Trajectories of disability and influence of contextual factors among adults aging with HIV: insights from a community-based longitudinal study in Toronto, Canada
Bibliographic record
Abstract
Abstract Background Individuals aging with HIV may experience disability that is multidimensional and evolving over time. Our aims were to characterize the longitudinal trajectories of disability and to investigate how intrinsic and extrinsic contextual factors influence dimensions of disability over an 8-month period among adults aging with HIV. Methods We analyzed longitudinal observational data from a community-based study in Toronto, Canada, where adults aging with HIV completed self-reported questionnaires over 8 months (5 time points). We measured disability using the Short-Form HIV Disability Questionnaire (SF-HDQ), which included six dimensions: physical, cognitive, mental-emotional health challenges, uncertainty, difficulties with day-to-day activities, and challenges to social inclusion. Higher SF-HDQ scores (range: 0-100) indicate greater severity of disability. We assessed intrinsic (age, gender, education, living status, number of comorbidities, mastery) and extrinsic (stigma, social support) contextual factors using baseline self-reported questionnaires. Latent class growth analysis was performed to identify distinct disability trajectories within each of the six dimensions. Multinomial logistic regression models were used to assess the influence of contextual factors on the disability trajectories. Results Of 108 participants, 89% identified as men with a mean age of 50.6 years (standard deviation ±10.9). We identified three disability trajectories: low, medium, and high disability severity in the physical, mental-emotional, and day-to-day activities dimensions. Four trajectories: low, medium-low, medium-high, and high (or high-declining) disability severity were in the cognitive, uncertainty, and social inclusion dimensions. Factors such as higher self-mastery and social support were associated with lower disability trajectories, whereas greater number of comorbidities and stigma were associated with more severe disability trajectories over time. Conclusion Disability experiences among adults aging with HIV included three or four distinct trajectories with considerable heterogeneity over time. Information on contextual factors may be helpful for informing interventions and supports that mitigate disability among adults aging with HIV.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.005 |
| Science and technology studies | 0.004 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".