Mary Jo Trepka1, Kristopher P Fennie2, Diana M Sheehan2, Theophile Niyonsenga3, Spencer Lieb4, Lorene M Maddox5. 1. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami. Electronic address: trepkam@fiu.edu. 2. Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami. 3. Centre for Population Health Research, School of Population Health, University of South Australia, Adelaide, South Australia, Australia. 4. Florida Consortium for HIV/AIDS Research, The AIDS Institute, Tampa. 5. HIV/AIDS Section, Bureau of Communicable Diseases, Florida Department of Health, Tallahassee.
Abstract
PURPOSE: We compared all-cause and human immunodeficiency virus (HIV) mortality in a population-based, HIV-infected cohort. METHODS: Using records of people diagnosed with HIV during 2000-2009 from the Florida Enhanced HIV-acquired immunodeficiency syndrome (AIDS) Reporting System, we conducted a proportional hazards analysis for all-cause mortality and a competing risk analysis for HIV mortality through 2011 controlling for individual-level factors, neighborhood poverty, and rural-urban status and stratifying by concurrent AIDS status (AIDS within 3 months of HIV diagnosis). RESULTS: Of 59,880 HIV-infected people, 32.2% had concurrent AIDS and 19.3% died. Adjusting for period of diagnosis, age group, sex, country of birth, HIV transmission mode, area-level poverty, and rural-urban status, non-Hispanic black (NHB) and Hispanic people had an elevated adjusted hazards ratio (aHR) for HIV mortality relative to non-Hispanic whites (NHB concurrent AIDS: aHR 1.34, 95% confidence interval [CI], 1.23-1.47; NHB without concurrent AIDS: aHR 1.41, 95% CI 1.26-1.57; Hispanic concurrent AIDS: aHR 1.18, 95% CI 1.05-1.32; Hispanic without concurrent AIDS: aHR 1.18, 95% CI 1.03-1.36). CONCLUSIONS: Considering competing causes of death, NHB and Hispanic people had a higher risk of HIV mortality even among those without concurrent AIDS, indicating a need to identify and address barriers to HIV care in these populations.
PURPOSE: We compared all-cause and human immunodeficiency virus (HIV) mortality in a population-based, HIV-infected cohort. METHODS: Using records of people diagnosed with HIV during 2000-2009 from the Florida Enhanced HIV-acquired immunodeficiency syndrome (AIDS) Reporting System, we conducted a proportional hazards analysis for all-cause mortality and a competing risk analysis for HIV mortality through 2011 controlling for individual-level factors, neighborhood poverty, and rural-urban status and stratifying by concurrent AIDS status (AIDS within 3 months of HIV diagnosis). RESULTS: Of 59,880 HIV-infected people, 32.2% had concurrent AIDS and 19.3% died. Adjusting for period of diagnosis, age group, sex, country of birth, HIV transmission mode, area-level poverty, and rural-urban status, non-Hispanic black (NHB) and Hispanic people had an elevated adjusted hazards ratio (aHR) for HIV mortality relative to non-Hispanic whites (NHB concurrent AIDS: aHR 1.34, 95% confidence interval [CI], 1.23-1.47; NHB without concurrent AIDS: aHR 1.41, 95% CI 1.26-1.57; Hispanic concurrent AIDS: aHR 1.18, 95% CI 1.05-1.32; Hispanic without concurrent AIDS: aHR 1.18, 95% CI 1.03-1.36). CONCLUSIONS: Considering competing causes of death, NHB and Hispanic people had a higher risk of HIV mortality even among those without concurrent AIDS, indicating a need to identify and address barriers to HIV care in these populations.
Authors: Mary Jo Trepka; Diana M Sheehan; Kristopher P Fennie; Daniel E Mauck; Spencer Lieb; Lorene M Maddox; Theophile Niyonsenga Journal: J Health Care Poor Underserved Date: 2018
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