Life Expectancy Among People With HIV in New York City, 2009–2018

Qiang Xia, MD, MPH; Gil A. Maduro, PhD; Wenhui Li, PhD; Mary Huynh, PhD; Lucia V. Torian, PhD

Disclosures

J Acquir Immune Defic Syndr. 2022;91(5):434-438. 

In This Article

Abstract and Introduction

Abstract

Objective: To conduct a population-based analysis and compare life expectancy between people with HIV and the general population in New York City (NYC).

Methods: We obtained the annual total number and age, sex, and race/ethnicity distributions of people with HIV from the NYC HIV registry and generated comparable numbers for the NYC general population from the Census 2000 and 2010 data using linear interpolation.

Results: Life expectancy at age 20 among people with HIV increased from 38.5 years [95% confidence interval (CI): 37.4 to 39.5] in 2009 to 50.6 (95% CI: 48.5 to 52.7) in 2018, whereas it increased from 62.0 years (95% CI: 61.8 to 62.1) to 63.6 (95% CI: 63.5 to 63.7) among the NYC general population. The gap between the 2 populations narrowed from 23.5 years (95% CI: 22.4 to 24.6) in 2009 to 13.0 (95% CI: 10.9 to 15.1) in 2018. By sex and race/ethnicity, life expectancy at age 20 among people with HIV increased from 36.7 years in 2009 to 47.9 in 2018 among Black men; 37.5 to 50.5 years among Black women; 38.6 to 48.9 years among Hispanic men; 46.0 to 51.0 years among Hispanic women; 44.7 to 59.7 years among White men; and 38.0 years in 2009–2013 to 50.4 years in 2014–2018 among White women.

Conclusions: Life expectancy among people with HIV improved greatly in NYC in 2009–2018, but the improvement was not equal across sex and racial/ethnic groups. The gap in life expectancy between people with HIV and the general population narrowed but remained.

Introduction

Antiretroviral treatment (ART) has significantly improved survival among people with HIV.[1] The Centers for Disease Control and Prevention (CDC) reported that the age-adjusted HIV-related death rate (the number of HIV-related deaths per 1000 people with HIV) in the United States decreased from 9.1 in 2010 to 4.7 in 2017, a decline of 48%.[2] Life expectancy has also been used to describe mortality. A collaborative analysis of cohort studies from high-income countries shows that life expectancy at age 20 among people treated with ART increased from 36 to 49 years between 1996 and 2005;[3] among patients receiving care at outpatient HIV clinics throughout the United Kingdom, life expectancy at age 20 increased from 30 to 46 years from 1996 to 1999 to 2006–2008;[4] among patients receiving care at a large US health care system, life expectancy at age 21 increased from 38 to 56 years from 2000 to 2003 to 2014–2016.[5]

Previous studies were limited to patients who participated in cohort studies or were receiving care at a particular health care system, and their findings may not be generalizable.[3–8] Using population-based HIV surveillance data, CDC reported life expectancy among people newly diagnosed with HIV in the United States, but we may be more interested in life expectancy among all people with HIV including newly and previously diagnosed.[9,10] Our objective was to conduct a population-based analysis to compare life expectancy between people with HIV and the general population.

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