title: Racial-ethnic differences in all-cause and HIV mortality, Florida, 2000-2011.
abstract: OBJECTIVE
  We compared all-cause and human immunodeficiency virus (HIV) mortality in a population-based, HIV-infected cohort.
  
  
  METHODS
  Using records of people diagnosed with HIV during 2000-2009 from the Florida Enhanced HIV-acquired immunodeficiency syndrome (AIDS) Reporting System, we conducted a proportional hazards analysis for all-cause mortality and a competing risk analysis for HIV mortality through 2011 controlling for individual-level factors, neighborhood poverty, and rural-urban status and stratifying by concurrent AIDS status (AIDS within 3 months of HIV diagnosis).
  
  
  RESULTS
  Of 59,880 HIV-infected people, 32.2% had concurrent AIDS and 19.3% died. Adjusting for period of diagnosis, age group, sex, country of birth, HIV transmission mode, area-level poverty, and rural-urban status, non-Hispanic black (NHB) and Hispanic people had an elevated adjusted hazards ratio (aHR) for HIV mortality relative to non-Hispanic whites (NHB concurrent AIDS: aHR 1.34, 95% confidence interval [CI], 1.23-1.47; NHB without concurrent AIDS: aHR 1.41, 95% CI 1.26-1.57; Hispanic concurrent AIDS: aHR 1.18, 95% CI 1.05-1.32; Hispanic without concurrent AIDS: aHR 1.18, 95% CI 1.03-1.36).
  
  
  CONCLUSIONS
  Considering competing causes of death, NHB and Hispanic people had a higher risk of HIV mortality even among those without concurrent AIDS, indicating a need to identify and address barriers to HIV care in these populations.
authors.affiliation: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami. Electronic address: trepkam@fiu.edu.
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Trepka
authors.affiliation: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.
authors.forename: Kristopher P
authors.initials: KP
authors.lastname: Fennie
authors.affiliation: Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Sheehan
authors.affiliation: Centre for Population Health Research, School of Population Health, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Theophile
authors.initials: T
authors.lastname: Niyonsenga
authors.affiliation: Florida Consortium for HIV/AIDS Research, The AIDS Institute, Tampa.
authors.forename: Spencer
authors.initials: S
authors.lastname: Lieb
authors.affiliation: HIV/AIDS Section, Bureau of Communicable Diseases, Florida Department of Health, Tallahassee.
authors.forename: Lorene M
authors.initials: LM
authors.lastname: Maddox
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000208:ethnology / Q000401:mortality; D001741:Black or African American / Q000706:statistics & numerical data; D002423:Cause of Death; D005431:Florida / Q000453:epidemiology; D015658:HIV Infections / Q000208:ethnology* / Q000401:mortality*; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D053208:Kaplan-Meier Estimate; D011203:Poverty; D016016:Proportional Hazards Models; D012307:Risk Factors; D012423:Rural Health / Q000208:ethnology* / Q000706:statistics & numerical data; D014504:Urban Health / Q000208:ethnology* / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data
keywords: Acquired immunodeficiency syndrome; Competing risks models; Human immunodeficiency virus; Mortality; Racial disparities