Citation

Singh K, Chander G, Lau B, Edwards JK, Moore RD, Lesko CR. AIDS Behav. 2019; 23(12): 3286-3293.

Copyright

(Copyright © 2019, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s10461-019-02497-6

PMID

30955176

PMCID

PMC6778696

Abstract

High mortality rates among persons with HIV with a history of injection drug use (PWID) are thought to be driven in part by higher rates of external cause-related mortality. We followed 4796 persons aged 18-70 engaged in continuity HIV care from 2001 to 2015 until death or administrative censoring. We compared cause-specific (csHR) and subdistribution hazards (sdHR) of death due to external causes among PWID and persons who acquired their HIV infection through other routes (non-IDU). We standardized estimates on age, sex, race, and HIV-related health status. The standardized csHR for external cause-related death was 3.57 (95% CI 2.39, 5.33), and the sdHR was 3.14 (95% CI 2.16, 4.55). The majority of external cause-related deaths were overdose-related and standardized sdHR was 4.02 (95% CI 2.40, 6.72). Absolute rate of suicide was low but the csHR for PWID compared to non-IDU was most elevated for suicide (6.50, 95% CI 1.51, 28.03). HIV-infected PWID are at a disproportionately increased risk of death due to external causes, particularly overdose and suicide.

Language: en

Keywords

Humans; Adult; Aged; Female; Male; Middle Aged; Adolescent; Cause of Death; Suicide; Young Adult; Survival; HIV Infections; Substance Abuse, Intravenous; Baltimore; Cause-specific mortality; Injection drug use; Drug Users; Ambulatory Care Facilities; Competing risks; Injury-related mortality