列和普通社区。
评估包括适应肯尼亚背景的 SVI（SVI-Kenya）、临床虚弱量表（CFS）和世界卫生组织残疾评估（WHODAS），并按 HIV 状况进行比较。使用线性回归来确定 SVI-Kenya 评分与 CFS 和 WHODAS 之间的关系，调整潜在混杂因素后。进行探索性分析以确定与 SVI-Kenya 评分相关的因素。如果在未调整分析中具有统计学意义，则测试年龄与 HIV 状态的交互项并保留。
平均 SVI-Kenya 评分为 34.1（SD，12.9），与 HIV 状态无关（p=0.49）。在调整分析中，SVI-Kenya 评分每增加一个单位，WHODAS 评分就会增加 1.10 分（95%CI：0.21，1.99），但与 CFS 无关。在探索性分析中，与较高 SVI-Kenya 评分相关的因素包括 WHODAS 评分（调整后的β=0.20；95%CI：0.05，0.35）和蒙巴萨队列招募（调整后的β=5.91；95%CI：2.07，9.75）。已婚、分居/离婚或丧偶者的 SVI-Kenya 评分预测值低于单身者（低 5.52-9.09 分）。年龄与 SVI-Kenya 评分无关。
SVI-Kenya 评分衡量的社会脆弱性与更大的残疾有关，但与身体虚弱无关。社会脆弱性也与之前的性工作和从未结婚有关。我们的研究结果表明，社会脆弱性是肯尼亚老年妇女中与身体虚弱不同的一个独特结构，与 HIV 状态无关。
