International Journal of Epidemiology, Vol 26, 657-661, Copyright © 1997 by International Epidemiological Association
RS Hogg, SA Strathdee, KJ Craib, MV O'Shaughnessy, JS Montaner and MT Schechter
OBJECTIVE: To assess how HIV infection and AIDS (HIV/AIDS) impacts on
mortality rates for gay and bisexual men. METHODS: Vital statistics data
were obtained for a large Canadian urban centre from 1987 to 1992. Three
scenarios were utilized with assumed proportions of gay and bisexual men of
3%, 6% and 9% among the male population age 20 years. For each scenario,
non-HIV deaths were distributed according to the assumed proportion of the
total population (3%, 6% or 9%) but 95% of HIV deaths were distributed to
gay and bisexual men as this is the proportion of AIDS cases in gay and
bisexual men in this centre. The main outcome measures of interest were
age-specific patterns of death, life expectancy and life expectancy lost
due to HIV/AIDS at exact age 20 years, and the probability of living from
age 20 to 65 years. RESULTS: Estimates of the mid-period gay and bisexual
population ranged from 5406 to 16,219 for the three scenarios, and total
deaths in these men from 953 to 1703. Age-specific mortality was
significantly higher for gay and bisexual men than all men aged 30-44. Life
expectancy at age 20 for gay and bisexual men ranged from 34.0 years to
46.3 years for the 3% and 9% scenarios respectively. These were all lower
than the 54.3 year life expectancy at age 20 for all men. The probability
of living from age 20 to 65 years for gay and bisexual men ranged from 32%
for the 3% scenario, to 59% for the 9% scenario. These figures were
considerably lower than for all men where the probability of living from 20
to 65 was 78%. CONCLUSION: In a major Canadian centre, life expectancy at
age 20 years for gay and bisexual men is 8 to 20 years less than for all
men. If the same pattern of mortality were to continue, we estimate that
nearly half of gay and bisexual men currently aged 20 years will not reach
their 65th birthday. Under even the most liberal assumptions, gay and
bisexual men in this urban centre are now experiencing a life expectancy
similar to that experienced by all men in Canada in the year 1871.
ARTICLES
Modelling the impact of HIV disease on mortality in gay and bisexual men
British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, Canada.
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