Population-level adult mortality following the expansion of antiretroviral therapy in Rakai, Uganda

Dorean Nabukalu; Georges Reniers; Kathryn A. Risher; Sylvia Blom; Emma Slaymaker; Chodziwadziwa Kabudula; Basia Zaba; Fred Nalugoda; Godfrey Kigozi; Fred Makumbi; David Serwadda; Steven J. Reynolds; Milly Marston; Jeffrey W. Eaton; Ron Gray; Maria Wawer; Nelson Sewankambo; Tom Lutalo

doi:10.1080/00324728.2019.1595099

Population-level adult mortality following the expansion of antiretroviral therapy in Rakai, Uganda

Dorean Nabukalu, Georges Reniers, Kathryn A. Risher, Sylvia Blom, Emma Slaymaker, Chodziwadziwa Kabudula, Basia Zaba, Fred Nalugoda, Godfrey Kigozi, Fred Makumbi, David Serwadda, Steven J. Reynolds, Milly Marston, Jeffrey W. Eaton, Ron Gray, Maria Wawer, Nelson Sewankambo, Tom Lutalo

Research output: Contribution to journal › Article › peer-review

Abstract

There are limited data on the impact of antiretroviral therapy (ART) on population-level adult mortality in sub-Saharan Africa. We analysed data for 2000–14 from the Rakai Community Cohort Study (RCCS) in Uganda, where free ART was scaled up after 2004. Using non-parametric and parametric (Weibull) survival analysis, we estimated trends in average person-years lived between exact ages 15 and 50, per capita life-years lost to HIV, and the mortality hazards of people living with HIV (PLHIV). Between 2000 and 2014, average adult life-years lived before age 50 increased significantly, from 26.4 to 33.5 years for all women and from 28.6 to 33.8 years for all men. As of 2014, life-years lost to HIV had declined significantly, to 1.3 years among women and 0.4 years among men. Following the roll-out of ART, mortality reductions among PLHIV were initially larger in women than men, but this is no longer the case.

Original language	English (US)
Pages (from-to)	93-102
Number of pages	10
Journal	Population Studies
Volume	74
Issue number	1
DOIs	https://doi.org/10.1080/00324728.2019.1595099
State	Published - Jan 2 2020

Keywords

HIV
Rakai
Uganda
antiretroviral therapy (ART)
mortality

ASJC Scopus subject areas

Demography
History

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10.1080/00324728.2019.1595099

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Nabukalu, D., Reniers, G., Risher, K. A., Blom, S., Slaymaker, E., Kabudula, C., Zaba, B., Nalugoda, F., Kigozi, G., Makumbi, F., Serwadda, D., Reynolds, S. J., Marston, M., Eaton, J. W., Gray, R., Wawer, M., Sewankambo, N., & Lutalo, T. (2020). Population-level adult mortality following the expansion of antiretroviral therapy in Rakai, Uganda. Population Studies, 74(1), 93-102. https://doi.org/10.1080/00324728.2019.1595099

Nabukalu, D, Reniers, G, Risher, KA, Blom, S, Slaymaker, E, Kabudula, C, Zaba, B, Nalugoda, F, Kigozi, G, Makumbi, F, Serwadda, D, Reynolds, SJ, Marston, M, Eaton, JW, Gray, R, Wawer, M, Sewankambo, N & Lutalo, T 2020, 'Population-level adult mortality following the expansion of antiretroviral therapy in Rakai, Uganda', Population Studies, vol. 74, no. 1, pp. 93-102. https://doi.org/10.1080/00324728.2019.1595099

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AB - There are limited data on the impact of antiretroviral therapy (ART) on population-level adult mortality in sub-Saharan Africa. We analysed data for 2000–14 from the Rakai Community Cohort Study (RCCS) in Uganda, where free ART was scaled up after 2004. Using non-parametric and parametric (Weibull) survival analysis, we estimated trends in average person-years lived between exact ages 15 and 50, per capita life-years lost to HIV, and the mortality hazards of people living with HIV (PLHIV). Between 2000 and 2014, average adult life-years lived before age 50 increased significantly, from 26.4 to 33.5 years for all women and from 28.6 to 33.8 years for all men. As of 2014, life-years lost to HIV had declined significantly, to 1.3 years among women and 0.4 years among men. Following the roll-out of ART, mortality reductions among PLHIV were initially larger in women than men, but this is no longer the case.

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Population-level adult mortality following the expansion of antiretroviral therapy in Rakai, Uganda

Abstract

Keywords

ASJC Scopus subject areas

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