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To what extent were life expectancy gains in South Africa attributable to declines in HIV/AIDS mortality from 2006 to 2017? A life table analysis of age-specific mortality (by Tran Doan, Woosub Shin, Neil Mehta)
Demographic Research ( IF 2.1 ) Pub Date : 2022-03-29 , DOI: 10.4054/demres.2022.46.18 Tran Doan , Woosub Shin , Neil Mehta
Demographic Research ( IF 2.1 ) Pub Date : 2022-03-29 , DOI: 10.4054/demres.2022.46.18 Tran Doan , Woosub Shin , Neil Mehta
BACKGROUND
In South Africa, life expectancy increased considerably after the government introduced its antiretroviral therapy (ART) program in 2004. The impact of the national ART program on life expectancy may be underestimated if child mortality is not accounted for in formal evaluations.
OBJECTIVE
We measured the extent to which life expectancy gains from 2006 to 2017 were attributable to declines in HIV/AIDS mortality, accounting for all age groups, including infants and children.
METHODS
To calculate life expectancies, we constructed period life tables using age-specific mortality rates estimated by Thembisa, a South Africa–based HIV epidemic model that integrates pediatric HIV data sources. We modeled counterfactual scenarios, a worst-case and best-case, to discern life expectancy gains related to HIV mortality versus other causes of mortality. We reported outcomes as life expectancy gains and life-years saved per person at varying ages.
RESULTS
In South Africa, life expectancy at birth was 65.1 years in 2017, compared to 54.0 years in 2006. Of these 11.1 life-years gained, we found that 8.9 life-years were attributable to HIV mortality reductions. In people under 49 years old, most gains were attributable to HIV reduction. Gains from HIV reduction and other causes became equivalent at about age 49. In people over 60, most gains were attributable to causes other than HIV/AIDS reduction.
中文翻译：
从 2006 年到 2017 年，南非的预期寿命增长在多大程度上归因于艾滋病毒/艾滋病死亡率的下降？特定年龄死亡率的生命表分析（作者：Tran Doan、Woosub Shin、Neil Mehta）
背景
在南非，在政府于 2004 年推出抗逆转录病毒治疗 (ART) 计划后，预期寿命显着增加。如果在正式评估中未考虑儿童死亡率，则国家抗逆转录病毒治疗 (ART) 计划对预期寿命的影响可能被低估。
目标
我们衡量了从 2006 年到 2017 年预期寿命增长在多大程度上归因于 HIV/AIDS 死亡率的下降，包括婴儿和儿童在内的所有年龄组。
方法
为了计算预期寿命，我们使用 Thembisa 估计的特定年龄死亡率构建了周期寿命表，Thembisa 是一种基于南非的 HIV 流行模型，整合了儿科 HIV 数据源。我们对反事实情景（最坏情况和最佳情况）进行了建模，以区分与 HIV 死亡率和其他死亡原因相关的预期寿命增长。我们将结果报告为不同年龄段的人均预期寿命增加和节省的寿命年。
结果
在南非，2017 年出生时的预期寿命为 65.1 岁，而 2006 年为 54.0 岁。在增加的 11.1 岁中，我们发现 8.9 岁可归因于艾滋病毒死亡率的降低。在 49 岁以下的人群中，大部分收益归因于艾滋病毒的减少。艾滋病毒减少和其他原因带来的收益在 49 岁左右变得相当。在 60 岁以上的人群中，大部分收益归因于艾滋病毒/艾滋病减少以外的其他原因。
更新日期：2022-03-29
In South Africa, life expectancy increased considerably after the government introduced its antiretroviral therapy (ART) program in 2004. The impact of the national ART program on life expectancy may be underestimated if child mortality is not accounted for in formal evaluations.
OBJECTIVE
We measured the extent to which life expectancy gains from 2006 to 2017 were attributable to declines in HIV/AIDS mortality, accounting for all age groups, including infants and children.
METHODS
To calculate life expectancies, we constructed period life tables using age-specific mortality rates estimated by Thembisa, a South Africa–based HIV epidemic model that integrates pediatric HIV data sources. We modeled counterfactual scenarios, a worst-case and best-case, to discern life expectancy gains related to HIV mortality versus other causes of mortality. We reported outcomes as life expectancy gains and life-years saved per person at varying ages.
RESULTS
In South Africa, life expectancy at birth was 65.1 years in 2017, compared to 54.0 years in 2006. Of these 11.1 life-years gained, we found that 8.9 life-years were attributable to HIV mortality reductions. In people under 49 years old, most gains were attributable to HIV reduction. Gains from HIV reduction and other causes became equivalent at about age 49. In people over 60, most gains were attributable to causes other than HIV/AIDS reduction.
中文翻译：
从 2006 年到 2017 年，南非的预期寿命增长在多大程度上归因于艾滋病毒/艾滋病死亡率的下降？特定年龄死亡率的生命表分析（作者：Tran Doan、Woosub Shin、Neil Mehta）
背景
在南非，在政府于 2004 年推出抗逆转录病毒治疗 (ART) 计划后，预期寿命显着增加。如果在正式评估中未考虑儿童死亡率，则国家抗逆转录病毒治疗 (ART) 计划对预期寿命的影响可能被低估。
目标
我们衡量了从 2006 年到 2017 年预期寿命增长在多大程度上归因于 HIV/AIDS 死亡率的下降，包括婴儿和儿童在内的所有年龄组。
方法
为了计算预期寿命，我们使用 Thembisa 估计的特定年龄死亡率构建了周期寿命表，Thembisa 是一种基于南非的 HIV 流行模型，整合了儿科 HIV 数据源。我们对反事实情景（最坏情况和最佳情况）进行了建模，以区分与 HIV 死亡率和其他死亡原因相关的预期寿命增长。我们将结果报告为不同年龄段的人均预期寿命增加和节省的寿命年。
结果
在南非，2017 年出生时的预期寿命为 65.1 岁，而 2006 年为 54.0 岁。在增加的 11.1 岁中，我们发现 8.9 岁可归因于艾滋病毒死亡率的降低。在 49 岁以下的人群中，大部分收益归因于艾滋病毒的减少。艾滋病毒减少和其他原因带来的收益在 49 岁左右变得相当。在 60 岁以上的人群中，大部分收益归因于艾滋病毒/艾滋病减少以外的其他原因。
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