International AIDS Society

Being Single Raises Death Risk in Some HIV-Positive US Populations

Author: Mark Mascolini

04 May 2013

Being divorced, separated, or never married independently raised the risk of death among HIV-positive people in the United States, according to an analysis of the US National Longitudinal Mortality Study. The higher death risk applied to all men and to African-American or Hispanic women.

The impact of marital status on survival with HIV infection is not well understood. This analysis began with the hypothesis that divorced and never-married people have a much higher death risk than married people. Researchers derived data from the third release of the US National Longitudinal Mortality Study. They used Cox proportional regression models to explore the impact of marital status on death risk.

Overall, divorced and separated people had a quadrupled risk of dying compared with married people (adjusted relative risk [aRR] 4.3, 95% confidence interval [CI] 3.0 to 6.3). People who never married had a 13 times higher death risk (aRR 13.1, 95% CI 9.7 to 17.8).

When the investigators repeated the analysis after dividing the population into men and women, marital status affected survival in men but not in women.

However, when the researchers further divided the analysis by race and ethnicity, they determined that African-American women had a 9 times higher death risk than non-Hispanic white women (aRR 9.2, 95% CI 4.5 to 19.0), and Hispanic women had 7 times higher risk (aRR 7.1, 95% CI 3.0 to 16.5).

The researchers believe the gender-based differences in how marital status affects mortality “suggest that for HIV/AIDS more population-based studies comprising marital status risk factor histories are needed, given the limited research on marital status and mortality from the disease.”

Source: Augustine J. Kposowa. Marital status and HIV/AIDS mortality: evidence from the US National Longitudinal Mortality Study. International Journal of Infectious Diseases. Available online 4 April 2013.

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