Patterns of survival with AIDS in the United States

We examined patterns of survival with AIDS (acquired immune deficiency syndrome) using the Centers for Disease Control (CDC) "AIDS Public Information Data Set." Analyses used a census of 23,271 cases diagnosed between January 1, 1984 and December 31, 1986. Three Cox proportional hazards models were fit to the data. The first used clinical and demographic parameters only in an effort to replicate Rothenberg's analysis of survival for patients diagnosed in New York City prior to 1986. The second model included variables that capture the effect of time of diagnosis in order to determine whether temporal trends exist. The third model included variables indicating the geographic region from which the cases were reported. The results of these models support earlier findings of demographic and clinical survival correlates. Controlling for covariates, patients diagnosed during 1986 lived significantly longer than those diagnosed earlier; the difference was most profound when Pneumocystis carinii (PCP) was present. Last, we observed large regional differences; their implications for health services planning are discussed.