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Trends in HIV-related mortality by sex, race, age, and region in the United States, 1999–2023

Year: 2026

Type: article

Abstract: Although antiretroviral therapy has improved human immunodeficiency virus (HIV) prognosis, mortality and demographic disparities remain critical public health issues in the United States (US). This study analyzed long-term trends in HIV-related mortality from 1999 to 2023 using Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research data. This retrospective database study analyzed death certificate data for HIV-related deaths in the US from 1999 to 2023. Crude and age-adjusted mortality rates were calculated. Joinpoint regression was used to assess trends using annual percent change (APC) and average APC (AAPC), stratified by sex, race/ethnicity, age group, census region, and urbanization level. A total of 221,831 HIV-related deaths occurred from 1999 to 2023. Annual deaths declined from 14,499 in 1999 to 4719 in 2023, representing a 67.45% reduction. The age-adjusted mortality rate decreased from 8.05 to 1.92 per 100,000 population, with an AAPC of -5.73. The decline was fastest from 2007 to 2011 (APC = -10.99) but slowed from 2019 to 2023 (APC = -2.79). Mortality rates remained higher among men, non-Hispanic Black individuals, and residents of the Southern US. Although mortality declined in both metropolitan and nonmetropolitan areas, the decline was slower in nonmetropolitan areas than in metropolitan areas (AAPC = -3.92 vs -6.54). Mortality increased among older age groups, particularly those aged 75 to 84 years. HIV-related mortality in the US decreased substantially from 1999 to 2023, but the pace of decline slowed in recent years. Persistent racial, geographic, urban-rural, and age-related disparities highlight the need for targeted interventions, improved access to HIV care, and strategies addressing the growing burden among older adults.

Source: Medicine

DOI: 10.1097/md.0000000000050986

Authors: Feng Jiang, Ming-Jie Jia, Ying-Lu Ma, Fei-Qing Liang, Weiwei Zeng

Institutions: The First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Guangxi University of Chinese Medicine, Longgang Central Hospital, Shenzhen Second People's Hospital

Language: English

Topic: HIV/AIDS Research and Interventions

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $1,950