Abstract
This study was undertaken to evaluate the life expectancy of gay and bisexual men in the West End of Vancouver, British Columbia during two time periods. Mortality data for males were obtained for the periods 1990 to 1992 and 1995 to 1997 and population estimates were obtained from the 1991 and 1996 Census. The proportion of the male population over 20 years of age estimated to be gay and bisexual was derived from a random telephone survey. Mortality patterns were assessed by comparing changes in life expectancy at age 20 years between the periods, and by examining the life expectancy lost attributed to HIV/AIDS. Between the periods there was 3.8 ± 3.4 years increase in life expectancy among gay and bisexual men. At exact age 20 years, life expectancy increased from 37.0 ± 3.5 years during the period 1990 to 1992 to 40.8 ± 2.4 years during the period 1995 to 1997. The loss of life expectancy attributed to HIV/AIDS at this age was 13.8 ± 3.9 during the first period and 9.8 ± 3.6 years during the second period. This gain is most likely the result of the improved efficacy of antiretroviral therapies.
Résumé
L’étude a été faite afin de comparer l’espérance de vie des hommes gais et bisexuels dans le quartier West End de Vancouver (Colombie-Britannique) sur deux périodes. On a calculé les données relatives à la mortalité masculine pour les périodes de 1990 à 1992 et de 1995 à 1997 et on a dérivé les estimations démographiques à partir des recensements de 1991 et de 1996. La proportion de la population masculine de plus de 20 ans que l’on estime être gaie ou bisexuelle a été dérivée d’un sondage téléphonique par échantillons aléatoires. On a évalué les courbes de mortalité en comparant les changements de l’espérance de vie à 20 ans d’une période à l’autre, et en examinant l’espérance de vie perdue pour cause de VIH/sida. Entre les deux périodes, il y a eu augmentation de 3,8 ans (± 3,4 ans) de l’espérance de vie des hommes gais et bisexuels. L’espérance de vie à 20 ans exactement est passée de 37,0 ans (± 3,5 ans) pour la période de 1990 à 1992 à 40,8 ans (± 2,4 ans) pour la période de 1995 à 1997. La perte d’espérance de vie pour cause de VIH/sida à 20 ans était de 13,8 ans (± 3,9 ans) durant la première période, et de 9,8 ans (± 3,6 ans) durant la seconde. Sous toute probabilité, l’augmentation de l’espérance de vie résulte de l’efficacité accrue des thérapies antirétrovirales.
References
- 1.Schechter MT, Hogg RS, Aylward B, et al. Higher socioeconomic status is associated with slower progression of HIV infection independent of access to health care. J Clin Epidemiol. 1994;47(1):59–67. doi: 10.1016/0895-4356(94)90034-5. [DOI] [PubMed] [Google Scholar]
- 2.Hu DJ, Fleming PL, Mays MA, Ward JW. The expanding regional diversity of the acquired immunodeficiency syndrome epidemic in the United States. Arch Intern Med. 1994;154(6):654–59. doi: 10.1001/archinte.1994.00420060084009. [DOI] [PubMed] [Google Scholar]
- 3.Hogg RS, Heath KV, Strathdee SA, et al. HIV/AIDS mortality in Canada: Evidence of gender, regional and local area differentials. AIDS. 1996;10(8):889–94. doi: 10.1097/00002030-199607000-00012. [DOI] [PubMed] [Google Scholar]
- 4.Burr KF, Costanzo GA, Hayer MV, et al. Mortality and Health Status in Vancouver: An Analysis by Neighbourhood Areas. BC: Division of Vital Statistics; 1995. [Google Scholar]
- 5.Lancet. 1997.
- 6.Hogg RS, Rhone SA, Yip B, et al. Antiviral effect of double and triple drug combinations amongst HIV- infected adults: Lessons from the implementation of viral load-driven antiretroviral therapy. AIDS. 1998;12(3):279–84. doi: 10.1097/00002030-199803000-00005. [DOI] [PubMed] [Google Scholar]
- 7.British Columbia Division of Vital Statistics, Ministry of Health and Ministry Responsible for Seniors.
- 8.Statistics Canada. 1996 Population Census of Canada. 1996. [Google Scholar]
- 9.Chiang CL. The Life Table and Its Applications. Malabar: Robert E. Krieger Publishing Company; 1984. [Google Scholar]
- 10.Hsieh JJ. Construction of expanded continuous life tables–a generalization of abridged and complete life tables. Mathematical Biosciences. 1991;103(2):287–302. doi: 10.1016/0025-5564(91)90057-P. [DOI] [PubMed] [Google Scholar]
- 11.Keyfitz N, Frauenthal J. An improved life table method. Biometrics. 1975;31(4):889–99. doi: 10.2307/2529814. [DOI] [PubMed] [Google Scholar]
- 12.Can J Infect Dis. 1999.
- 13.Can J Infect Dis. 1999.
- 14.Statistics Canada, Life Tables, Canada and Provinces 1990–1992.
- 15.Remis RS, Meunier L, Vandal AC, et al. AIDS underreporting may distort the epidemic: The Quebec experience. Int AIDS Conf. 1996;11(1):32. [Google Scholar]
- 16.Hessol NA, Buchbinder SP, Colbert D, et al. Impact of HIV infection on mortality and accuracy of AIDS reporting on death certificates. Am J Public Health. 1992;82(4):561–64. doi: 10.2105/AJPH.82.4.561. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.McCormick A. Unrecognised HIV related deaths. BMJ. 1991;302(6789):1365–67. doi: 10.1136/bmj.302.6789.1365. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 18.Johnson RJ, Montano BL, Wallace EM. Using death certificates to estimate the completeness of AIDS case reporting in Ontario in 1985–87. CMAJ. 1989;141(6):537–40. [PMC free article] [PubMed] [Google Scholar]