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OPIOID OVERDOSE DEATHS AMONG PERSONS WITH HIV INFECTION, UNITED STATES, 2011-2015
Karin A. Bosh1, Nicole Crepaz1, Xueyuan Dong2, Sheryl Lyss1, Maria Mendoza1, Andrew J. Mitsch1
1CDC, Atlanta, GA, USA,2ICF International, Atlanta, GA, USA
The opioid epidemic is a nationwide public health emergency. Persons with HIV might be at increased risk for drug overdose deaths, including overdoses involving an opioid. We examined characteristics of unintentional drug overdose deaths involving an opioid (hereafter, opioid overdose deaths) during 2011-2015 among persons with diagnosed HIV infection in the United States.
We used National HIV Surveillance System data reported through December 2017 to summarize opioid overdose deaths between 2011 and 2015 among persons with diagnosed HIV in the 50 states and District of Columbia. Opioid overdose deaths were selected by using the [i]International Classification of Disease, Tenth Revision[/i] (ICD-10). Death rates were calculated per 100,000 persons with diagnosed HIV. We examined death rates by demographic, geographic, and HIV transmission categories.
There were 1,363 opioid overdose deaths among persons with diagnosed HIV during 2011-2015. Although the rate of all deaths among persons with diagnosed HIV was 12.7% less in 2015 (1630.6 per 100,000) than in 2011 (1,868.8 per 100,000), the opioid overdose death rate among persons with diagnosed HIV was 42.7% greater in 2015 (33.1 per 100,000) than in 2011 (23.2 per 100,000). Rates of opioid overdose deaths were higher in 2015 than 2011 for all subgroups examined by age, sex, race/ethnicity, transmission category, and US Census region of residence at death, with the exception of the West US Census region. In 2015, the rate of opioid overdose deaths was highest among persons aged 50–59 years at death (41.9 per 100,000), females (35.2 per 100,000), whites (49.1 per 100,000), persons who inject drugs (137.4 per 100,000), and the Northeast US Census region (60.6 per 100,000), compared to their respective counterparts.
Opioid overdose death rates were higher in 2015 than in 2011 among nearly all demographic, transmission, and geographic categories examined despite the decreased rate of total deaths among persons with diagnosed HIV during 2011–2015. Differences in opioid overdose deaths among subgroups of persons with diagnosed HIV call for targeted prevention efforts. Intensified overdose prevention is needed for achieving optimal care of persons with diagnosed HIV and to further decrease mortality.