Trepka Mary Jo, Niyonsenga Theophile, Fennie Kristopher P, McKelvey Karma, Lieb Spencer, Maddox Lorene M
Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, Miami, FL.
University of South Australia, School of Population Health, Adelaide, South Australia.
Public Health Rep. 2015 Sep-Oct;130(5):505-13. doi: 10.1177/003335491513000513.
This study aimed to characterize premature mortality among people diagnosed with HIV infection from 2000 to 2009 in Florida, by sex and race/ethnicity, to estimate differences in premature mortality that could be prevented by linkage to HIV care and treatment.
Florida surveillance data for HIV diagnoses (excluding concurrent AIDS diagnoses) were linked with vital records data to ascertain deaths through 2011. Years of potential life lost (YPLL) were obtained from the expected number of remaining years of life at a given age from the U.S. sex-specific period life tables.
Among 41,565 people diagnosed with HIV infection during the study period, 5,249 died, and 2,563 (48.8%) deaths were due to HIV/AIDS. Age-standardized YPLL (aYPLL) due to HIV/AIDS per 1,000 person-years was significantly higher for females than males (372.6, 95% confidence interval [CI] 349.8, 396.2 vs. 295.2, 95% CI 278.4, 312.5); for non-Hispanic black (NHB) females than non-Hispanic white (NHW) and Hispanic females (388.2, 95% CI 360.7, 416.9; 294.3, 95% CI 239.8, 354.9; and 295.0, 95% CI 242.9, 352.5, respectively); and for NHB males compared with NHW and Hispanic males (378.7, 95% CI 353.7, 404.7; 210.6, 95% CI 174.3, 250.8; and 240.9, 95% CI 204.8, 280.2, respectively). In multilevel modeling controlling for individual factors, NHB race was associated with YPLL due to HIV/AIDS for women (p=0.04) and men (p<0.001).
Among people diagnosed with HIV infection, females and NHB people had a disproportionately high premature mortality from HIV/AIDS, suggesting the need for enhanced efforts to improve linkage to and retention in care and medication adherence for these groups.
本研究旨在按性别和种族/民族特征描述2000年至2009年在佛罗里达州被诊断感染艾滋病毒的人群中的过早死亡率，以估计通过与艾滋病毒护理和治疗相联系可预防的过早死亡率差异。
将佛罗里达州艾滋病毒诊断监测数据（不包括同时诊断为艾滋病的情况）与生命记录数据相链接，以确定截至2011年的死亡情况。潜在寿命损失年数（YPLL）从美国特定性别的时期生命表中给定年龄的预期剩余寿命年数获得。
在研究期间被诊断感染艾滋病毒的41,565人中，5,249人死亡，其中2,563人（48.8%）死于艾滋病毒/艾滋病。每1000人年因艾滋病毒/艾滋病导致的年龄标准化潜在寿命损失年数（aYPLL），女性显著高于男性（372.6，95%置信区间[CI]349.8，396.2对295.2，95%CI278.4，312.5）；非西班牙裔黑人（NHB）女性高于非西班牙裔白人（NHW）和西班牙裔女性（分别为388.2，95%CI360.7，416.9；294.3，95%CI239.8，354.9；和295.0，95%CI242.9，352.5）；NHB男性与NHW和西班牙裔男性相比（分别为378.7，95%CI353.7，404.7；210.6，95%CI174.3，250.8；和240.9，95%CI204.8，280.2）。在控制个体因素的多水平模型中，NHB种族与女性（p=0.04）和男性（p<0.001）因艾滋病毒/艾滋病导致的潜在寿命损失年数相关。
在被诊断感染艾滋病毒的人群中，女性和NHB人群因艾滋病毒/艾滋病导致的过早死亡率过高，这表明需要加大力度改善这些群体与护理的联系、护理保留率和药物依从性。
