title: Causes of death in HIV-infected women: persistent role of AIDS. The 'Mortalité 2000 & 2005' Surveys (ANRS EN19).
abstract: BACKGROUND
  Little is known about the causes of death in human immunodeficiency virus (HIV)-infected women in the era of combination antiretroviral therapy (ART).
  
  
  METHODS
  In the French nationwide Mortalité 2000 and 2005 surveys, physicians reported causes of deaths in HIV-infected adults in 2000 and 2005, using a standardized questionnaire. We used multivariate logistic regression models to study the association between gender and AIDS-defining causes of death, adjusting for other characteristics.
  
  
  RESULTS
  Of the 1013 HIV-infected adults who died in 2005, 247 (24%) were women. Half of women were infected through heterosexual contacts, compared with 25% men. In 2005, the proportion of AIDS-defining causes of death was higher in women than in men (43 vs 34%; P = 0.01), whereas it had been the same in 2000 (47% in women and men). In 2005, women died less frequently than men from respiratory malignancies (lung, ear/nose/throat) and cardiovascular disease (9% of all causes of death in women compared with 16% in men; P = 0.004), and suicides or accidents (4 vs 9%; P = 0.02). Socio-economic precariousness, younger age, less alcohol and tobacco consumption and lack of prior ART explained the higher proportion of deaths from AIDS in women compared with men.
  
  
  CONCLUSIONS
  The higher proportion of AIDS-related deaths in women is probably explained by two factors: (i) some HIV-infected women, especially migrants in poor socio-economic conditions, may not have access to optimal care; and (ii) a lower prevalence of risk factors for respiratory, cardiovascular and violent deaths means that the risk of dying from non-AIDS causes may be lower in women.
authors.affiliation: INSERM, U897, Bordeaux, France. mojgan.bonarek@isped.u-bordeaux2.fr
authors.forename: Mojgan
authors.initials: M
authors.lastname: Hessamfar-Bonarek
authors.forename: Philippe
authors.initials: P
authors.lastname: Morlat
authors.forename: Dominique
authors.initials: D
authors.lastname: Salmon
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
authors.forename: Thierry
authors.initials: T
authors.lastname: May
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonnet
authors.forename: Eric
authors.initials: E
authors.lastname: Rosenthal
authors.forename: Dominique
authors.initials: D
authors.lastname: Costagliola
authors.forename: Charlotte
authors.initials: C
authors.lastname: Lewden
authors.forename: Geneviève
authors.initials: G
authors.lastname: Chêne
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000401:mortality; D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D012959:Socioeconomic Factors; D013997:Time Factors