Bureau of HIV, New York City Department of Health and Mental Hygiene, New York, NY ; and.
Division of Disease Control, New York City Department of Health and Mental Hygiene, New York, NY .
J Acquir Immune Defic Syndr. 2021 Feb 1;86(2):e18-e22. doi: 10.1097/QAI.0000000000002545.
Preventable deaths, including those because of drug overdose (OD), are a significant public health concern in New York City (NYC). Trends in drug OD death among people with HIV (PWH) in NYC have not been described.
We selected PWH from the NYC HIV Registry who died during 2007-2017, resided in NYC at death, and died because of drug OD. We characterized PWH who died of drug OD and analyzed CD4 and viral load tests from surveillance to evaluate retention in care and viral suppression (viral load < 200 cc/mL) in the 12 months before death as markers of care-seeking.
From 2007 to 2017, 870 NYC PWH died of drug OD. Of the total OD deaths, 821 (94.4%) were classified as accidental and 49 (5.6%) as intentional. Although the rate of OD deaths among PWH declined during the full period, from 58.5 per 100,000 in 2007 to 47.9 per 100,000 in 2017, it increased from 2014 (30.9/100,000) to 2016 (53.3/100,000) and stayed high through 2017 (47.9/100,000). Decedents during 2007-2017 were predominantly men (70.8%), Black (38.0%) or Latino/Hispanic (38.7%), aged 40-59 years (73.2%), and had a history of injection drug use (43.0%). Over 3-quarters (80.1%) of decedents were retained in HIV care in the 12 months preceding death; 45.4% were viral suppression.
A sizeable number of PWH died of OD during 2007-2017, and OD death rates in recent years increased. Predeath care patterns reveal frequent interaction with the health care system, underscoring missed opportunities for harm-reduction and suicide prevention interventions for PWH.
可预防的死亡，包括因药物过量（OD）导致的死亡，是纽约市（NYC）一个严重的公共卫生问题。纽约市 HIV 感染者（PWH）中药物 OD 死亡趋势尚未得到描述。
我们从 NYC HIV 注册处中选择了在 2007-2017 年期间死亡、在纽约市死亡且因药物 OD 导致死亡的 PWH。我们对因药物 OD 而死亡的 PWH 进行了特征描述，并分析了监测中 CD4 和病毒载量检测，以评估在死亡前 12 个月内的护理保留和病毒抑制（病毒载量 < 200 cc/mL），作为寻求护理的指标。
从 2007 年到 2017 年，870 名 NYC PWH 死于药物 OD。在所有 OD 死亡中，821 例（94.4%）被归类为意外，49 例（5.6%）为故意。尽管 PWH 的 OD 死亡率在整个时期有所下降，从 2007 年的每 100,000 人 58.5 例降至 2017 年的每 100,000 人 47.9 例，但从 2014 年（30.9/100,000）到 2016 年（53.3/100,000）有所增加，并一直持续到 2017 年（每 100,000 人 47.9 例）。2007-2017 年期间的死者主要为男性（70.8%）、黑种人（38.0%）或拉丁裔/西班牙裔（38.7%）、年龄在 40-59 岁（73.2%）、有注射吸毒史（43.0%）。超过 3/4（80.1%）的死者在死亡前 12 个月内保留了 HIV 护理；45.4%的患者病毒得到抑制。
在 2007-2017 年期间，大量 PWH 死于 OD，近年来 OD 死亡率有所上升。死亡前的护理模式显示经常与医疗保健系统互动，这突显了为 PWH 提供减少伤害和预防自杀干预措施的机会错失。
