Abstract Body: Background: The intersection of HIV and stroke presents a significant public health concern, with stroke-related mortality in HIV patients influenced by various demographic factors such as race and gender. This study aims to elucidate the trends in stroke-related mortality among HIV patients in the US over two decades, stratified by race and gender.
Methods: Data from the CDC-WONDER database was analyzed from 1999 to 2020 to assess stroke-related mortality rates among HIV patients. Age-adjusted mortality rates were calculated, and trends were analyzed using Joinpoint regression to identify changes in mortality patterns over time. The analysis was stratified by race (Black or African American, White) and gender (male, female).
Results: Stroke-related mortality among HIV patients showed a significant initial decline from 1999 to 2001 with an Annual Percent Change (APC) of -21.57% (p<0.05), followed by a more gradual decline from 2001 to 2018 (APC = -1.16%, p<0.05). However, there was a marked increase in mortality rates from 2018 to 2020 (APC = 22.32%, p<0.05). For Black or African American patients, the mortality rate initially decreased significantly from 1999 to 2001 (APC = -15.70%, p<0.05) and continued to decline more gradually until 2014 (APC = -2.67%, p<0.05). Post-2014, an increasing trend was observed (APC = 3.88%, p<0.05). In contrast, White patients experienced a sharp decline in mortality from 1999 to 2001 (APC = -25.06%, p<0.05), followed by a stable period until 2018 (APC = -0.58%, p<0.05). However, a significant increase was observed between 2018 and 2020 (APC = 31.16%, p<0.05). Among male HIV patients, mortality rates declined significantly from 1999 to 2001 (APC = -18.32%, p<0.05) and continued to decrease until 2012 (APC = -2.56%, p<0.05). A slight increase was observed from 2012 to 2020 (APC = 4.39%, p<0.05). Female patients exhibited a similar trend with an initial decline from 1999 to 2001 (APC = -16.57%, p<0.05), followed by a steady decline until 2018 (APC = -2.34%, p<0.05). A marked increase in mortality rates was observed from 2018 to 2020 (APC = 26.94%, p<0.05).
Conclusion: While overall stroke-related mortality among individuals with HIV has decreased over the past two decades, significant racial and gender disparities persist. The alarmingly high mortality rates among African Americans with HIV emphasize the urgent need for targeted interventions to address the underlying social and health inequities contributing to this disparity.