HIV Infection as Leading Cause of Death Among Young Adults in US Cities and States

Objective. —To describe the extent to which human immunodeficiency virus (HIV) infection has become the leading cause of death among young adults (25 to 44 years of age) in US states and cities of at least 100000 population. Design. —Analysis of underlying causes of death using national vital statistics for 1990 by state and city. Deaths caused by HIV were defined as those with underlying cause assigned a code number of 042,043, or 044, as established by the National Center for Health Statistics. Results. —Infection with HIV was the leading cause of death among young men in five states, causing 29% of their deaths in New York, 28% in New Jersey, 24% in California and Florida, and 16% in Massachusetts. Among young women, HIV was not the leading cause of death in any state. Among young men, HIV infection was the leading cause of death in 64 cities, with the proportion of deaths due to HIV ranging from 16% in Bridgeport, Conn, to 61% in San Francisco, Calif. Among young women, HIV infection was the leading cause of death in nine cities, with the proportion of deaths due to HIV ranging from 15% in Baltimore, Md, to 43% in Newark, NJ. Conclusion. —In many US communities, HIV infection is the leading cause of death among young men and women, causing a large proportion of deaths in this age group. (JAMA. 1993;269:2991-2994)