title: Adult life expectancy trends in the era of antiretroviral treatment in rural Uganda (1991-2012).
abstract: OBJECTIVE
  To estimate the impact of antiretroviral therapy (ART) on population-wide adult life expectancy.
  
  
  METHODS
  A population-based open cohort study with repeated HIV status measurements and registration of vital events in Southwestern Uganda (1991-2012).
  
  
  METHODS
  Nonparametric survival analysis techniques are used for estimating trends in the adult life expectancy of the general population (aged 15 and above), the adult life expectancy by HIV status, and the adult life expectancy deficit. The life expectancy deficit is estimated as the difference between overall life expectancy and life expectancy of the HIV-negative population. All estimates are disaggregated by sex.
  
  
  RESULTS
  Between 1991-1993 and 2009-2012, population-wide adult life expectancy increased from 39.3 [95% confidence interval (CI): 35.9-42.8] to 56.1 years (95% CI: 54.0-58.5) in women, and from 38.6 (95% CI: 35.4-42.1) to 51.4 years (95% CI: 49.2-53.7) in men. Most of the adult life expectancy gains coincide with the introduction of ART in 2004; as evidenced by an increase in the adult life expectancy of people living with HIV between 2000-2002 and 2009-2012 of 22.9 and 20.0 years for women and men, respectively. Over the whole period of observation, the adult life expectancy deficit associated with HIV decreased from 16.1 (95% CI: 12.7-19.8) to 6.0 years (95% CI: 4.1-7.8) among women, and from 16.0 (95% CI: 12.1-19.9) to 2.8 years (95% CI: 1.2-4.6) among men.
  
  
  CONCLUSIONS
  Population-wide life expectancy increased substantially, largely driven by reductions in HIV-related mortality. Women have gained more adult life years than men since the introduction of ART, but the burden of HIV in terms of the life years lost is still larger for women than it is for men.
authors.affiliation: aMedical Research Council/Uganda Virus Research Institute, Uganda Research Unit on AIDS, Entebbe, UgandabDepartment of Women's and Children's Health, Karolinska Institute, Stockholm, SwedencLondon School of Hygiene and Tropical Medicine, LondondDepartment of Health Sciences, University of York, YorkeTropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Gershim
authors.initials: G
authors.lastname: Asiki
authors.forename: Georges
authors.initials: G
authors.lastname: Reniers
authors.forename: Robert
authors.initials: R
authors.lastname: Newton
authors.forename: Kathy
authors.initials: K
authors.lastname: Baisley
authors.forename: Jessica
authors.initials: J
authors.lastname: Nakiyingi-Miiro
authors.forename: Emma
authors.initials: E
authors.lastname: Slaymaker
authors.forename: Ivan
authors.initials: I
authors.lastname: Kasamba
authors.forename: Janet
authors.initials: J
authors.lastname: Seeley
authors.forename: Jim
authors.initials: J
authors.lastname: Todd
authors.forename: Pontiano
authors.initials: P
authors.lastname: Kaleebu
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kamali
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D012737:Sex Factors; D014454:Uganda; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents