Life-Expectancy Disparities Among Adults With HIV in the United States and Canada: The Impact of a Reduction in Drug- and Alcohol-Related Deaths Using the Lives Saved Simulation Model

被引：34

作者：

Althoff, Keri N. ^{[1
]}

Chandran, Aruna ^{[1
]}

Zhang, Jinbing ^{[1
]}

Arevalo, Wendy Miranda ^{[2
]}

Gange, Stephen J. ^{[1
]}

Sterling, Timothy R. ^{[3
]}

Gill, M. John ^{[4
]}

Justice, Amy C. ^{[5
,6
]}

Palella, Frank J., Jr. ^{[7
]}

Rebeiro, Peter F. ^{[3
]}

Silverberg, Michael J. ^{[8
]}

Mayor, Angel M. ^{[9
]}

Horberg, Michael A. ^{[10
]}

Thorne, Jennifer E. ^{[1
,11
]}

Rabkin, Charles S. ^{[12
]}

Mathews, W. Christopher ^{[13
]}

Klein, Marina B. ^{[14
,15
]}

Humes, Elizabeth ^{[1
]}

Lee, Jennifer ^{[1
]}

Hogg, Robert ^{[16
,17
]}

Moore, Richard D. ^{[18
]}

机构：

[1] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[2] Calif State Univ Long Beach, Dept Kinesiol, Long Beach, CA 90840 USA

[3] Vanderbilt Univ, Dept Med, Nashville, TN USA

[4] Univ Calgary, Dept Med, Calgary, AB, Canada

[5] Yale Univ, Dept Med, New Haven, CT 06520 USA

[6] Vet Affairs Connecticut Healthcare Syst, New Haven, CT USA

[7] Northwestern Univ, Dept Med, Feinberg Sch Med, Chicago, IL 60611 USA

[8] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA

[9] Univ Cent Caribe, Dept Med, Bayamon, PR USA

[10] Kaiser Permanente Midatlant Permanente Med Grp, Rockville, MD USA

[11] Johns Hopkins Univ, Sch Med, Wilmer Eye Inst, Baltimore, MD 21205 USA

[12] NCI, Bethesda, MD 20892 USA

[13] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA

[14] McGill Univ, Div Infect Dis, Hlth Ctr, Montreal, PQ, Canada

[15] McGill Univ, Chron Viral Illness Serv, Hlth Ctr, Montreal, PQ, Canada

[16] Simon Fraser Univ, Dept Hlth Sci, Burnaby, BC, Canada

[17] British Columbia Ctr HIV AIDS Excellence, Vancouver, BC, Canada

[18] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21205 USA

来源：

AMERICAN JOURNAL OF EPIDEMIOLOGY | 2019年 / 188卷 / 12期

基金：

加拿大健康研究院; 美国医疗保健研究与质量局; 美国国家卫生研究院;

关键词：

black women; drug- and alcohol-related deaths; health disparities; Hispanic adults; HIV; life expectancy; men who have sex with men; people who inject drugs; COMBINATION ANTIRETROVIRAL THERAPY; PEOPLE; CARE; INDIVIDUALS; QUALITY; STIGMA; HEALTH; SEX;

D O I：

10.1093/aje/kwz232

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Improvements in life expectancy among people living with human immunodeficiency virus (PLWH) receiving antiretroviral treatment in the United States and Canada might differ among key populations. Given the difference in substance use among key populations and the current opioid epidemic, drug- and alcohol-related deaths might be contributing to the disparities in life expectancy. We sought to estimate life expectancy at age 20 years in key populations (and their comparison groups) in 3 time periods (2004-2007, 2008-2011, and 2012-2015) and the potential increase in expected life expectancy with a simulated 20% reduction in drug- and alcohol-related deaths using the novel Lives Saved Simulation model. Among 92,289 PLWH, life expectancy increased in all key populations and comparison groups from 2004-2007 to 2012-2015. Disparities in survival of approximately a decade persisted among black versus white men who have sex with men and people with (vs. without) a history of injection drug use. A 20% reduction in drug- and alcohol-related mortality would have the greatest life-expectancy benefit for black men who have sex with men, white women, and people with a history of injection drug use. Our findings suggest that preventing drug- and alcohol-related deaths among PLWH could narrow disparities in life expectancy among some key populations, but other causes of death must be addressed to further narrow the disparities.

引用

页码：2097 / 2109

页数：13

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