HIV morbidity and mortality in Jamaica: analysis of national surveillance data, 1993-2005

Elena Losina*, Peter Figueroa, Jacqueline Duncan, Nomita Divi, Lindsey L. Wolf, Lisa R. Hirschhorn, Minnette Robertson, Kevin Harvey, Sheldon Whorms, Kenneth A. Freedberg, Yitades Gebre

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

Objectives: Pre-antiretroviral therapy (ART) HIV-related survival and timing of HIV identification have not been reported from the Caribbean. Using Jamaican national surveillance data, we estimated overall, AIDS-free, and AIDS survival, identified factors influencing HIV-related mortality, and examined factors associated with late HIV/AIDS identification. Methods: The Jamaican HIV/AIDS tracking system (HATS) national surveillance data included timing of first positive HIV test, stage at identification, date of AIDS diagnosis, and death. We estimated overall and AIDS-free survival by initial stage, using a proportional hazard model to identify factors associated with worse survival, and logistic regression to examine factors related to later case identification. Results: Of 10 674 reported HIV cases, 48% were asymptomatic, 14% symptomatic, and 38% first reported with AIDS. Five-year AIDS-free survival was 77% for asymptomatic persons and 63% for symptomatic. Median survival after AIDS diagnosis was 1.02 years. Age, number of opportunistic diseases, and initial stage were strongly associated with mortality. Older age, drug use, and sex with a commercial sex worker were associated with later identification. Conclusions: In the pre-ART era, over one-third of HIV-infected persons in Jamaica were first identified with advanced disease. This highlights the need for earlier diagnosis as ART programs roll out in the Caribbean.

Original languageEnglish (US)
Pages (from-to)132-138
Number of pages7
JournalInternational Journal of Infectious Diseases
Volume12
Issue number2
DOIs
StatePublished - Mar 2008

Keywords

  • AIDS
  • Caribbean
  • HIV
  • Jamaica
  • Morbidity
  • Mortality

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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