Publication:
Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Simple item page
dc.contributor.authorLocal Burden of Disease HIV Collaborators
dc.contributor.authorSarmiento Suárez, Rodrigo
dc.contributor.funderBill & Melinda Gates Foundationes_ES
dc.date.accessioned2022-09-19T08:42:20Z
dc.date.available2022-09-19T08:42:20Z
dc.date.issued2021-01-08
dc.description.abstractBackground: Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods: We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results: All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries-apart from Ecuador-across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups-the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions: Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.es_ES
dc.description.peerreviewedSíes_ES
dc.description.sponsorshipThis work was primarily supported by grant OPP1132415 from the Bill & Melinda Gates Foundation. The funder of the study had no role in study design, data collection, data analysis, data interpretation, writing of the report, or decision to publish. The corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.es_ES
dc.format.number1es_ES
dc.format.page4es_ES
dc.format.volume19es_ES
dc.identifier.citationBMC Med. 2021 Jan 8;19(1):4es_ES
dc.identifier.doi10.1186/s12916-020-01876-4es_ES
dc.identifier.e-issn1741-7015es_ES
dc.identifier.journalBMC medicinees_ES
dc.identifier.pubmedID33413343es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/14993
dc.language.isoenges_ES
dc.publisherBioMed Central (BMC)es_ES
dc.relation.publisherversionhttps://doi.org/10.1186/s12916-020-01876-4es_ES
dc.repisalud.centroISCIII::Escuela Nacional de Sanidades_ES
dc.repisalud.institucionISCIIIes_ES
dc.rights.accessRightsopen accesses_ES
dc.rights.licenseAttribution 4.0 International*
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectHIV mortalityes_ES
dc.subjectHIV/AIDSes_ES
dc.subjectLatin Americaes_ES
dc.subjectMappinges_ES
dc.subjectSmall area estimationes_ES
dc.subjectSpatial statisticses_ES
dc.subjectVital registrationes_ES
dc.subject.meshVital Statisticses_ES
dc.subject.meshAdolescentes_ES
dc.subject.meshAdultes_ES
dc.subject.meshAgedes_ES
dc.subject.meshBayes Theoremes_ES
dc.subject.meshFemalees_ES
dc.subject.meshHIV Infectionses_ES
dc.subject.meshHumanses_ES
dc.subject.meshLatin Americaes_ES
dc.subject.meshMalees_ES
dc.subject.meshMiddle Agedes_ES
dc.subject.meshRegistrieses_ES
dc.subject.meshSex Factorses_ES
dc.titleMapping subnational HIV mortality in six Latin American countries with incomplete vital registration systemses_ES
dc.typejournal articlees_ES
dc.type.hasVersionVoRes_ES
dspace.entity.typePublication
relation.isAuthorOfPublication6db78000-ffee-47f9-8f99-ed58a04be5b0
relation.isAuthorOfPublication.latestForDiscovery6db78000-ffee-47f9-8f99-ed58a04be5b0
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
MappingSubnationalHIVMortality_2021.pdf
Size:
3.97 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Escuela Nacional de Sanidad (ENS)