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Increased HIV/AIDS Mortality Among Residents Aged 25-44 Years --
Baltimore, Maryland, 1987-1989
From 1987 through 1989, overall mortality among Baltimore
residents aged 25-44 years increased from 380.7 deaths per 100,000
residents to 452.6 deaths per 100,000, reflecting the substantial
impact of human immunodeficiency virus (HIV) infection and acquired
immunodeficiency syndrome (AIDS). To better characterize this
increase in mortality, the Baltimore City Health Department
analyzed information on death certificates from the Baltimore City
Bureau of Vital Statistics for persons aged 25-44 years for 1987-
1989. This report summarizes the analysis and characterizes
HIV-infection/AIDS-related deaths among residents of Baltimore in
this age group.
Of the five leading causes of death in Baltimore, the increase
was greatest for HIV infection/AIDS (International Classification
of Diseases, Ninth Revision [ICD-9], codes 042-044); the rate for
persons aged 25-44 years more than doubled (Table 1). In 1989,
mortality attributable to HIV infection/AIDS was more than three
times the national rate; the impact was greatest among black* men,
accounting for 15.5% of all deaths in this group.
From 1987 through 1989, HIV-infection/AIDS-related deaths
among black men more than doubled (Table 1). In 1987, HIV
infection/AIDS was the third leading cause of death for this group
(64.6 deaths per 100,000; n=40) but by 1988, had become the leading
cause of death (114.9; n=73). In 1989, the death rate for this
group increased to 137.1 (n=90). HIV-infection/AIDS-related
mortality among white men also increased: among this group,
HIV-infection/AIDS-related mortality was the sixth leading cause of
death in 1987 (19.9; n=9), but had become the leading cause of
death in 1989 (65.3; n=29).
In 1988, HIV infection/AIDS was the third leading cause of
death (22.6 deaths per 100,000; n=17) for black women (Table 1); by
1989, HIV infection/AIDS had become the second leading cause of
death (34.9; n=27), surpassed only by heart disease.
Reported by: TL McArdell, JJ Sweitzer, MS, JN Lewis, MD, A Cohen,
JD, Preventive Medicine and Epidemiology, Baltimore City Health
Dept. Div of HIV/AIDS, National Center for Infectious Diseases; Div
of Sexually Transmitted Diseases and HIV Prevention and Office of
the Director, National Center for Prevention Svcs, CDC. Editorial Note
Editorial Note: The high HIV-infection/AIDS-related death rate for
persons aged 25-44 years in Baltimore reflects the increasing
burden of disease associated with HIV infection/AIDS in certain
U.S. metropolitan areas. In San Francisco, Los Angeles, New York
City, and Baltimore, HIV infection/AIDS has become the leading
cause of death among young adult men, surpassing heart disease,
cancer, and homicide (1).
In 1989, HIV infection/AIDS was the second leading cause of
death for men and the sixth leading cause of death for women aged
25-44 years in the United States (2). In comparison, in 1989 in
Baltimore, HIV-infection/AIDS-related mortality among persons aged
25-44 years was more than twice the national average for white men
and three times the national average for black men. The increase of
HIV-infection/AIDS-related mortality among blacks reflects the
disproportionate representation of minorities in urban communities
with a high incidence of HIV infection. The findings in this report
also are consistent with national trends that indicate HIV
infection/AIDS is becoming a leading cause of death among young
women. For example, in New York City, HIV infection/AIDS is now the
leading cause of death among women aged 25-44 years (3).
In Baltimore and other metropolitan areas, the reduction of
new HIV infections will require the cooperative efforts of public
and private organizations in providing 1) public information about
HIV infection/AIDS; 2) HIV health education and risk-reduction
initiatives; 3) HIV counseling, testing, referral, and
partner-notification services; and 4) HIV early intervention
services. For example, the Baltimore community used the
HIV-infection/AIDS-related mortality data at city health
conferences and seminars to train health professionals to work with
subpopulations within the metropolitan area through the development
of 1) a "grass roots" HIV-infection prevention campaign for persons
with high-risk behaviors and 2) a needle clean-up program within
neighborhoods with high levels of HIV infection.
References
CDC. Mortality attributable to HIV infection/AIDS -- United
States, 1981-1990. MMWR 1991;40:41-4.
NCHS. Advance report of final mortality statistics, 1989.
Hyattsville, Maryland: US Department of Health and Human Services,
Public Health Service, CDC, 1992. (Monthly vital statistics report;
vol 40, no. 8, suppl 2).
New York City Department of Health. AIDS surveillance update.
Disclaimer
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