Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Dec 21, 2021
Open Peer Review Period: Dec 17, 2021 - Dec 31, 2021
Date Accepted: Oct 23, 2022
(closed for review but you can still tweet)
Patterns of HIV/AIDS mortality among the elderly from 1990-2019 in China: age-period-cohort analysis
ABSTRACT
Background:
With the increasing effectiveness of antiretroviral therapy and shifting demographics, the problem of elder people with HIV and AIDS is increasingly grim in China, and neglecting infection among elders may cause more serious social problems, exacerbating the difficulty of controlling HIV transmission and raise the risk of death.
Objective:
We investigated the variations in the trends of Chinese mortality by age, period, and cohort from 1990 to 2019，to reveal the relationship between age-period-cohort and HIV burden and guidance for resource allocation to prevent HIV-related deaths in vulnerable target populations.
Methods:
We extracted the HIV/AIDS mortality data from the Globe Burden of Disease (GBD 2019) and online databases published by governments. The Joinpoint regression model was applied to detect changes in HIV/AIDS trends. The age–period–cohort model was used to explore the age, period, and cohort effects.
Results:
The trends in age-standardized HIV/AIDS mortality rates were increased in both genders, from .50 to 4.54 per 100,000 individuals for males and .19 to 1.43 per 100,000 individuals for females. Joinpoint regression model showed the average annual percentage change of standardized mortality rate (AAPC) was 7.0 for males and 6.4 for females, showing an increasing trend. The age effect of males' HIV/AIDs mortality showed a net increase of .59 = [(-.21) ~ .38], from the age of 50-79 years. There is a gradual upward trend in the change in risk of death from AIDS for the period effect among the older population, lowest at ages 50-54 (-.80 for males; -.78 for females) and highest at ages 75-79 (.86 for males; .69 for females). The variation of cohort effects was complex, but both genders had a nearly consistent tendency; people born in 1920-1929 had the lowest cohort effect, born in 1950-1954 had the highest values.
Conclusions:
Our study showed a marked rise in HIV mortality for both genders in China from 1990 to 2019. Aging is an important issue in current HIV prevention and control. There is an urgent need to promote HIV testing and health education. Our findings will help predict future changes in HIV/AIDS mortality and identify age-specific priority populations for intervention
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