title: Mortality among injecting drug users in Melbourne: a 16-year follow-up of the Victorian Injecting Cohort Study (VICS).
abstract: Multiple factors affect injecting drug-related mortality, many of which will vary over time and between jurisdictions. There are relatively few studies of mortality among injecting drug users (IDU) in Australia. We aimed to provide data comparable to those reported internationally on the rate of mortality among IDU in Australia. We retrospectively examined mortality among participants (N=220) from the first Australian cohort study of IDU by linking coded personal identifier records with a national death register. The overall mortality rate among those followed-up was 0.83 per 100 PY (95% CI, 0.56-1.21 per 100 PY). This rate is lower than those reported internationally but comparable to the limited Australian data from other cohorts of IDU. Mortality was higher among males, most common among those aged in their early thirties and drug-related mortality occurred typically after substantial injecting careers. Extensive experience of incarceration (>or=3 times) was associated with increased risk of mortality. These results suggest that rates of mortality among Australian IDU may be lower than those reported internationally, with low HIV prevalence and Australia's long-held harm reduction framework potentially contributing to this result. Further studies using defined cohorts followed over time are needed to examine long-term outcomes among IDU in Australia.
authors.affiliation: Centre for Epidemiology and Population Health Research, Macfarlane Burnet Institute for Medical Research and Public Health, 85 Commercial Road, Melbourne, Victoria 3004, Australia. stoove@burnet.edu.au
authors.forename: Mark A
authors.initials: MA
authors.lastname: Stoové
authors.forename: Paul M
authors.initials: PM
authors.lastname: Dietze
authors.forename: Campbell K
authors.initials: CK
authors.lastname: Aitken
authors.forename: Damien
authors.initials: D
authors.lastname: Jolley
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000401:mortality; D000328:Adult; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D038622:Internationality; D008297:Male; D016485:Needle Sharing; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012309:Risk-Taking; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000401:mortality*