1394. Clinical and Sociodemographic Characteristics Associated with Poor Self-rated Health across Multiple Domains among Older North American Adults Living with HIV

Abstract Background Older adults living with HIV (OALHIV) are a growing demographic in North America. We summarized baseline characteristics and associated self-rated suboptimal health in North American OALHIV. Methods OALHIV aged ≥ 50 years from the United States, Canada, and Mexico who participated in the 25-country 2019 Positive Perspectives survey were included. Self-rated health was assessed across 4 domains (physical, mental, sexual, overall); each was dichotomized as optimal (Good/Very good) or suboptimal (Neither good nor poor/Poor/Very poor). Multinomial logistic regression was measured for associations between domains and relevant sociodemographic and clinical characteristics. Results Of 583 participants from North America, 161 were aged ≥ 50 years and included in this analysis. Most were male (73%), 14% were aged ≥ 65 years, 66% were diagnosed with HIV ≥ 10 years ago, median disease duration was 20 years, and 55% took ≥ 5 non-HIV pills daily. Most OALHIV (n=128; 80%) had switched antiretroviral therapy (ART) at least once, 14% (18/128) because of potential drug-drug interactions and 22% (28/128) because it was no longer effective or for resistance, and 6% were very treatment experienced (changed ART ≥ 4 times, with ≥ 1 switch in the past year for resistance or poor tolerability). Among OALHIV, 86% reported ≥ 1 comorbidity; the most common were hypertension (42%), hypercholesterolemia (39%), mental illness (32%), and insomnia (29%). Overall, 48% (77/161) of OALHIV reported suboptimal physical health, 35% (56/161) suboptimal mental health, 60% (97/161) suboptimal sexual health, and 47% (75/161) suboptimal overall health. On all domains, 19% (31/161) reported suboptimal health; 24% (38/161) reported optimal health on all domains, 23% (37/161) on 3 domains only, 13% (21/161) on 2 domains only, and 21% (34/161) on 1 domain only. Comorbidities with a > 15% difference between OALHIV reporting suboptimal health in all domains vs those reporting optimal health in at least 1 domain, respectively, were mental health (48% vs 28%), substance abuse (26% vs 5%, as self-reported in the survey), bone disease (26% vs 8%), and insomnia (42% vs 25%). Conclusion Most OALHIV in North America reported comorbidities and polypharmacy, with approximately one-quarter reporting suboptimal health on all domains. Disclosures Megan Dominguez, PharmD, GlaxoSmithKline: Stocks/Bonds|ViiV Healthcare: Employee|ViiV Healthcare: Stocks/Bonds Chinyere Okoli, MSc, DIP, ViiV Healthcare: I am an employee of ViiV healthcare|ViiV Healthcare: Stocks/Bonds Patricia de los Rios, MSc, GlaxoSmithKline: Stocks/Bonds|ViiV Healthcare: Employment Manyu Prakash, PhD, GlaxoSmithKline: Stocks/Bonds|ViiV Healthcare: Employee Andrew Clark, MD, ViiV Healthcare: Employee|ViiV Healthcare: Stocks/Bonds.