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Excess mortality associated with HIV: Survey estimates from the PHIA project.
Shannon M Farley1, Giles Reid1, Kay Yuengling1
1ICAP at Columbia University, New York, NY, USA.
Demographic Research
|May 20, 2025
Summary
Households with people living with HIV (PLWH) experienced higher mortality rates. This study used population-based surveys and HIV biomarkers to assess excess deaths in these households across Africa.
Area of Science:
- Epidemiology
- Public Health
- Biomarker Research
Background:
- Inaccurate vital statistics in low-resource settings impede HIV epidemic assessments.
- Population-based surveys with HIV biomarkers can estimate excess mortality in households with people living with HIV (PLWH).
Purpose of the Study:
- To examine household-level excess HIV mortality in households with PLWH.
- Utilize population-based survey data, including mortality reports and HIV biomarkers.
Main Methods:
- Compared mortality in households with and without PLWH using data from 11 Population-based HIV Impact Assessments (2015-2019).
- Employed household-level regression models and Quasi-Poisson distribution to estimate death rates and ratios.
Main Results:
- Significantly higher death rates were observed in rural versus urban households in five countries.
- Households with PLWH showed significantly higher death rates (1.3-1.7-fold) in six countries.
- Excess mortality was evident in both rural and urban households with PLWH compared to those without.
Conclusions:
- General population household surveys in Africa reveal excess mortality in households with PLWH.
- This novel approach aids in measuring progress toward zero AIDS-related deaths.
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