Impact of human immunodeficiency virus infection on mortality among young men and women in Spain

Abstract

A, Llácer A, Belza M J, Ruiz C, Pérez de la Paz J and Noguer I. Impact of human immunodeficiency virus infection on mortality among young men and women in Spain. International Journal of Epidemiology 1997; 26: 1346-1351. Background. This paper describes the impact of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) mortality among young adults in Spain with specific reference to other causes of death. Methods. Based on death registration data for the period 1980-1993, HIV/AIDS was compared against all other causes of death by gender, using specific rates in the 25-44 age group and standardized rates for potential years of life lost (PYLL). Results. In 1993, HIV/AIDS was the leading cause of death among men aged 25-44 years (21.8% of all deaths) and the second leading cause of death among women (14.9%), exceeded only by cancer. Since 1982, the trend in the overall standardized mortality rate for men in the 25-44 age group has been reversed, showing a progressive increase. Similarly, since 1984 there has been a halt in the decline in female mortality. For both sexes, maintenance of these trends in mortality was largely ascribable to the effect of HIV/AIDS deaths which registered a marked rise, a rise far sharper than that witnessed for variations in all other causes studied. In 1993, the adjusted PYLL rate for HIV/AIDS for ages 1-70 rose to 615 per 100 000 population in men and 156 in women. These values accounted for 9.2% and 5.8% of PYLL for all causes, thereby ranking HIV/AIDS behind motor vehicle accidents as the second leading cause of premature death in men, and behind motor vehicle accidents and breast cancer as the third leading cause in women. For both sexes, the rise in the PYLL rate for HIV/AIDS from 1992 to 1993 proved far greater than that for all other causes of death. Conclusion. In Spain, HIV/AIDS has become the leading cause of death among young adults and is counteracting improvements in mortality due to other causes. It should therefore be regarded as a priority public health problem.

Trends in socioeconomic mortality inequalities in a southern European urban setting at the turn of the 21st century

“…Moreover, AIDS was the main cause of death among young adults during the 1990s26 and drug overdose the second,27 and these causes of death present high socioeconomic inequalities 28 29…”

Gender differences in progression to AIDS and death from HIV seroconversion in a cohort of injecting dug users from 1986 to 2001

“…24 25 HIV/AIDS has also been, until recently, the leading cause of death among young adults. 26 GEMES, Spanish Multicentre Study Group of Seroconverters, has consistently reported slower HIV progression rates in women before and after HAART, 20 27 although no differences in the population effectiveness of HAART by gender have been shown. 20 Nevertheless, the heterogeneity of transmission categories within GEMES and the low number of women who are not IDU may hamper the comparisons.…”

Premature death from infectious diseases in Spain, 1908-1995

“…Además, esta última sigue constituyendo un problema importante en España, no solo por sus relaciones patogénicas con el sida, sino porque la presencia de infección por VIH acelera la progresión de la TBC, al mismo tiempo que la TBC aumenta la replicación del VIH (30)(31)(32)(33). El sida ha tenido un gran impacto sobre la mortalidad prematura en las dos últimas décadas en España, sobre todo a partir de 1985, dado que es una enfermedad de grupos etarios jóvenes y con una alta letalidad (34,35).…”