scholarly journals Life-Expectancy Disparities Among Adults With HIV in the United States and Canada: The Impact of a Reduction in Drug- and Alcohol-Related Deaths Using the Lives Saved Simulation Model

2019 ◽  
Vol 188 (12) ◽  
pp. 2097-2109 ◽  
Author(s):  
Keri N Althoff ◽  
Aruna Chandran ◽  
Jinbing Zhang ◽  
Wendy Miranda Arevalo ◽  
Stephen J Gange ◽  
...  
Keyword(s):  
United States ◽  
Drug Use ◽  
Life Expectancy ◽  
Simulation Model ◽  
The United States ◽  
Key Populations ◽  
Comparison Groups ◽  
History Of ◽  
Sex With Men ◽  
Drug And Alcohol

Abstract Improvements in life expectancy among people living with human immunodeficiency virus (PLWH) receiving antiretroviral treatment in the United States and Canada might differ among key populations. Given the difference in substance use among key populations and the current opioid epidemic, drug- and alcohol-related deaths might be contributing to the disparities in life expectancy. We sought to estimate life expectancy at age 20 years in key populations (and their comparison groups) in 3 time periods (2004–2007, 2008–2011, and 2012–2015) and the potential increase in expected life expectancy with a simulated 20% reduction in drug- and alcohol-related deaths using the novel Lives Saved Simulation model. Among 92,289 PLWH, life expectancy increased in all key populations and comparison groups from 2004–2007 to 2012–2015. Disparities in survival of approximately a decade persisted among black versus white men who have sex with men and people with (vs. without) a history of injection drug use. A 20% reduction in drug- and alcohol-related mortality would have the greatest life-expectancy benefit for black men who have sex with men, white women, and people with a history of injection drug use. Our findings suggest that preventing drug- and alcohol-related deaths among PLWH could narrow disparities in life expectancy among some key populations, but other causes of death must be addressed to further narrow the disparities.

scholarly journals A three-city comparison of drug use and drug use before sex among young men who have sex with men in the United States

2017 ◽  
Vol 30 (1) ◽  
pp. 82-101 ◽  
Author(s):  
Brian A. Feinstein ◽  
Raymond L. Moody ◽  
Steven A. John ◽  
Jeffrey T. Parsons ◽  
Brian Mustanski
Keyword(s):  
United States ◽  
Drug Use ◽  
Young Men ◽  
The United States ◽  
Sex With Men

scholarly journals The Changing Science of HIV Epidemiology in the United States

2019 ◽  
Vol 188 (12) ◽  
pp. 2061-2068 ◽  
Author(s):  
Gypsyamber D’Souza ◽  
Elizabeth T Golub ◽  
Stephen J Gange
Keyword(s):  
United States ◽  
The United States ◽  
Key Populations ◽  
Large Prospective Study ◽  
New Era ◽  
Hiv Epidemiology ◽  
Immunodeficiency Virus ◽  
History Of ◽  
And Shifts

Abstract In 1984, a large prospective study of the natural history of human immunodeficiency virus (HIV) infection, the Multicenter AIDS Cohort Study (MACS), was established; 10 years later, the Women’s Interagency HIV Study (WIHS) was launched. Motivated by the merger and redesign of these long-standing HIV cohort studies in 2019, we review ways in which HIV epidemiology in the United States has transformed over the lives of these studies and how this evolution has influenced planning for enrollment and follow-up. We highlight changes that have occurred in the 3 major domains that are central to epidemiologic science: changes to key populations at highest risk for HIV, refinements in measurement and shifts in the outcomes of interest, and a new era in the tools and approaches that epidemiologists use to synthesize evidence from measurements made on populations. By embracing foundational principles with modern methods, the epidemiologic approach of analyzing the causes and distributions of diseases in contemporaneous populations will continue to advance HIV science over the next decade.

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