title: Mortality among participants in the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study.
abstract: BACKGROUND
  Many studies that have reported decreases in human immunodeficiency virus (HIV)-related mortality since the advent of highly active antiretroviral therapy (HAART) have also reported steady increases in non-HIV-related mortality over the same time periods. We examined temporal trends and risk factors for accident- and injury-related mortality among HIV-infected and -uninfected participants in the Women's Interagency HIV Study (WIHS) and the Multicenter AIDS Cohort Study (MACS).
  
  
  METHODS
  Information on causes of death was recorded for all participants in the MACS and WIHS cohort studies who died, and causes of death were categorized as accident- or injury-related deaths or not. Mortality rates were calculated by time periods, prior to the widespread use of HAART (before 1997) and after (1997-2002), and risk factors.
  
  
  RESULTS
  Cause of death information was available for 619 women in the WIHS who died (during the period 1994-2002) and 1830 men in the MACS who died (during the period 1984-2002). The death rates were higher for accident- or injury-related mortality in the WIHS (2.96 deaths per 1000 person-years for the HIV-infected group and 2.96 per 1000 person-years for the HIV-uninfected group), compared with the participants in MACS (0.79 deaths per 1000 person-years for the HIV-infected group and 0.63 per 1000 person-years for the HIV-uninfected group). In the final multivariate analysis, the following factors were associated with significantly higher risk in men: higher education, depressive symptoms, and a greater number of sex partners. Among women, the significant risk factors for death were decreased CD4+ T cell count, unemployment, higher alcohol use, and injection drug use.
  
  
  CONCLUSIONS
  The characteristics of the men in the MACS who died and women in the WIHS who died differ, as do the risk factors for mortality. These results characterize important target groups for interventions to reduce accident- and injury-related deaths.
authors.affiliation: Department of Medicine, University of California, San Francisco, CA 94122, USA. Nancy.Hessol@ucsf.edu
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hessol
authors.forename: Ann
authors.initials: A
authors.lastname: Kalinowski
authors.forename: Lorie
authors.initials: L
authors.lastname: Benning
authors.forename: Joanne
authors.initials: J
authors.lastname: Mullen
authors.forename: Mary
authors.initials: M
authors.lastname: Young
authors.forename: Frank
authors.initials: F
authors.lastname: Palella
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.forename: Roger
authors.initials: R
authors.lastname: Detels
authors.forename: Mardge H
authors.initials: MH
authors.lastname: Cohen
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents