Title : From descriptive epidemiology to intervention science: Lessons learned from the cardiovascular status of adults living with HIV in Panama
Abstract:
Background: Adults living with HIV (ALWH) are at an increased risk of cardiometabolic disease due to chronic inflammation, immune activation, and side effects of antiretroviral therapy (ART). The Colón C3 Study examines the cardiometabolic profile of 660 ALWH in Colón City, Republic of Panama, while also incorporating perspectives from both patients and healthcare providers to inform future interventions.
Methods: Participants were ≥18 years old, residing in Colón City, and receiving ART at a local clinic. The study collected data through four surveys, body composition analysis, physical measurements (height, weight, abdominal perimeter, blood pressure), and laboratory tests assessing cardiometabolic, inflammatory, and HIV-related markers. Additionally, focus groups with clinicians and patients explored barriers and needs for cardiometabolic prevention, emphasizing social determinants of health.
Results: Among the 660 participants (45% men, 55% women, mean [SD] age 43.8 [12.5] years), the majority identified as heterosexual (60.6%), Black/Afro-Caribbean (51.2%), and were single with a stable partner (54.5%). Educational attainment was high, with 63.1% completing at least high school, and 42.5% owned homes. Household structures varied, with a median of 2 adults and 2 children per home. The most prescribed ART regimen was Acriptega® (60.5%).
Two separate focus groups with ALWH and healthcare providers revealed key themes shaping experiences and healthcare needs of ALWH:
- The demand for safe spaces where ALWH can receive supportive, nonjudgmental care;
- The importance of peer-led, preventative interventions to foster trust and engagement in health programs; and
- The necessity for wraparound services addressing not just medical needs but also social and psychological well-being.
Conclusion: This study highlights the intersection of social determinants of health, cardiometabolic risk, and HIV care in Colón City, Panama. Initial insights from focus groups and baseline data emphasize the need for a culturally tailored preventative intervention that addresses health equity, community-building and support, and comprehensive care delivery to improve outcomes for ALWH.
