The changing landscape of both causes and locations of death in a regional HIV population 2010–2021

Abstract

AbstractBackgroundAlthough HIV‐related deaths among people with HIV have dramatically decreased, deaths from other medical conditions and non‐medical events have increased. The location of death among people with HIV remains underreported.ObjectivesWe reviewed the deaths, causes of death, and reported location of death (i.e. within or outside of medical settings) of all people with HIV with the Southern Alberta Cohort, Calgary, Canada, between 1 January 2010 and 1 January 2022.MethodsThis was a retrospective longitudinal cohort study reviewing all deaths within a comprehensive geographically defined HIV cohort over 11 years.ResultsDeaths from HIV‐related causes decreased from 52% of all deaths in 2010 to 14% in 2021. In 2021, non‐HIV medical deaths increased from 38% to 44%, and non‐medical deaths (e.g. violence, suicide, drug overdose) increased from 0.5% to 39%. Of non‐medical deaths, 67% resulted from substance use/overdose. Overall, deaths in any medical setting decreased from 91% in 2010 to 39% in 2021; 61% of all deaths occurred in a medical setting (e.g. hospital/emergency department or supported/long‐term/hospice care), 27% in a residence, and 9% in the community.ConclusionThe shifting causes of death (i.e. fewer HIV‐related deaths, more overdose deaths) and location of death (i.e. fewer in medical settings, more at home/in the community) requires close monitoring so future resources can be matched to predicted patient needs.