title: [Gender difference and mortality in a cohort of heroin users in the Provinces of Modena and Ferrara, 1975-1999].
abstract: OBJECTIVE
  To analyse overall and cause-specific hazards of death in a cohort of heroin users, separately by gender, survival and other risk factors.
  
  
  METHODS
  Longitudinal study of intravenous heroin users; subjects were enrolled between 1975 and 1999 in public health services of the Provinces of Modena and Ferrara and were included in a treatment program.
  
  
  METHODS
  For each gender, age-standardized mortality rates and standardized mortality ratios (SMR) for all causes and for specific causes. Kaplan-Meier method was used for estimating survival probability and Cox regression model to estimate hazard ratios (HR) of death.
  
  
  RESULTS
  in the cohort of 4.644 intravenous drug users, 801 deaths were observed. In both sexes, mortality due to AIDS was lower in subjects enrolled in 1990-99 than among those enrolled in 1980-89. Mortality caused by overdose was particularly high in males enrolled between 1995-99. (SMRs in males and females were respectively 12.12 (95% CI 11.22-13.08) and 20.26 (17.23-23.83). Survival probability at 20 years of observation was 62% (60% for males and 68% for females). Risk of death was highest in males, in subjects enrolled after age 25, in subjects with a low educational level and in unemployed persons.
  
  
  CONCLUSIONS
  Gender and socioeconomic conditions are important determinants of mortality among heroin users. The increase in deaths from heroin overdose in subjects enrolled in the recent years requires particular attention.
authors.affiliation: Osservatorio aziendale dipendenze patologiche, AUSL di Ferrara.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Antolini
authors.forename: Monica
authors.initials: M
authors.lastname: Pirani
authors.forename: Gianni
authors.initials: G
authors.lastname: Morandi
authors.forename: Cristina
authors.initials: C
authors.lastname: Sorio
mesh_terms: D000328:Adult; D002391:Catchment Area, Health; D015331:Cohort Studies; D005260:Female; D006556:Heroin Dependence / Q000401:mortality*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D017678:Sex Distribution; D013997:Time Factors