in British Columbia and Canada

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death in British Columbia and Vancouver from 1987 to 1992, as reported to the Division of. Vital Statistics ..... tually small problems that have been overblown by pub- lic health .... other community, government and business partners). Winnipeg.
CLINICAL AND COMMUNITY STUDIES

ETUDES CLINIQUES ET COMMUNAUTAIRES

Impact of HIV infection and AIDS on death rates in British Columbia and Canada

Robert S. Hogg,*t PhD; Martin T. Schechter,*t MD, MSc, PhD, FRCPC; Julio S.G. Montaner,*t MD, FRCPC; Irene Goldstone,*§ RN, BN, MSc; Kevin Craib,* MMath; Michael V. O'Shaughnessy,*1j PhD Objective: To assess the impact of HIV infection and AIDS on death rates in British Columbia and Canada. Design: Descriptive, population-based study. Setting: British Columbia and Canada. Patients: All people for whom HIV infection or AIDS was listed as the underlying cause of death in Canada and all provinces from 1987 to 1991, as reported to Statistics Canada, and all people for whom HIV infection or AIDS was listed as the underlying or antecedent cause of death in British Columbia and Vancouver from 1987 to 1992, as reported to the Division of Vital Statistics, British Columbia Ministry of Health. Main outcome measures: Age- and cause-specific pattems of death, and potential years of life lost (PYLLs) for men. Results: From 1987 to 1991 a total of 4189 deaths from HIV infection and AIDS (in 3941 males and 248 females) in Canada and 686 such deaths (in 671 males and 15 females) in British Columbia were reported to Statistics Canada. The rate of death from HIV infection and AIDS was 1.39 times higher (95% confidence interval [CI] 1.29 to 1.50) in British Columbia than in Canada as a whole and 1.95 times higher (95% CI 1.65 to 2.29) when HIV infection was associated with specified malignant neoplasms than with other related causes. The PYLLs from HIV infection and AIDS for men rose steadily in Canada, from 17 615 in 1987 to 38 735 in 1991; the latter is comparable to the PYLLs from stroke and colorectal cancer. In Vancouver the PYLLs from HIV infection and AIDS for men increased sharply from 1987 to 1992, surpassing the PYLLs from heart disease, malignant neoplasms and accidents. Conclusions: From 1987 to 1991 the rate of death from HIV infection and AIDS in British Columbia was higher than the national average. In Vancouver HIV infection and AIDS have become the leading causes of premature death in men, exceeding heart disease, malignant neoplasms and accidents.

Objectif: Evaluer l'impact de l'infection par le VIH et du SIDA sur les taux de deces en Colombie-Britannique et au Canada. Conception: Etude descriptive de nature demographique. Contexte: Colombie-Britannique et Canada. Patients: Toutes les personnes dont la cause sous-jacente de deces au Canada et dans toutes From *the British Columbia Centre for Excellence in HIVIAIDS, St. Paul's Hospital, Vancouver, BC, and the departments of tHealth Care and Epidemiology, ftMedicine, §Nursing and I1Pathology, University of British Columbia, Vancouver, BC

Reprint requests to: Dr. Robert S. Hogg, British Columbia Centre for Excellence in HIVIAIDS, St. Paul's Hospital, 1081 Burrard St., Vancouver, BC V6Z 1 Y6