Work

Increases in Overdose Deaths Among People With HIV Across 14 U.S. Jurisdictions, 2014–2023

Year: 2026

Type: article

Abstract: Introduction: Although overall overdose deaths in the U.S. have plateaued in recent years, there is limited information about how recent changes in the drug landscape have affected people with HIV at regional and national levels. The purpose of this analysis was to describe trends in the cause of death among people with HIV, with a focus on drug-related mortality in this population. Methods: The authors aggregated cause of death data from HIV surveillance systems in 14 jurisdictions across the U.S. to compare regional trends among people with HIV from 2014 to 2023. Causes of death were categorized as fatal overdose, HIV-related disease, or all other causes based on the underlying ICD-10 codes. Demographic characteristics, HIV care indicators, and substance use trends were also evaluated. Results: Among people with HIV, the number of overdose deaths increased from 225 in 2014 to 993 in 2023, accounting for 15.6% of all deaths, whereas HIV-related deaths declined from 1,904 to 1,312, representing 20.6% of all deaths in 2023. In the Pacific Northwest and on the East Coast, overdose deaths surpassed HIV-related deaths in 2023. The proportion of overdose deaths among people with HIV attributable to opioids increased in nearly all regions. Conclusions: Fatal overdose was a major contributor to mortality among people with HIV and, in some regions, exceeded HIV-related mortality. These findings underscore the importance of overdose prevention for people with HIV, who may benefit from syndemic approaches that integrate HIV care with mental health services, social support, and harm reduction interventions.

Source: AJPM Focus

DOI: 10.1016/j.focus.2026.100544