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. 2020 Nov 20;69(46):1717-1724.
doi: 10.15585/mmwr.mm6946a1.

Vital Signs: Deaths Among Persons with Diagnosed HIV Infection, United States, 2010-2018

Karin A Bosh  1 , Anna Satcher Johnson  1 , Angela L Hernandez  1 , Joseph Prejean  1 , Jocelyn Taylor  1 , Rachel Wingard  1 , Linda A Valleroy  1 , H Irene Hall  1
Affiliations

Vital Signs: Deaths Among Persons with Diagnosed HIV Infection, United States, 2010-2018

Karin A Bosh et al. MMWR Morb Mortal Wkly Rep. .

Abstract

Background: Life expectancy for persons with human immunodeficiency virus (HIV) infection who receive recommended treatment can approach that of the general population, yet HIV remains among the 10 leading causes of death among certain populations. Using surveillance data, CDC assessed progress toward reducing deaths among persons with diagnosed HIV (PWDH).

Methods: CDC analyzed National HIV Surveillance System data for persons aged ≥13 years to determine age-adjusted death rates per 1,000 PWDH during 2010-2018. Using the International Classification of Diseases, Tenth Revision, deaths with a nonmissing underlying cause were classified as HIV-related or non-HIV-related. Temporal changes in total deaths during 2010-2018 and deaths by cause during 2010-2017 (2018 excluded because of delays in reporting), by demographic characteristics, transmission category, and U.S. Census region of residence at time of death were calculated.

Results: During 2010-2018, rates of death decreased by 36.6% overall (from 19.4 to 12.3 per 1,000 PWDH). During 2010-2017, HIV-related death rates decreased 48.4% (from 9.1 to 4.7), whereas non-HIV-related death rates decreased 8.6% (from 9.3 to 8.5). Rates of HIV-related deaths during 2017 were highest by race/ethnicity among persons of multiple races (7.0) and Black/African American persons (5.6), followed by White persons (3.9) and Hispanic/Latino persons (3.9). The HIV-related death rate was highest in the South (6.0) and lowest in the Northeast (3.2).

Conclusion: Early diagnosis, prompt treatment, and maintaining access to high-quality care and treatment have been successful in reducing HIV-related deaths and remain necessary for continuing reductions in HIV-related deaths.

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Conflict of interest statement

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. No potential conflicts of interest were disclosed.

Figures

FIGURE 1
FIGURE 1
Age-adjusted rates of total deaths, human immunodeficiency virus (HIV)–related deaths, and non–HIV-related deaths among persons aged ≥13 years with diagnosed HIV infection — United States, 2010–2018 * Rates per 1,000 persons with diagnosed HIV infection. Rates age-adjusted using the U.S. 2000 standard population. † Deaths among persons with diagnosed HIV infection regardless of cause of death (n = 16,742 in 2010; n = 15,483 in 2018). § HIV-related deaths include deaths with an underlying cause with an International Classification of Diseases, Tenth Revision code of B20-B24, O98.7, or R75. Non–HIV-related deaths include all other deaths with a known underlying cause. Deaths by cause available through 2017 because of reporting delays.
FIGURE 2
FIGURE 2
Age-adjusted rates of human immunodeficiency virus (HIV)–related deaths among persons aged ≥13 years with diagnosed HIV infection, by area of residence at time of death — United States and Puerto Rico, 2017 Abbreviations: DC = District of Columbia; PR = Puerto Rico. * Rates per 1,000 persons with diagnosed HIV infection. Rates age-adjusted using the U.S. 2000 standard population. HIV-related deaths include deaths with an underlying cause with an International Classification of Diseases, Tenth Revision, code of B20 –B24, 098.7, or R75. Other U.S. dependent areas are excluded because they do not report underlying cause of death information. Jurisdictions with striped shading are those with <85% of deaths in 2017 with a known underlying cause of death. Rates from Alaska, Idaho, Maine, Montana, Nebraska, New Hampshire, New Mexico, North Dakota, Rhode Island, Utah, Vermont, and West Virginia are calculated based on <12 deaths and should be interpreted with caution.
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