Sex and Racial/Ethnic Differences in Premature Mortality Due to HIV: Florida, 2000-2009.
OBJECTIVE
This study aimed to characterize premature mortality among people diagnosed with HIV infection from 2000 to 2009 in Florida, by sex and race/ethnicity, to estimate differences in premature mortality that could be prevented by linkage to HIV care and treatment.


METHODS
Florida surveillance data for HIV diagnoses (excluding concurrent AIDS diagnoses) were linked with vital records data to ascertain deaths through 2011. Years of potential life lost (YPLL) were obtained from the expected number of remaining years of life at a given age from the U.S. sex-specific period life tables.


RESULTS
Among 41,565 people diagnosed with HIV infection during the study period, 5,249 died, and 2,563 (48.8%) deaths were due to HIV/AIDS. Age-standardized YPLL (aYPLL) due to HIV/AIDS per 1,000 person-years was significantly higher for females than males (372.6, 95% confidence interval [CI] 349.8, 396.2 vs. 295.2, 95% CI 278.4, 312.5); for non-Hispanic black (NHB) females than non-Hispanic white (NHW) and Hispanic females (388.2, 95% CI 360.7, 416.9; 294.3, 95% CI 239.8, 354.9; and 295.0, 95% CI 242.9, 352.5, respectively); and for NHB males compared with NHW and Hispanic males (378.7, 95% CI 353.7, 404.7; 210.6, 95% CI 174.3, 250.8; and 240.9, 95% CI 204.8, 280.2, respectively). In multilevel modeling controlling for individual factors, NHB race was associated with YPLL due to HIV/AIDS for women (p=0.04) and men (p<0.001).


CONCLUSIONS
Among people diagnosed with HIV infection, females and NHB people had a disproportionately high premature mortality from HIV/AIDS, suggesting the need for enhanced efforts to improve linkage to and retention in care and medication adherence for these groups.
Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, Miami, FL.
Mary Jo
MJ
Trepka
University of South Australia, School of Population Health, Adelaide, South Australia.
Theophile
T
Niyonsenga
Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, Miami, FL.
Kristopher P
KP
Fennie
Florida International University, Robert Stempel College of Public Health and Social Work, Department of Epidemiology, Miami, FL.
Karma
K
McKelvey
Florida Consortium for HIV/AIDS Research/The AIDS Institute, Tampa, FL.
Spencer
S
Lieb
Florida Department of Health, HIV/AIDS Section, Tallahassee, FL.
Lorene M
LM
Maddox
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D023241:Antiretroviral Therapy, Highly Active / Q000706:statistics & numerical data; D002423:Cause of Death; D042241:Early Diagnosis; D005260:Female; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D054625:Healthcare Disparities / Q000191:economics / Q000208:ethnology* / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054525:Minority Health / Q000191:economics / Q000208:ethnology / Q000706:statistics & numerical data; D061213:Mortality, Premature / Q000208:ethnology*; D055361:Multilevel Analysis; D011159:Population Surveillance; D011204:Poverty Areas; D017678:Sex Distribution; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult