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Marked Declines in Human Immunodeficiency Virus–Related Mortality in Chicago in Women, African Americans, Hispanics, Young Adults, and Injection Drug Users, From 1995 Through 1997
Steven Whitman, PhD;
James Murphy, MPH;
Mardge Cohen, MD;
Renslow Sherer, MD
Arch Intern Med. 2000;160:365-369.
Background Declines in human immunodeficiency virus (HIV)–related mortality between 1995 and 1996 were seen across the United States but were small to nonexistent among people in marginalized sectors who are most likely to contract HIV and die of its effects. No comprehensive analysis describing HIV-related mortality in 1997 was available.
Objective To describe Chicago's HIV-related mortality trends up to and including 1997, with specific attention focused on marginalized populations.
Methods An analysis of cross-sectional HIV-related mortality data with emphasis on the years 1995 through 1997 was conducted for Chicago, Ill. Numbers, proportions, and rates of declines in HIV-related deaths were examined for the city as a whole and also among those diagnosed at Cook County Hospital, as a proxy for people with very low socioeconomic status.
Results Between 1995 and 1996 there was an overall decline of 19% in HIV-related mortality in Chicago but small or no declines among women, African Americans, Hispanics, injection drug users, and people aged 20 to 29 years and more than 50 years. Between 1995 and 1997 there was an overall decline of 61%. At that time the declines were spread more evenly across diverse groups. There were almost no significant differences between the declines for these groups at Cook County Hospital and in the rest of Chicago.
Conclusions The HIV-related mortality has fallen dramatically in Chicago since 1995, the year of its maximum. During 1997, declines were seen among all groups. Declines were also seen among the most disenfranchised of the city. Access to care and the new combination therapies are apparently sustaining life for many in Chicago.
From the HIV/AIDS Surveillance and Epidemiology Programs, Chicago Department of Public Health, Chicago, Ill (Dr Whitman and Mr Murphy); Women and Children HIV Program, The Core Center at Cook County Hospital, Division of General Medicine/Primary Care, Department of Medicine, Cook County Hospital, Chicago (Dr Cohen); and The Core Center at Cook County Hospital, Division of Infectious Disease, Department of Medicine, Cook County Hospital and Rush Medical College, Chicago (Dr Sherer).
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