@article{fdi:010075733,
  title = {{A} generalized additive model to disentangle age and diagnosis-specific cohort effects in psychological and behavioral outcomes in people living with {HIV} : the {F}rench cross-sectional {ANRS}-{VESPA}2 survey},
  author = {{S}agaon {T}eyssier, {L}uis and {V}ilotitch, {A}. and {M}ora, {M}. and {M}aradan, {G}. and {G}uagliardo, {V}. and {S}uzan-{M}onti, {M}. and {D}ray-{S}pira, {R}. and {S}pire, {B}. and {VESPA}2 {S}tudy {G}roup},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground{U}nlike their younger counterparts, some of today's older {HIV} patients were diagnosed before the advent of highly active antiretroviral therapy ({HAART}). {T}he psychosocial and behavioral outcomes of people living with {HIV} ({PLWH}) have been widely studied, and associated factors are well known. {H}owever, their evolution both in terms of age and diagnosis-specific cohort effects is not well understood.{M}ethods{D}ata from the {ANRS}-{VESPA}2 cross-sectional survey, representative of {F}rench {PLWH}, were used to investigate whether psychosocial and behavioral outcomes such as quality of life, need for support and {HIV} status disclosure, evolve under both the influence of patients' age and diagnosis-specific cohort effects. {A} semi-parametric generalized additive model ({GAM}) was employed. {T}he physical and mental components of health-related quality of life, the need for material and moral support, and {HIV}-status disclosure, constituted our outcomes.{R}esults{N}on-linear diagnosis-specific cohort effects were found for physical and mental {Q}o{L} and {HIV}-status disclosure. {O}verall, physical {Q}o{L} was better in recently diagnosed patients than in those diagnosed in the early 1980s. {A}n increasing influence of diagnosis-specific cohort effects between 1983 and 1995 was observed. {N}o cohort effects were noticeable between 1996 and 2000, while an increasing influence was apparent for patients diagnosed with {HIV} from 2000 to 2011 (year of study). {F}or mental {Q}o{L}, the only increase was observed in participants diagnosed with {HIV} between 1983 and 2000. {T}he relationship between diagnosis-specific cohort effects and {HIV} status disclosure was negative overall: participants diagnosed after 2000 were much less likely to disclose than those diagnosed before 1995. {T}he effect of age was significantly associated with all outcomes, with a non-linear influence on mental {Q}o{L} and with the need for material/moral support.{C}onclusions{P}sychosocial and behavioral outcomes are complex processes which can be explained in different ways by a combination of the clinical and social contexts which {PLWH} are exposed to at the time of diagnosis, and by developmental characteristics. {A} greater understanding of these processes could inform healthcare policy-making for specific {HIV} generations and different {HIV} age groups.},
  keywords = {{A}ge ; {C}ohort effects ; {Q}uality of life ; {M}aterial and moral support ; {HIV}-status disclosure ; {S}emi-parametric {GAM} ; {FRANCE}},
  booktitle = {},
  journal = {{BMC} {P}ublic {H}ealth},
  volume = {19},
  numero = {},
  pages = {art. 590 [10 p.]},
  ISSN = {1471-2458},
  year = {2019},
  DOI = {10.1186/s12889-019-6905-z},
  URL = {https://www.documentation.ird.fr/hor/fdi:010075733},
}