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[Correcting for misclassified HIV/aids deaths in Mexico: Retrospective analysis, 1983-2012]

Lucero Cahuana-Hurtado1, Olivia Chilian-Herrera1, Sergio Bautista-Arredondo1

  • 1Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.

Salud Publica De Mexico
|November 7, 2015
PubMed
Abstract

Insights

This study corrected misclassified AIDS deaths in Mexico from 1983-2012. The analysis revealed declining Acquired Immunodeficiency Syndrome mortality rates, particularly after 1996 for men and 2008 for women.

Area of Science:

  • Epidemiology
  • Public Health
  • Demography

Background:

  • Accurate mortality data is crucial for understanding disease burden and guiding public health interventions.
  • Misclassification of deaths, particularly for Acquired Immunodeficiency Syndrome (AIDS), can lead to underestimation of the epidemic's impact.
  • Reconstructing accurate time series of AIDS mortality is essential for effective policy-making.

Purpose of the Study:

  • To identify and reassign misclassified AIDS deaths in Mexico.
  • To reconstruct the time series of AIDS mortality from 1983 to 2012, stratified by state, sex, age, and social security affiliation.
  • To develop a replicable methodology for correcting AIDS mortality data.

Main Methods:

  • Analysis of 15.5 million deaths recorded between 1979 and 2012.
  • A three-phase correction process for Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS) mortality: direct AIDS causes, miscoded deaths, and hidden AIDS deaths.
  • Calculation of age-standardized mortality rates (SMR) by sex, social security status, and state.

Main Results:

  • Accumulation of 107,981 AIDS deaths between 1983 and 2012, constituting 11% of total deaths.
  • Significant decline in SMR for men starting in 1996 and for women in 2008.
  • Similar trends observed for populations with and without social security, with notable state-level heterogeneity in SMR.

Conclusions:

  • A straightforward and reproducible methodology for correcting AIDS mortality data has been established.
  • The corrected data provides valuable evidence for informed decision-making in public health.
  • The study highlights the importance of accurate cause-of-death ascertainment for monitoring and controlling the HIV-AIDS epidemic.

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