@article{b63b92435a5f41aca21978745411badb,
title = "Gender difference in all-cause mortality of people living with HIV in Iran: findings from a 20-year cohort study",
abstract = "Objectives Gender differences in the efficacy of treatment and the mortality of HIV-infected patients have not yet been fully elucidated. For the first time, we used data from a 20-year cohort of people living with HIV (PLWH) in four provinces (Fars, Bushehr, Bandar Abbas, and Kohgiluyeh and Boyer-Ahmad) in the southern part of Iran to assess the gender difference in all-cause mortality in PLWH in Iran. Methods We analysed data for 1216 patients aged >= 15 years who were diagnosed with HIV/AIDS between 1997 and 2017. Three hundred and fourteen (25.8%) were women. Results The death rate from all causes among women was 13.7%vs. 43.8% among men (P <0.001). All-cause mortality was significantly associated with gender [the adjusted hazard ratio (aHR) for men compared with women was 3.20], not being on antiretroviral therapy (ART) compared with being on ART at the last visit (aHR 5.42), older age (aHR 1.03), delayed HIV diagnosis compared with early diagnosis (aHR 1.72), history of incarceration (aHR 1.57), higher log CD4 count at diagnosis (aHR 0.54), and prophylaxis forPneumocystispneumonia (aHR 0.09). Conclusions Improving early HIV diagnosis and early ART initiation in men, as well as increased access to hepatitis C virus treatment are needed to increase the survival rate of HIV-infected patients in Iran.",
keywords = "AIDS, antiretroviral therapy regime, gender, HIV, mortality, survival, ACTIVE ANTIRETROVIRAL THERAPY, INFECTED PATIENTS, SEX-DIFFERENCES, COLLABORATIVE ANALYSIS, OUTCOMES, MEN, IMPACT, INDIVIDUALS, SURVIVAL",
author = "Z. Gheibi and M. Dianatinasab and A. Haghparast and A. Mirzazadeh and M. Fararouei",
note = "Funding Information: : This study was financially supported by Shiraz University of Medical Sciences. Also, for this paper, AM received support from the University of California, San Francisco{\textquoteright}s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712. Financial disclosure Funding Information: The study sponsors had no role in the design of the study, the collection, analysis or interpretation of the data, the writing of the manuscript, or the decision to submit the manuscript for publication. The authors would like to thank Ms A. Keivanshekouh at the Research Improvement Center of Shiraz University of Medical Sciences and Center for Development of Clinical Research of Namazi Hospital and Dr Nasrin Shokrpour for editorial assistance for improving the use of English in the manuscript. The authors also wish to thank Dr Elizabeth Fair, Associate Professor of Medicine at the University of California, San Francisco for her invaluable assistance in the editing of this article. Conflicts of interest: We have no conflicts of interest to declare. Financial disclosure: This study was financially supported by Shiraz University of Medical Sciences. Also, for this paper, AM received support from the University of California, San Francisco{\textquoteright}s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712. Availability of data and material: Data and material are available upon request. Publisher Copyright: {\textcopyright} 2020 British HIV Association",
year = "2020",
month = nov,
doi = "10.1111/hiv.12940",
language = "English",
volume = "21",
pages = "659--667",
journal = "HIV Medicine",
issn = "1464-2662",
publisher = "Wiley-Blackwell",
number = "10",
}