High Incidence of HIV-Associated Mortality Among Black and Hispanic Infants and Women of Childbearing Age in the United States 1990-2001

Abstract

This study examined HIV-associated mortality in infants and in women of childbearing age (15-44 years) in the United States from 1990-2001. HIV-associated deaths were identified from national vital records using multiple cause-of-death data. HIV-associated mortality was higher in black and Hispanic women than in white women (rate ratio(black) = 13.5, 95% CI = 13.2-13.8; rate ratio(Hispanic) = 2.4, 95% CI = 1.9-3.2). Racial/ethnic trends in infant mortality rates from HIV reflected trends observed in women (rate ratio(black) = 16.3, 95% CI = 13.5-19.7; rate ratio(Hispanic) = 3.4, 95% CI = 3.3-3.5). HIV-associated mortality decreased in infants and in women of childbearing age following the availability of highly active antiretroviral therapy, but the decrease was considerably less marked in black women than in women of other racial/ethnic groups. Our findings indicate the need for increased emphasis on prevention of HIV mortality in black and Hispanic women and infants. Reduction of HIV prevalence in young women may also prevent infant mortality from HIV by reducing mother-to-child transmission.