Female mortality associated with HIV-infection: social context

Abstract

Abstract Against the background of the increased HIV-associated mortality in Russia, more negative trends are being registered in females. However, the social grounds for these dynamics are yet to be investigated. The study used official Rosstat mortality statistics and the European standard population to calculate age-specific and standardized indicators of HIV-associated mortality. To analyze socio-demographic status of HIV-related deaths, the authors used the Moscow Death Information System (RFS-EMIAS), based on data from medical death certificates issued by medical organizations in Moscow. In Russia, for over 15 years, until 2019, the increased HIV-associated mortality had remained unchanged with higher rates registered in females. The gender mortality ratio suggests that young people aged 15-30 are the least advantaged population group with similar female and male death rates. Regional differences in HIV-associated mortality in Russia are huge adding up to 10-fold. HIV-unfavorable and relatively advantaged regions hardly differ in gender distribution, meaning that factors determining HIV-related epidemiological situation in the region are universal without any gender specifics. Medical status of HIV patients: a combination of socially-significant pathology (Hepatitis C, drug addiction, Tuberculosis) with delayed treatment are closely related to the social status: usually, low education, unemployment or employment in low-skilled labor, and loneliness. The socio-demographic profile of HIV-associated deaths is gender-neutral without any significant differences between sexes in terms of education, unemployment or loneliness. The results may suggest that HIV-infection is a filter, more significant in terms of the risk of getting sick and falling victim of HIV-infection rather than gender specifics. Grounds for negative dynamics in the female HIV-associated mortality are rather determined by other factors than socio-demographic status. Key messages The socio-demographic profile of HIV-associated deaths is gender-neutral without any significant differences between sexes in terms of education. Grounds for negative dynamics in the female HIV-associated mortality are rather determined by other factors than socio-demographic status.