模拟艾滋病毒疾病对男同性恋者和双性恋男性死亡率的影响。

Modelling the impact of HIV disease on mortality in gay and bisexual men.

作者信息

Hogg R S, Strathdee S A, Craib K J, O'Shaughnessy M V, Montaner J S, Schechter M T

机构信息

British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.

出版信息

Int J Epidemiol. 1997 Jun;26(3):657-61. doi: 10.1093/ije/26.3.657.

DOI:10.1093/ije/26.3.657

PMID:9222793

Abstract

OBJECTIVE

To assess how HIV infection and AIDS (HIV/AIDS) impacts on mortality rates for gay and bisexual men.

METHODS

Vital statistics data were obtained for a large Canadian urban centre from 1987 to 1992. Three scenarios were utilized with assumed proportions of gay and bisexual men of 3%, 6% and 9% among the male population age 20 years. For each scenario, non-HIV deaths were distributed according to the assumed proportion of the total population (3%, 6% or 9%) but 95% of HIV deaths were distributed to gay and bisexual men as this is the proportion of AIDS cases in gay and bisexual men in this centre. The main outcome measures of interest were age-specific patterns of death, life expectancy and life expectancy lost due to HIV/AIDS at exact age 20 years, and the probability of living from age 20 to 65 years.

RESULTS

Estimates of the mid-period gay and bisexual population ranged from 5406 to 16,219 for the three scenarios, and total deaths in these men from 953 to 1703. Age-specific mortality was significantly higher for gay and bisexual men than all men aged 30-44. Life expectancy at age 20 for gay and bisexual men ranged from 34.0 years to 46.3 years for the 3% and 9% scenarios respectively. These were all lower than the 54.3 year life expectancy at age 20 for all men. The probability of living from age 20 to 65 years for gay and bisexual men ranged from 32% for the 3% scenario, to 59% for the 9% scenario. These figures were considerably lower than for all men where the probability of living from 20 to 65 was 78%.

CONCLUSION

In a major Canadian centre, life expectancy at age 20 years for gay and bisexual men is 8 to 20 years less than for all men. If the same pattern of mortality were to continue, we estimate that nearly half of gay and bisexual men currently aged 20 years will not reach their 65th birthday. Under even the most liberal assumptions, gay and bisexual men in this urban centre are now experiencing a life expectancy similar to that experienced by all men in Canada in the year 1871.

摘要

目的

评估艾滋病毒感染和艾滋病（HIV/AIDS）对男同性恋者和双性恋男性死亡率的影响。

方法

获取了1987年至1992年加拿大一个大型城市中心的人口动态统计数据。采用了三种假设情景，假设20岁男性人群中男同性恋者和双性恋男性的比例分别为3%、6%和9%。对于每种情景，非艾滋病毒死亡人数按照总人口假设比例（3%、6%或9%）进行分配，但95%的艾滋病毒死亡人数分配给男同性恋者和双性恋男性，因为这是该中心男同性恋者和双性恋男性艾滋病病例的比例。主要关注的结果指标包括特定年龄的死亡模式、预期寿命以及20岁时因HIV/AIDS导致的预期寿命损失，还有从20岁活到65岁的概率。

结果

三种情景下男同性恋者和双性恋男性的中期人口估计数在5406至16219人之间，这些男性的总死亡人数在953至1703人之间。男同性恋者和双性恋男性的特定年龄死亡率显著高于所有30 - 44岁的男性。在3%和9%的情景下，男同性恋者和双性恋男性20岁时的预期寿命分别为34.0岁至46.3岁。这些均低于所有男性20岁时54.3岁的预期寿命。男同性恋者和双性恋男性从20岁活到65岁的概率在3%情景下为32%，在9%情景下为59%。这些数字远低于所有男性，所有男性从20岁活到65岁的概率为78%。