Qiang Xia, Chitra Ramaswamy, and Lucia V. Torian are with the Bureau of HIV, Division of Disease Control, New York City Department of Health and Mental Hygiene, Queens, NY. Ying Sun and Wenhui Li are with the Bureau of Vital Statistics, Division of Epidemiology, New York City Department of Health and Mental Hygiene.
Am J Public Health. 2021 Jan;111(1):121-126. doi: 10.2105/AJPH.2020.305954. Epub 2020 Nov 19.
The Centers for Disease Control and Prevention (CDC) and local health jurisdictions have been using HIV surveillance data to monitor mortality among people with HIV in the United States with age-standardized death rates, but the principles of age standardization have not been consistently followed, making age standardization lose its purpose-comparison over time, across jurisdictions, or by other characteristics.We review the current practices of age standardization in calculating death rates among people with HIV in the United States, discuss the principles of age standardization including those specific to the HIV population whose age distribution differs markedly from that of the US 2000 standard population, make recommendations, and report age-standardized death rates among people with HIV in New York City.When we restricted the analysis population to adults aged between 18 and 84 years in New York City, the age-standardized death rate among people with HIV decreased from 20.8 per 1000 (95% confidence interval [CI] = 19.2, 22.3) in 2013 to 17.1 per 1000 (95% CI = 15.8, 18.3) in 2017, and the age-standardized death rate among people without HIV decreased from 5.8 per 1000 in 2013 to 5.5 per 1000 in 2017.
疾病控制与预防中心(CDC)和地方卫生部门一直在使用艾滋病毒监测数据来监测美国艾滋病毒感染者的死亡率,并采用年龄标准化死亡率进行监测,但年龄标准化原则并未得到一致遵循,这使得年龄标准化失去了其目的——随时间进行比较、在不同司法管辖区进行比较或按其他特征进行比较。我们回顾了目前在美国计算艾滋病毒感染者死亡率时的年龄标准化实践,讨论了年龄标准化原则,包括针对艾滋病毒人群的那些具体原则,其年龄分布与美国 2000 年标准人群明显不同,提出了建议,并报告了纽约市艾滋病毒感染者的年龄标准化死亡率。当我们将分析人群限制为纽约市年龄在 18 至 84 岁的成年人时,艾滋病毒感染者的年龄标准化死亡率从 2013 年的每 1000 人 20.8 例(95%置信区间 [CI] = 19.2,22.3)降至 2017 年的每 1000 人 17.1 例(95%CI = 15.8,18.3),而艾滋病毒感染者的年龄标准化死亡率从 2013 年的每 1000 人 5.8 例降至 2017 年的每 1000 人 5.5 例。