Using cohort studies to estimate mortality among injecting drug users that is not attributable to AIDS

Degenhardt, L., Hall, W. D. and Warner-Smith, M. (2006) Using cohort studies to estimate mortality among injecting drug users that is not attributable to AIDS. Sexually Transmitted Infections, 82 Supplement 3: iii56-iii63. doi:10.1136/sti.2005.019273


Author Degenhardt, L.
Hall, W. D.
Warner-Smith, M.
Title Using cohort studies to estimate mortality among injecting drug users that is not attributable to AIDS
Journal name Sexually Transmitted Infections   Check publisher's open access policy
ISSN 1368-4973
Publication date 2006-06
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1136/sti.2005.019273
Volume 82
Issue Supplement 3
Start page iii56
End page iii63
Total pages 8
Editor Helen Ward
Rob Miller
Place of publication London, U.K.
Publisher B M J Publishing Group
Collection year 2006
Language eng
Subject C1
321202 Epidemiology
730205 Substance abuse
111706 Epidemiology
1117 Public Health and Health Services
Abstract Background: Injecting drug use (IDU) and associated mortality appear to be increasing in many parts of the world. IDU is an important factor in HIV transmission. In estimating AIDS mortality attributable to IDU, it is important to take account of premature mortality rates from other causes to ensure that AIDS related mortality among injecting drug users (IDUs) is not overestimated. The current review provides estimates of the excess non-AIDS mortality among IDUs. Method: Searches were conducted with Medline, PsycINFO, and the Web of Science. The authors also searched reference lists of identified papers and an earlier literature review by English et al (1995). Crude. mortality rates (CMRs) were derived from data on the number of deaths, period of follow UP, and number of participants. In estimating the all-cause mortality, two rates were calculated: one that included all cohort studies identified in the search, and one that only included studies that reported on AIDS deaths in their cohort. This provided lower and upper mortality rates, respectively. Results: The current paper derived weighted mortality rates based upon cohort studies that included 179 885 participants, 1 219 422 person-years of observation, and 16 593 deaths. The weighted crude AIDS mortality rate from studies that reported AIDS deaths was approximately 0.78% per annum. The median estimated non-AIDS mortality rate was 1.08% per annum. Conclusions: Illicit drug users have a greatly increased risk of premature death and mortality due to AIDS forms a significant part of that increased risk; it is, however, only part of that risk. Future work needs to examine mortality rates among IDUs in developing countries, and collect data on the relation between HIV and increased mortality due to all causes among this group.
Keyword Infectious diseases
Active antiretroviral therapy
Human-immunodeficiency-virus
Hepatitis-c-virus
Regular amphetamine users
Serious suicide attempts
22-year follow-up
Heroin-addicts
Hiv-infection
Methadone-maintenance
Cocaine use
Q-Index Code C1

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Excellence in Research Australia (ERA) - Collection
2007 Higher Education Research Data Collection
School of Public Health Publications
 
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Created: Wed, 15 Aug 2007, 09:27:23 EST