Trends in mortality and causes of death among women with HIV in the United States: a 10-year study

J Acquir Immune Defic Syndr. 2009 Aug 1;51(4):399-406. doi: 10.1097/QAI.0b013e3181acb4e5.


Background: To assess trends in mortality and cause of death for women with HIV, we studied deaths over a 10-year period among participants in the Women's Interagency HIV Study, a representative US cohort.

Methods: Deaths were ascertained by National Death Index Plus match, and causes of death determined by death certificate.

Results: From 1995 through 2004, 710 of 2792 HIV-infected participants died. During this interval, the standardized mortality ratio fell from a high of 24.7 in 1996 to a plateau with a mean of 10.3 from 2001 to 2004. Over the decade, deaths from non-AIDS causes increased and accounted for the majority of deaths by 2001-2004. The most common non-AIDS causes of death were trauma or overdose, liver disease, cardiovascular disease, and malignancy. Independent predictors of mortality besides HIV-associated variables were depressive symptoms and active hepatitis B or C. Women who were overweight or obese were significantly less likely to die of AIDS than women of normal weight.

Conclusions: In the Women's Interagency HIV Study, the death rate has plateaued in recent years. Although HIV-associated factors predicted AIDS and non-AIDS deaths, other treatable conditions predicted mortality. Further gains in reducing mortality among HIV-infected women may require broader access to therapies for depression, viral hepatitis, and HIV itself.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • Cause of Death
  • Cohort Studies
  • Female
  • HIV Infections / drug therapy
  • HIV Infections / mortality*
  • Humans
  • Longitudinal Studies