In the first 5 years of surveillance of reports of the acquired immune deficiency syndrome (AIDS) in Canada, from February 1982, the Laboratory Centre for Disease Control, Ottawa, was notified of 1133 cases reported through provincial ministries of health that met the case definition developed by the US Centers for Disease Control, Atlanta. Most cases (82.2%) were reported from the homosexual/bisexual risk group. Other risk groups were less frequently represented, in contrast to the experience in the United States, where a higher proportion of cases in drug abusers has been observed, and in Africa, where heterosexual spread is far more common. The presenting clinical picture and length of survival after diagnosis were similar to those reported for other countries. Differences between projected estimates of the number of AIDS cases obtained with polynomial and logistic growth models emphasize the need for solid epidemiologic data on the number of people infected with human immunodeficiency virus, the rates of transmission and the rates of progression to disease.
OBJECTIVE: To describe trends and patterns in the AIDS epidemic among Scandinavian women with AIDS. SUBJECTS AND METHODS: All women with AIDS reported to national surveillance units in Denmark, Norway and Sweden in 1980-1990 were included for analyses. RESULTS: The number of heterosexually infected female AIDS cases increased over time. AIDS-defining diseases varied with transmission categories, a variation similar to that found among heterosexual Danish male AIDS cases. Heterosexually infected women were more frequently diagnosed with Pneumocystis carinii pneumonia than with oesophagus candidiasis compared with intravenous drug using women. Twenty-five out of 56 heterosexually infected women reported having a male partner who was bisexual or from a Pattern II country, while one in four did not recognize any risk in their sex partner(s). Survival time increased between 1980 and 1990 and did not differ from survival in male AIDS cases. In a proportional hazards model, age, year of diagnosis and the duration of known HIV-positivity before development of AIDS had an independent impact on survival. The number of women known to be HIV-positive for more than 1 year before diagnosis of AIDS increased over time, although the number of women tested for HIV close to the development of AIDS was especially high among heterosexually infected women. CONCLUSION: Increasing numbers of heterosexually infected women are being diagnosed with AIDS in Scandinavia.
AIMS: This study seeks to describe the impact of AIDS on the city of Copenhagen by estimating potential years of life lost (PYLL) before the age of 65 years and to estimate the impact of AIDS deaths on life expectancy for males and females. METHODS: All AIDS cases reported to the national AIDS surveillance register for residents in the city of Copenhagen in the period 1983-98 were included. For comparative purposes data were obtained on six other causes of death: accidents, suicide, lung cancer, ischaemic heart disease, testicular cancer, and breast cancer. RESULTS: Overall, deaths from AIDS accounted for 8% of all PYLL in men and showed an increasing tendency from 1983 to 1991, when it became the leading cause of PYLL. AIDS had most impact in men in the age group 25-44 years and accounted for 29% of all PYLL in this group at the peak in 1993, decreasing significantly after the introduction of anti-retroviral treatments to 5% of PYLL in 1998. Other leading causes of PYLL, accidents and suicide, also showed a decreasing tendency over the years, but of a much smaller magnitude than AIDS. The impact of AIDS in women was more modest. In the entire study period suicide, accidents, and breast cancer were the leading causes of PYLL in women. It was shown that AIDS deaths at the top of the epidemic in 1991-95 were responsible for a loss of 0.76 years in life expectancy for men and 0.08 years for women. CONCLUSIONS: AIDS has had a considerable impact on potential years of life lost. A significant decline in AIDS deaths has been seen since 1995 with an effect on life expectancy for men in the city of Copenhagen.
In February 1997, the U.S. Centers for Disease Control and Prevention (CDC) reported a 12 percent decline in AIDS deaths over a 1-year period, the first drop in total deaths from AIDS in the United States. The decline was greatest in the West and Northeast, followed by the Midwest and South. By ethnicity, the drop was greatest among non-Hispanic whites and American Indians/Alaskan Natives. Deaths increased in women and persons infected heterosexually, but declined for men and other risk groups, such as men who have sex with men and injection drug users. France also reported a 25 percent reduction in AIDS deaths from 1995 to 1996, as well as a 21 percent decrease in diagnosed AIDS cases from the first to second half of 1996.