Trends in Mortality and Causes of Death Among Women With HIV in the United States: A 10-Year Study

Toward the goal of assessing trends in mortality and causes of death for HIV-positive women, the authors studied deaths occurring during a 10-year period among participants in the Women's Interagency HIV Study, a representative U.S. cohort. Deaths were ascertained by National Death Index Plus match; death certificates were referenced to determine causes of death.

Of 2,792 HIV-positive participants, 710 died from 1995 through 2004. During this period, the standardized mortality ratio fell from a high of 24.7 in 1996 to a plateau with a mean of 10.3 from 2001 to 2004. During the decade, deaths from non-AIDS causes rose: By 2001-04, these accounted for the majority of deaths.

Among non-AIDS causes of death, the most common were trauma or overdose, liver disease, cardiovascular disease, and malignancy. Besides HIV-associated variables, independent predictors of mortality were depressive symptoms and active hepatitis B or C. Those women who were overweight or obese were significantly less likely to die of AIDS than normal-weight women.

"In the Women's Interagency HIV Study, the death rate has plateaued in recent years," the authors concluded. "Although HIV-associated factors predicted AIDS and non-AIDS deaths, other treatable conditions predicted mortality. Further gains in reducing mortality among HIV-infected women may require broader access to therapies for depression, viral hepatitis, and HIV itself."

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