Social determinants of tuberculosis risk in patients with human immunodeficiency virus infection A single-center observational study.

Abstract

Introduction: The Human Immunodeficiency Virus (HIV) compromises the immune system, making infected patients more susceptible to developing opportunistic infections such as tuberculosis. The objective of this research was to describe the social determinants that act as risk factors for tuberculosis in HIV-positive patients.

Methodology: This observational study was conducted at the “Dr. José Daniel Rodríguez” Hospital in Guayaquil, Ecuador, from December 2022 to December 2024. Patients over 14 years of age with HIV/TB coinfections were included. The variables were: age, social determinants (overcrowding, poor nutritional status, drug use, limitations in access to medical care, poor adherence to treatment, low socioeconomic status, stigma, and discrimination). The source was indirect. The sample was probabilistic, and descriptive statistics were used.

Results: A total of 76 patients with coinfections were registered. 79% were between 27 and 59 years old. 63% of the HIV/TB coinfected population were men. Social determinants included low socioeconomic status (86%); overcrowding (80%), and living in overcrowded conditions. Similarly, 79%, 76%, 74%, 72%, and 55% of participants reported poor nutritional status, stigmatization and discrimination due to their condition, poor treatment adherence due to financial hardship, limited access to healthcare, and drug use, respectively.

Conclusions: Social determinants act as risk factors for tuberculosis in HIV-positive patients, including low socioeconomic status, overcrowded conditions, poor nutritional status, stigmatization and discrimination, poor treatment adherence, limited access to healthcare, and drug use.