Marked declines in human immunodeficiency virus-related mortality in Chicago in women, African Americans, Hispanics, young adults, and injection drugusers, from 1995 through 1997

Background: Declines in human immunodeficiency virus (HIV)-related mortalit y between 1995 and 1996 were seen across the United States but were small t o nonexistent among people in marginalized sectors who are most likely to c ontract HIV and die of its effects. No comprehensive analysis describing HI V-related mortality in 1997 was available. Objective: To describe Chicago's HIV-related mortality trends up to and inc luding 1997, with specific attention focused on marginalized populations. Methods: An analysis of cross-sectional HIV-related mortality data with emp hasis on the years 1995 through 1997 was conducted for Chicago, ill. Number s, proportions, and rates of declines in HIV-related deaths were examined f or the city as a whole and also among those diagnosed at Cook County Hospit al, as a proxy for people with very low socioeconomic status. Results: Between 1995 and 1996 there was an overall decline of 19% in HIV-r elated mortality in Chicago but small or no declines among women, African A mericans, Hispanics, injection drug users, and people aged 20 to 29 years a nd more than 50 years. Between 1995 and 1997 there was an overall decline o f 61%. At that time the declines were spread more evenly across diverse gro ups. There were almost no significant differences between the declines for these groups at Cook County Hospital and in the rest of Chicago. Conclusion: The HIV-related mortality has fallen dramatically in Chicago si nce 1995, the year of its maximum. During 1997, declines were seen among al l groups. Declines were also seen among the most disenfranchised of the cit y. Access to care and the new combination therapies are apparently sustaini ng life for many in Chicago.