HIV mortality trends among the United States population, from 1999-2023: a CDC wonder database study.

IF 2.3
Infectious diseases (London, England) Pub Date : 2025-05-01 Epub Date: 2025-03-17 DOI:10.1080/23744235.2025.2477700
Abuoma Cherry Ekpendu, Muhammad Sohaib Asghar, Afsana Ansari Shaik, Muhammad Zain Khalid, Maria Duharte, Luis Duharte-Vidaurre, Moustafa Hegazi, Chad K Brands
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Abstract

Background: Despite the progress made in managing HIV, the mortality trends among general population in the US remains understudied. Our aim is to analyse the trends in HIV-related mortality among US residents by demographic characteristics and association with social vulnerability index (SVI).

Methods: We abstracted national mortality data from the multiple cause of death files in the CDC WONDER database. The ICD-10 Codes (B20-B24) were used to identify HIV deaths among US population from 1999 to 2023. Trends in age-adjusted mortality rate (AAMR) were assessed using Joinpoint regression analysis. For 10-year increment age-groups, crude mortality rates were reported. Results were expressed as annual percentage changes (APC), average annual percentage changes (AAPC), and 95% confidence intervals (CI). SVI was obtained from CDC for each county.

Results: Between 1999 and 2023, a total of 271,932 HIV-infected patients died within the US (AAMR= 3.4 per 100,000; 95% CI: 3.3-3.5). Overall mortality trends decreased at an annual rate of -4.34% (95% CI: -5.25, -3.41) from 1999 through 2023 in the whole population. Specifically, the trends are higher among males age groups 45-54 years (overall rising in age 65 and above), African Americans, South Region and Large metropolitan areas. States in the top 90th percentile included District of Columbia, Florida, Maryland, Louisiana, New York, and Georgia. Union county followed by Miami-Dade are highly affected within Florida State which ranks second after District of Columbia. SVI was independently associated with HIV mortality with strong association throughout the United States counties.

Conclusions: HIV mortality among US population has decreased overall from 1999 to 2023, but with varying trends by race and ethnicity. This highlights the need for enhanced public health surveillance to better understand the scope of HIV mortality and identify high-risk demographic and regional subgroups for targeted interventions.

1999-2023年美国艾滋病死亡率趋势:疾病控制与预防中心的数据库研究
背景:尽管在艾滋病毒管理方面取得了进展,但美国普通人群的死亡率趋势仍未得到充分研究。我们的目的是通过人口统计学特征和与社会脆弱性指数(SVI)的关联来分析美国居民中hiv相关死亡率的趋势。方法:从CDC WONDER数据库的多死因文件中提取全国死亡率数据。ICD-10代码(B20-B24)用于确定1999年至2023年美国人口中艾滋病毒死亡人数。采用关节点回归分析评估年龄调整死亡率(AAMR)的趋势。对于10岁增长年龄组,报告了粗死亡率。结果以年变化百分比(APC)、平均年变化百分比(AAPC)和95%置信区间(CI)表示。SVI由CDC为每个县提供。结果:1999年至2023年间,美国共有271,932名艾滋病毒感染患者死亡(AAMR= 3.4 / 100,000;95% ci: 3.3-3.5)。从1999年到2023年,整个人口的总死亡率趋势以每年-4.34%(95%置信区间:-5.25,-3.41)的速度下降。具体来说,45-54岁的男性群体(65岁及以上的总体上升)、非洲裔美国人、南部地区和大城市地区的趋势更高。排名前90位的州包括哥伦比亚特区、佛罗里达州、马里兰州、路易斯安那州、纽约州和佐治亚州。尤尼恩县紧随其后的是迈阿密-戴德县,在佛罗里达州受到严重影响,仅次于哥伦比亚特区。SVI与HIV死亡率独立相关,在美国各县有很强的相关性。结论:从1999年到2023年,美国人口中的艾滋病毒死亡率总体下降,但不同种族和民族的趋势不同。这突出表明需要加强公共卫生监测,以便更好地了解艾滋病毒死亡率的范围,并确定高危人口和区域亚群体,以便采取有针对性的干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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