{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:39:31Z","timestamp":1793911171584,"version":"4.8.0"},"reference-count":41,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["IN\u2010HK\u2010985\u20105721"],"award-info":[{"award-number":["IN\u2010HK\u2010985\u20105721"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Disability disproportionally impacts people living with HIV (PLWH). The burden and determinants of disability among PLWH in Asia have not been well studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multi\u2010country observational cross\u2010sectional study in five cities in Asia involving PLWH and age\u2010 and sex\u2010matched controls living without HIV from March 2020 to November 2023. We compared the prevalence of disability (measured by World Health Organization Disability Assessment Schedule 2.0, WHODAS 2.0) between PLWH and controls, and determined the association between living with HIV and disability using multivariable logistic regression and mediation analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1004 PLWH and 416 age\u2010 and sex\u2010matched controls were enrolled. PLWH (mean age 53.6 \u00b1 10.3 years, 84.4% male, 72.2% \u22651 comorbidities) had a higher Charlson Comorbidity Index, more depression, anxiety, stress, social isolation and loneliness, and poorer cognitive performance.<\/jats:p>\n                    <jats:p>\n                      The prevalence of disability was 50.9% among PLWH and 40.6% among controls (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). PLWH had significantly higher WHODAS 2.0 complex score, and significantly more PLWH had impairments in all of the six domains of disability. The presence of disability correlated with living with HIV after adjusting for demographic characteristics, physical health parameters and cognition, but not after adjusting for socio\u2010behavioural variables and mental health parameters. Mediation analysis showed that living with HIV had a significant indirect effect on disability mediated by social isolation, mental health disorders and poor cognitive performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PLWH in Asia had a higher burden of disability as compared with matched controls. The effect of living with HIV on disability was mediated by social isolation, mental health disorders and impaired cognition. Future work should be directed to developing interventions that mitigate these conditions with the goal of reducing disability among PLWH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.70052","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T04:00:34Z","timestamp":1761710434000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cognitive and mental health significantly contribute to disability in people ageing with HIV in Asia: an observational case\u2010control study"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5242-2967","authenticated-orcid":false,"given":"Grace","family":"Lui","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"},{"name":"SH Ho Research Centre for Infectious Diseases The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaokai","family":"Chen","sequence":"additional","affiliation":[{"name":"Chongqing Public Health Medical Centre  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-0836","authenticated-orcid":false,"given":"Chien\u2010Ching","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine National Taiwan University Hospital Yunlin Branch  Yunlin Taiwan"},{"name":"Department of Internal Medicine National Taiwan University Hospital and National University Hospital College of Medicine  Taipei Taiwan"},{"name":"Department of Tropical Medicine and Parasitology National University Hospital College of Medicine  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pui Li","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Research in AIDS Department of Medicine Universiti Malaya  Kuala Lumpur Malaysia"},{"name":"Department of Medicine Faculty of Medicine Universiti Malaya  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen Seong","family":"Wong","sequence":"additional","affiliation":[{"name":"National Centre for Infectious Diseases  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Leung","sequence":"additional","affiliation":[{"name":"Jockey Club Centre for Osteoporosis Care and Control The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolei","family":"Xu","sequence":"additional","affiliation":[{"name":"Chongqing Public Health Medical Centre  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanlin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shui","family":"Shan Lee","sequence":"additional","affiliation":[{"name":"SH Ho Research Centre for Infectious Diseases The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Kwok","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics The Chinese University of Hong Kong  Sha Tin Hong Kong SAR"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3756-0629","authenticated-orcid":false,"given":"Reena","family":"Rajasuriar","sequence":"additional","affiliation":[{"name":"Centre of Excellence for Research in AIDS Department of Medicine Universiti Malaya  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(21)00345-3"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/59.3.M255"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa031"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.808318"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(23)00214-3"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207005"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir627"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40471-021-00265-6"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0267271"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325958219850558"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v9.31098"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2021.1967852"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-6-76"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.09.067231"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4203-0"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143936"},{"key":"e_1_2_11_18_1","volume-title":"Measuring health and disability: manual for WHO Disability Assessment Schedule (WHODAS 2.0)","author":"Ustun TB","year":"2010"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_11_20_1","volume-title":"Refinements to the Lubben Social Network Scale: The LSNS\u2010R","author":"Perloff E","year":"2002"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0164027506289723"},{"key":"e_1_2_11_22_1","volume-title":"Introduction to mediation, moderation, and conditional process analysis: a regression\u2010based approach","author":"Hayes AF","year":"2022"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.focus.2023.100115"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001138"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(22)00400-3"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s44197-023-00184-3"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-17013-8"},{"key":"e_1_2_11_28_1","first-page":"1","article-title":"Reliability and validity of the HIV Disability Questionnaire (HDQ) with adults living with HIV in the United States","volume":"18","author":"O'Brien KK","year":"2019","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2023.0126"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajp.v80i1.2001"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12981-023-00582-4"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-020-03000-2"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-024-04506-9"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540121.2020.1842318"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2024.0031"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239291"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcae224"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001898"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2304146"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(23)00028-0"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1080\/19317611.2024.2349615"},{"key":"e_1_2_11_42_1","first-page":"445","article-title":"Health system responsiveness for persons with HIV and disability in south western Uganda","volume":"15","author":"Kibet E","year":"2023","journal-title":"HIV AIDS (Auckl)"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.70052","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T06:53:28Z","timestamp":1764140008000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.70052"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,28]]},"references-count":41,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/jia2.70052"],"URL":"https:\/\/doi.org\/10.1002\/jia2.70052","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,28]]},"assertion":[{"value":"2025-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70052"}}