HIV mortality trends among older adults in the United States, 1999–2020

Marium, Amatul; Ogunsola, Ayobami S.; Mercy, Udeh C.; Anikpo, Ifedioranma; Sa'id, Maryam A.; Karaye, Rukayyah M.; Yusuf, Aishatu; Olatunji, Eniola; Yunusa, Ismaeel; Karaye, Ibraheem M.

doi:10.1016/j.archger.2023.104950

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Over the 10 years of our study, approximately 31% of our sample died, and 6% were lost to follow-up. This translates to an annual mortality rate of 3.1%, which is similar to mortality rates identified in other samples of US adults aging with HIV [21].…”

Section: Resultssupporting

confidence: 79%

Performance of a modified fracture risk assessment tool for fragility fracture prediction among older veterans living with HIV

Womack

Murphy

Kidwai-Khan

et al. 2023

Aids

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Objective: Fragility fractures (fractures) are a critical outcome for persons aging with HIV (PAH). Research suggests that the fracture risk assessment tool (FRAX) only modestly estimates fracture risk among PAH. We provide an updated evaluation of how well a ‘modified FRAX’ identifies PAH at risk for fractures in a contemporary HIV cohort. Design: Cohort study. Methods: We used data from the Veterans Aging Cohort Study to evaluate veterans living with HIV, aged 50+ years, for the occurrence of fractures from 1 January 2010 through 31 December 2019. Data from 2009 were used to evaluate the eight FRAX predictors available to us: age, sex, BMI, history of previous fracture, glucocorticoid use, rheumatoid arthritis, alcohol use, and smoking status. These predictor values were then used to estimate participant risk for each of two types of fractures (major osteoporotic and hip) over the subsequent 10 years in strata defined by race/ethnicity using multivariable logistic regression. Results: Discrimination for major osteoporotic fracture was modest [Blacks: area under the curve (AUC) 0.62; 95% confidence interval (CI) 0.62, 0.63; Whites: AUC 0.61; 95% CI 0.60, 0.61; Hispanic: AUC 0.63; 95% CI 0.62, 0.65]. For hip fractures, discrimination was modest to good (Blacks: AUC 0.70; 95% CI 0.69, 0.71; Whites: AUC 0.68; 95% CI 0.67, 0.69]. Calibration was good in all models across all racial/ethnic groups. Conclusion: Our ‘modified FRAX’ exhibited modest discrimination for predicting major osteoporotic fracture and slightly better discrimination for hip fracture. Future studies should explore whether augmentation of this subset of FRAX predictors results in enhanced prediction of fractures among PAH.

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Section: Resultssupporting

confidence: 79%

Performance of a modified fracture risk assessment tool for fragility fracture prediction among older veterans living with HIV

Womack

Murphy

Kidwai-Khan

et al. 2023

Aids

View full text Add to dashboard Cite

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“…Older individuals are also more frequently underdiagnosed because of clinicians as well as individuals underestimating the risk of contracting the virus, which leads to a poorer prognosis. [23] As this is a population-based analysis, the main strength of our study is the robust sample size. We effectively explored the different trends in mortality in PWH across 2 decades across different groups.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…[ 25 ] These particular ICD-10 codes had previously been used to examine mortality rates related to HIV in the elderly. [ 23 ] CDC-Wonder data censorship for groups with ≤20 annual deaths restricted trend analysis to age group 15 to 64, excluding the younger population due to their low HIV mortality rates. Individuals with any indication of HIV on their death certificates were identified using multiple cause of death dataset.…”

Section: Methodsmentioning

confidence: 99%

“…[ 22 ] However, this reduction in mortality rates has not been explained by improvements in immunologic-virologic status or other risk factors. Notably, mortality trends and disparities related to HIV have predominantly been studied in older adults aged over 65 years, [ 23 ] leaving a critical gap in understanding its diverse impact on younger populations. The vulnerability of certain demographics to new HIV infections and potential disparities in healthcare access underscores the need for a focused examination.…”

Section: Introductionmentioning

confidence: 99%

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Disparities in mortality trends of adults with HIV in the USA: A comprehensive examination across 2 decades

Ashraf,

Nadeem,

Ashfaq

et al. 2024

Medicine

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Approximately 38 million people worldwide are affected by human immunodeficiency virus (HIV), with 4000 new infections daily. While literature explores HIV mortality among the elderly in the US, there is an underrepresentation of mortality data for adults. By scrutinizing mortality trends based on demographic factors such as gender, race or ethnicity, age groups, and geographic location, the study seeks to uncover patterns that may facilitate a longitudinal perspective for tailoring interventions and allocating resources effectively. Crude death rates and age-adjusted mortality rates (AAMR) per 100,000 individuals were calculated using HIV mortality data (ICD-10 Codes B20–24) from CDC WONDER database. Permutation test was used to calculate annual percentage changes in AAMR with 95% confidence interval. Average annual percentage changes were computed as weighted average of annual percentage changes. Between 1999 to 2020, US adult HIV deaths totaled 225,396 (AAMR: 5.03), with a significantly decreasing average annual percentage changes (‐5.94). Males exhibited a 3-fold higher AAMR (7.50) than females (2.67). Non-Hispanic Blacks had the highest AAMR (21.82), while Non-Hispanic Asians had the lowest (0.67). The South and Northeast regions had the highest AAMRs (6.91 and 6.33, respectively). Notably, the District of Columbia had an alarmingly high mortality rate of 39.9, while North Dakota had the lowest (0.7). Urban regions (5.47) had double the mortality rates of rural regions (2.70). Mortality rate peaked in age groups 45 to 54 (8.65) and 35 to 44 (7.42). While overall HIV mortality is declining, disparities persist among demographics. Targeted interventions are crucial to improve preventive measures and healthcare access for disproportionately affected groups.

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Demographical and Regional Trends of HIV-Related Mortality Among Young Adults in the United States From 1999 to 2020

Fatima,

Siddiqui,

Malik

et al. 2024

The American Journal of Medicine

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HIV mortality trends among older adults in the United States, 1999–2020

Cited by 4 publications

References 16 publications

Performance of a modified fracture risk assessment tool for fragility fracture prediction among older veterans living with HIV

Performance of a modified fracture risk assessment tool for fragility fracture prediction among older veterans living with HIV

Disparities in mortality trends of adults with HIV in the USA: A comprehensive examination across 2 decades

Demographical and Regional Trends of HIV-Related Mortality Among Young Adults in the United States From 1999 to 2020

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