Syndemic burden and systemic inflammation, HIV health status, and blood pressure among women with unsuppressed HIV viral loads in the Women's Interagency HIV Study.

INTRODUCTION Smoking, low education, obesity, and depressive symptoms are all associated with HIV health status, increased blood pressure, and inflammation, and constitute a syndemic burden that may contribute to poor health outcomes. The current study examined syndemic burden and health outcomes among women living with HIV (WLHIV). METHODS Women were participants enrolled in the Women's Interagency HIV Study (WIHS). Outcomes included blood pressure, HIV health status (HIV-1 RNA viral load and CD4 T-cell counts), and interleukin-6. Syndemic burden was defined as a count variable of low education, obesity, cigarette use, and depressive symptoms. RESULTS Women (N = 131) were an average of 60.54 years of age (SD = 8.86), and 49% were non-Hispanic Black. In multivariable analyses, syndemic burden was not significantly associated with systolic (p = .342) or diastolic blood pressure (p = .763), interleukin-6 (p = .168), or CD4 count (p = .846). However, syndemic burden was associated with increased viral load (age adjusted β = .35, p < .001). Comparing women with high versus low syndemic burden, also controlling for women's age, women with high syndemic burden had higher diastolic blood pressure and HIV viral load. DISCUSSION Syndemic burden appeared to play an important role in HIV health status and could potentially increase the risk of HIV transmission. High syndemic burden, defined as at least two syndemic conditions, had the greatest effects of HIV viral load and diastolic blood pressure. Targeted interventions to address syndemic burden may help improve health outcomes in WLHIV as well as reduce the risk of hypertension and HIV transmission.