Prevalence and Consequences of Perceived Vision Difficulty in Aging Adults with HIV Infection

Alison G. Abraham, Ann Ervin, Bonnie Swenor, Pradeep Ramulu, Roomasa Channa, Xiangrong Kong, Valentina Stosor, M. Reuel Friedman, Roger Detels, Michael Plankey

Research output: Contribution to journalArticlepeer-review


Purpose: Despite well-known ocular complications of HIV-related immune suppression, few studies have examined the prevalence and consequences of visual impairment among aging long-term survivors of HIV. Design: Retrospective cohort study. Methods: Aging HIV-infected (HIV+) men who have sex with men (MSM) and HIV-uninfected (HIV−) MSM controls reported their difficulty performing 6 vision-dependent tasks (difficulty defined as: no, a little, moderate, and extreme difficulty). Relationships were examined using logistic regression, regressing each outcome separately on categorical visual function responses, with missing data multiply imputed. Results: There were 634 age-matched pairs for a total sample of 1,268 MSM of 1,700 MSM with available data. The median age was 60 years old (interquartile range [IQR], 54, 66), and 23% were African American. Among HIV+ men, 95% were virally suppressed (viral load <400 copies/mL). HIV+ men were more likely to report moderate or extreme difficulty performing at least 1 task (21% for HIV+ compared to 13% for HIV−; P <.01). Participants reporting extreme vision-related difficulty performing at least 1 task had 11.2 times the odds of frailty (95% confidence interval [CI], 5.2-23.9), 2.6 times the odds of a slow gait speed (95% CI, 1.4-4.8), and 3.2 times the odds of impaired instrumental activities of daily living (95% CI: 1.6-6.3) compared to those reporting no vision-related difficulty on any task. Conclusions: Perceived vision difficulty was more common among older HIV+ MSM than age-matched HIV− MSM controls and was associated with higher risk of depression and physical function loss among MSM.

Original languageEnglish (US)
Pages (from-to)268-278
Number of pages11
JournalAmerican journal of ophthalmology
StatePublished - Oct 2020

ASJC Scopus subject areas

  • Ophthalmology


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