Decline In HIV Deaths Includes High-risk Groups
NEW YORK, Feb 15
(Reuters Health) -- The number of HIV-related deaths in Chicago have been falling since
1995, the peak year for such deaths. Study findings show that at first this decline did
not include high-risk groups, such as injection drug users, women, African Americans, or
people over 50. But since 1997, HIV-related deaths have also fallen in those most at risk.
"Access to care and the new combination therapies are apparently sustaining life for
many in Chicago," according to researchers in the Archives of Internal Medicine.
Between 1995 and 1996, declines in HIV-related mortality occurred in the US for the first
time since the start of the epidemic. These declines are largely attributed to the
introduction of highly active antiretroviral drug therapy and better access to primary
care.
A team of researchers led by Dr. Steven Whitman, of the Chicago Department of Health in
Illinois, analyzed HIV-related mortality data reported in Chicago between 1995 and 1997.
They looked at mortality for the city as a whole and for patients diagnosed at Cook County
Hospital, which primarily serves patients of very low socioeconomic status.
While the HIV-related mortality rates declined by 19% in Chicago between 1995 and 1996,
Whitman's group found only "small or no declines among women, African Americans,
Hispanics, injection drug users, and people aged 20 to 29 years and more than 50
years."
When the investigators looked at the period between 1995 and 1997, the overall HIV-related
mortality declined by 61%. "At that time the declines were spread more evenly across
diverse groups," they report. Furthermore, they observed "almost no significant
differences between the declines for these groups at Cook County Hospital and in the rest
of Chicago."
Whitman's group adds, however, that several key questions still remain. The durability of
these mortality changes and the impact of multidrug-resistant HIV are unknown. Continued
access to primary care, through continuation of the AIDS Drug Assistance Program and other
publicly funded resources, along with future response to AIDS advocacy efforts, are other
factors that may influence future mortality statistics