IDEAS home Printed from https://ideas.repec.org/a/dem/demres/v51y2024i38.html
   My bibliography  Save this article

Excess mortality associated with HIV: Survey estimates from the PHIA project

Author

Listed:
  • Shannon Farley

    (Columbia University)

  • Giles Reid

    (Columbia University)

  • Kay Yuengling

    (Columbia University)

  • Connor Wright

    (Columbia University)

  • Vesper H. Chisumpa

    (University of Zambia)

  • George Bello

    (Ministry of Health, Malawi)

  • James M. Juma

    (Ministry of Health, Tanzania)

  • Abigail R. Greenleaf

    (Columbia University)

  • Stephen McCracken

    (Centers for Disease Control and Prevention)

  • Paul Stupp

    (Centers for Disease Control and Prevention)

  • Stephane Helleringer

    (New York University, Abu Dhabi)

  • Jessica Justman

    (Columbia University)

Abstract

Background: Incomplete vital statistics systems in resource-limited countries hinder accurate HIV epidemic assessments. Population-based survey data combined with HIV infection biomarkers may partially address this gap, providing excess mortality estimates in households where people living with HIV (PLWH) reside. Objective: Examine household-level excess HIV mortality in households with PLWH using population-based survey data, including mortality reported by heads of households, and HIV biomarkers. Methods: We compared mortality between households with and without PLWH using publicly available data from 11 Population-based HIV Impact Assessments conducted between 2015 and 2019 in Cameroon, Côte d’Ivoire, Eswatini, Kenya, Malawi, Namibia, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe. Eligible, consenting household members provided blood for HIV testing. Household-level regression models estimated deaths per 1,000 person-years (PY) for the three-year period before the survey; death rate ratios were calculated. Quasi-Poisson distribution accounted for household death over-dispersion. Results: Country-specific deaths rates per 1,000 PY were significantly higher among rural versus urban households for five countries. For example, in Cameroon, the rates were 9.3 (95% confidence interval [CI]: 8.7–9.9) versus 6.5 (95% CI: 5.9–7.1). In six countries, death rates were significantly higher (1.3–1.7-fold) among households with PLWH versus those without. Death rate ratios were significantly higher among rural (1.4–1.8-fold) and urban households (1.6–2.3-fold) with PLWH versus those without in four and three countries, respectively. Conclusions: General population household survey findings in multiple countries in Africa indicate that households where PLWH resided experienced excess mortality relative to other households. Contribution: The novel approach we use to describe HIV-related household-level mortality offers an additional method to measure progress toward zero AIDS-related deaths.

Suggested Citation

  • Shannon Farley & Giles Reid & Kay Yuengling & Connor Wright & Vesper H. Chisumpa & George Bello & James M. Juma & Abigail R. Greenleaf & Stephen McCracken & Paul Stupp & Stephane Helleringer & Jessica, 2024. "Excess mortality associated with HIV: Survey estimates from the PHIA project," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 51(38), pages 1183-1200.
    • Handle: RePEc:dem:demres:v:51:y:2024:i:38
    DOI: 10.4054/DemRes.2024.51.38
    as

    Download full text from publisher

    File URL: https://www.demographic-research.org/volumes/vol51/38/51-38.pdf
    Download Restriction: no
    File URL: https://libkey.io/10.4054/DemRes.2024.51.38?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Dennis M. Feehan & Mary Mahy & Matthew J. Salganik, 2017. "The Network Survival Method for Estimating Adult Mortality: Evidence From a Survey Experiment in Rwanda," Demography, Springer;Population Association of America (PAA), vol. 54(4), pages 1503-1528, August.
    2. Bruno Masquelier & Georges Reniers & Gilles Pison, 2014. "Divergences in trends in child and adult mortality in sub-Saharan Africa: Survey evidence on the survival of children and siblings," Population Studies, Taylor & Francis Journals, vol. 68(2), pages 161-177, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Stéphane Helleringer & Li Liu & Yue Chu & Amabelia Rodrigues & Ane Barent Fisker, 2020. "Biases in Survey Estimates of Neonatal Mortality: Results From a Validation Study in Urban Areas of Guinea-Bissau," Demography, Springer;Population Association of America (PAA), vol. 57(5), pages 1705-1726, October.
    2. Gilles Pison & Bruno Masquelier & Almamy Malick Kante & Cheikh Tidiane Ndiaye & Laetitia Douillot & Géraldine Duthé & Cheikh Sokhna & Valerie Delaunay & Stephane Helleringer, 2018. "Estimating mortality from external causes using data from retrospective surveys: A validation study in Niakhar (Senegal)," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 38(32), pages 879-896.
    3. Soumaïla Ouedraogo, 2020. "Estimation of older adult mortality from imperfect data: A comparative review of methods using Burkina Faso censuses," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 43(38), pages 1119-1154.
    4. Henry V. Doctor & Ifeyinwa E. Udo, 2017. "Prime-age adult mortality in sub-Saharan Africa: examining trends in Demographic and Health Surveys conducted between 1990 and 2014," Journal of Population Research, Springer, vol. 34(4), pages 373-386, December.
    5. González Alejandro López & González-González María Jesús, 2018. "Third demographic transition and demographic dividend: An application based on panel data analysis," Bulletin of Geography. Socio-economic Series, Sciendo, vol. 42(42), pages 59-82, December.
    6. Ashira Menashe-Oren & Philippe Bocquier & Carren Ginsburg & Yacouba Compaoré & Mark Collinson, 2023. "The dynamic role of household structure on under-5 mortality in southern and eastern sub-Saharan Africa," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 49(11), pages 249-294.
    7. Helleringer, Stephane & Liu, Li & Chu, Yue & Rodrigues, Amabelia & Fisker, Ane Baerent, 2020. "Biases in Survey Estimates of Neonatal Mortality: Results from a Validation Study in Urban Areas of Guinea-Bissau," SocArXiv qx2kn, Center for Open Science.
    8. Queiroz, Bernardo L & Lima, Everton & Gonzaga, Marcos Roberto & Freire, Flávio, 2018. "Adult Mortality Differentials and Regional Development at the local level in Brazil, 1980-2010," OSF Preprints szvtq, Center for Open Science.
    9. Dennis M. Feehan & Mary Mahy & Matthew J. Salganik, 2017. "The Network Survival Method for Estimating Adult Mortality: Evidence From a Survey Experiment in Rwanda," Demography, Springer;Population Association of America (PAA), vol. 54(4), pages 1503-1528, August.

    More about this item

    Keywords

    mortality; excess mortality; HIV/AIDS;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:dem:demres:v:51:y:2024:i:38. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Editorial Office (email available below). General contact details of provider: https://www.demogr.mpg.de/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.