Being Single Raises Risk of Death From HIV in US, But Only in Men

Single, divorced, or separated HIV-positive people in the United States had a higher risk of death from HIV/AIDS than married people, according to analysis of the US National Longitudinal Mortality Study. But the higher death risk applied only to men. Little research addresses the impact of marriage on mortality from HIV infection and AIDS. To address this question, a University of California, Riverside investigator used Cox proportional regression models to analyze data from the third release of the US National Longitudinal Mortality Study.

The overall analysis determined that divorced or separated people had a 4.3 times higher death risk from HIV/AIDS than married people (adjusted relative risk [aRR] 4.321, 95% confidence interval [CI] 2.978 to 6.269). Compared with married people, those who were single or never married had a 13 times higher risk of death from HIV/AIDS (aRR 13.092, 95% CI 9.652 to 17.757).

But when the researcher analyzed risk by gender, marital status affected risk of mortality among men but not among women. However, compared with non-Hispanic white women, African-American women had a 9 times higher risk of death from HIV/AIDS (aRR 9.23, 95% CI 4.47 to 19.03) and Hispanic women had a 7 times higher risk (aRR 7.06, 95% CI 3.03 to 16.45).

The study did not access risk of death from any cause in HIV-positive people. Nor was the researcher able to determine whether gay men living in a committed partnership had a different risk of death from HIV/AIDS than single men who have sex with men. Marriage is now legal for gay men in some US states and several countries.

The author believes "the different gender mortality experiences 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. 2013; 17: e868-e874.

Written by Mark Mascolini on behalf of the International AIDS Society