Study Shows Black Women with HIV Had Highest Rates of Premature Mortality Between 1998-2018
Researchers at Vanderbilt University Medical Center found that despite improvements in mortality rates among people with HIV over 20 years, women had a higher risk of mortality than men, and Black women had the highest years of potential life lost, according to a study presented at IDWeek.
The study examined mortality trends among 6,531 people who received care at the Vanderbilt Comprehensive Care Clinic from January 1998 to December 2018. As expected, with improved availability and tolerability of antiretroviral therapy during this time period, mortality rates dramatically decreased. Yet after adjusting for age, CD4 cell count, and other factors, the data showed that women had increased mortality risk compared to men.
“HIV is no longer a death sentence for millions living with the disease. While this progress is cause for celebration, we cannot ignore persistent disparities in outcomes that make women with HIV and Black women, in particular, more likely to die or die prematurely,” says Rachael Pellegrino, MD, MPH, a physician at Vanderbilt University Medical Center and the study’s lead author. “When we examined premature mortality, the data show that Black women were the most affected.”
Researchers calculated premature mortality, or years of potential life lost, by comparing age at death among individuals within the cohort who died to age- and sex-specific life expectancy from U.S. general-population life tables. The data show that Black women experienced the greatest years of potential life lost.
“Years of potential life lost, or premature mortality, is a measure that hasn’t been widely used in HIV research,” said Jessica L. Castilho, MD, MPH, Assistant Professor of Medicine in the Division of Infectious Diseases at Vanderbilt University Medical Center, and senior co-author of the study. “We tend to focus on death as the outcome, but looking at years of potential life lost gives us a different perspective on the impact of health disparities.”
This observational study points to the need for more research into the social determinants of health and other environmental and structural exposures that affect mortality in people with HIV, particularly Black women.
In addition to Drs. Pellegrino and Castilho, co-authors on this study included Peter F. Rebeiro, PhD, MHS, Megan Turner, MA, Amber Davidson, BS, Noelle Best, BS, Chandler Shaffernocker, MPS, Timothy Sterling, MD.
IDWeek is the joint annual meeting of the Infectious Diseases Society of America (IDSA), Society for Healthcare Epidemiology of America (SHEA), the HIV Medicine Association (HIVMA), the Pediatric Infectious Diseases Society (PIDS), and the Society of Infectious Diseases Pharmacists (SIDP). IDWeek is a recognized forum for peer-reviewed presentations of new research on scientific advances and bench-to-bedside approaches in prevention, diagnosis, treatment, and epidemiology of infectious diseases, including HIV, across the lifespan. For more information, visit www.idweek.org.