Castilla J, Martínez de Aragón M V, Gutiérrez A, Llácer A, Belza M J, Ruiz C, Pérez de la Paz J, Noguer I
National Center for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
Int J Epidemiol. 1997 Dec;26(6):1346-51. doi: 10.1093/ije/26.6.1346.
This paper describes the impact of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) mortality among young adults in Spain with specific reference to other causes of death.
Based on death registration data for the period 1980-1993, HIV/AIDS was compared against all other causes of death by gender, using specific rates in the 25-44 age group and standardized rates for potential years of life lost (PYLL).
In 1993, HIV/AIDS was the leading cause of death among men aged 25-44 years (21.8% of all deaths) and the second leading cause of death among women (14.9%), exceeded only by cancer. Since 1982, the trend in the overall standardized mortality rate for men in the 25-44 age group has been reversed, showing a progressive increase. Similarly, since 1984 there has been a halt in the decline in female mortality. For both sexes, maintenance of these trends in mortality was largely ascribable to the effect of HIV/AIDS deaths which registered a marked rise, a rise far sharper than that witnessed for variations in all other causes studied. In 1993, the adjusted PYLL rate for HIV/AIDS for ages 1-70 rose to 615 per 100,000 population in men and 156 in women. These values accounted for 9.2% and 5.8% of PYLL for all causes, thereby ranking HIV/AIDS behind motor vehicle accidents as the second leading cause of premature death in men, and behind motor vehicle accidents and breast cancer as the third leading cause in women. For both sexes, the rise in the PYLL rate for HIV/AIDS from 1992 to 1993 proved far greater than that for all other causes of death.
In Spain, HIV/AIDS has become the leading cause of death among young adults and is counteracting improvements in mortality due to other causes. It should therefore be regarded as a priority public health problem.
本文描述了西班牙年轻人中人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）死亡率的影响，并特别提及其他死因。
基于1980 - 1993年期间的死亡登记数据，按性别将HIV/AIDS与所有其他死因进行比较，采用25 - 44岁年龄组的特定死亡率以及潜在寿命损失年（PYLL）的标准化率。
1993年，HIV/AIDS是25 - 44岁男性的首要死因（占所有死亡的21.8%），是女性的第二大死因（14.9%），仅次于癌症。自1982年以来，25 - 44岁男性总体标准化死亡率的趋势发生逆转，呈逐步上升趋势。同样，自1984年以来，女性死亡率下降趋势停止。对于两性而言，死亡率的这些趋势主要归因于HIV/AIDS死亡人数的影响，其显著上升，上升幅度远高于所研究的所有其他死因的变化幅度。1993年，1 - 70岁年龄段HIV/AIDS的调整后PYLL率在男性中升至每10万人615，在女性中为156。这些数值分别占所有死因PYLL的9.2%和5.8%，从而使HIV/AIDS在男性中成为仅次于机动车事故的第二大过早死亡原因，在女性中成为仅次于机动车事故和乳腺癌的第三大过早死亡原因。对于两性而言，1992年至1993年HIV/AIDS的PYLL率上升幅度远大于所有其他死因。
在西班牙，HIV/AIDS已成为年轻人的首要死因，并抵消了其他原因导致的死亡率改善。因此，应将其视为优先的公共卫生问题。
