Marital status and HIV/AIDS mortality: evidence from the US National Longitudinal Mortality Study

Objectives: The purpose of the study was to examine associations between marital status groups and death from HIV/AIDS. The primary hypothesis was that divorced and single/never married individuals have a much higher risk of death than married persons. Methods: Data were derived from the third release of the US National Longitudinal Mortality Study. Cox proportional regression models were fitted to the data. Results: It was found that marital status is associated with mortality from HIV. Divorced and separated individuals were 4.3 times more likely to die of HIV/AIDS than married individuals (adjusted relative risk (aRR) 4.321, 95% confidence interval (CI) 2.978, 6.269). Single/never married persons were 13 times as likely to die of HIV/AIDS as their married counterparts (aRR 13.092, 95% CI 9.652, 17.757). When the sample was stratified by sex, however, it was observed that while marital status was associated with HIV/AIDS mortality among men, it had no significant association with death in women. However, African-American women (aRR 9.23, 95% CI 4.47, 19.03) and Hispanic women (aRR 7.06, 95% CI 3.03, 16.45) had a significantly higher risk of death than their non-Hispanic white female counterparts. Conclusions: Marital status is a significant risk factor for mortality from HIV/AIDS, but this association is only valid for men. 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. (C) 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.