142nd APHA Annual Meeting and Exposition

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Rural/urban differences in years of potential life lost to HIV/AIDS: Florida, 2000-2009

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 3:15 PM - 3:30 PM

Mary Jo Trepka, MD, MSPH , Robert Stempel College of Public Health and Social Work, Department of Epidemiology, Florida International University, Miami, FL
Karma McKelvey, MPH , Department of Epidemiology, Florida International University, Miami, FL
Kristopher P. Fennie, MPH, PhD , Robert Stempel College of Public Health and Social Work, Department of Epidemiology, Florida International University, Miami, FL
Lorene Maddox, MPH , HIV/AIDS Section, Florida Department of Health, Tallahassee, FL
Spencer Lieb, MPH , Florida Consortium for HIV/AIDS Research, The AIDS Institute, Tampa, FL
Audio (mp3) recording Recorded Presentation (mp4)
Background:  The objective of this study was to compare the magnitude of premature mortality among people diagnosed with HIV infection between 2000-2009 by rural/urban residence in Florida and estimate the percentage that could be prevented by linkage to HIV care and treatment.

Methods:  Florida HIV/AIDS surveillance data for people diagnosed with HIV during 2000-2009 were linked with Florida Vital Records, the Social Security Administration’s Death Master File, and the National Death Index to ascertain deaths.  Data were merged with 2000 Census data using zip code tabulation areas (ZCTA). Rural status of ZCTA was classified based on the rural-urban commuting area coding of the ZCTA.  Years of potential life lost (YPLL) prior to age 75 were calculated by cause of death for those diagnosed with HIV. 

Results:  Of the 61,135 HIV cases, 1,702 (2.8%) were diagnosed in rural areas.  Among rural cases, 651.6 (63%) of 1040.6 YPLL per 1000 person years were due to deaths caused by HIV (ICD-10 B20-B24) compared with 514.3 (61.4%) of 838.1 in urban areas.  Controlling for sex, race/ethnicity, HIV transmission mode, and country of birth, there was no statistically significant difference between rural and urban areas in YPLL from deaths due to HIV/AIDS (zero inflated Poisson P = 0.88).    

Conclusions:  Most YPLL among people with HIV infection was due to deaths from HIV.  We found no evidence that rural Florida residents infected with HIV were more likely to die prematurely from HIV than urban residents. 

Learning Areas:

Epidemiology
Public health or related research

Learning Objectives:
Describe premature mortality among rural residents diagnosed with HIV between 2000 and 2009 in Florida. Describe premature mortality by major causes of death among rural residents diagnosed with HIV between 2000 and 2009 in Florida. Identify differences in premature mortality between urban and rural areas of Florida.

Keyword(s): HIV/AIDS, Rural Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist for the Florida Department of Health, and responsible for co-analyzing the HIV/AIDS data used in this presentation. I have worked in my position for over 20 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3365.0: Rural Perspectives in HIV/AIDS