Changes in mortality following HIV and AIDS and estimation of the number of people living with diagnosed HIV/AIDS in Australia, 1981-2003.
OBJECTIVE
To investigate changes in mortality following HIV and AIDS in Australia.


METHODS
The results of a linkage between HIV/AIDS diagnoses and the National Death Index (NDI) to the end of 2003 were used to estimate mortality rates following HIV/AIDS. Standardised Mortality Ratios (SMRs) were calculated for deaths following HIV, with and without AIDS, in three periods of treatment; before antiretroviral therapy (< or =1989), pre- and early-HAART (1990-1996) and HAART (1997-2003). Crude mortality rates were calculated as the number of deaths per 1000 person-years. The total number of people living with HIV/AIDS was estimated.


RESULTS
There were 1789 deaths following HIV without AIDS and 6730 deaths after AIDS. For deaths following HIV without AIDS, the SMRs were 2.99, 1.22 and 1.6 during the periods before 1990, 1990-1996 and 1997-2003. For deaths after AIDS the SMRs were 137.84, 28.64 and 4.55 in the periods one to three, respectively. The crude death rate following HIV without AIDS increased from 16.8 before 1986 to 19.6 in 2003. Death rates after AIDS decreased from 958.7 up to 1986 to 60.4 in 2003. The number of new HIV diagnoses increased to 1276 in 1990 then decreased to 780 in 2003, while AIDS diagnoses increased to 950 in 1994 then decreased to 252 in 2003. The total number of people living with HIV was estimated to be 7873 in 1989, and 12828 in 2003.


CONCLUSIONS
Mortality following AIDS decreased while deaths before AIDS remained low. The number of people living with HIV/AIDS has increased.
Nakhaee
Fatemeh
F
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Darlinghurst, NSW 2010, Australia. fnakhaee@kmu.ac.ir
Black
Deborah
D
Wand
Handan
H
McDonald
Ann
A
Law
Matthew
M
D000163:Acquired Immunodeficiency Syndrome / Q000401:mortality; D023241:Antiretroviral Therapy, Highly Active / Q000401:mortality*; D000998:Antiviral Agents / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends; D018450:Disease Progression; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D015999:Multivariate Analysis; D011159:Population Surveillance; D012307:Risk Factors; D012959:Socioeconomic Factors
D000998:Antiviral Agents