Recommendations for defining preventable HIV-related mortality for public health monitoring in the era of Getting to Zero: an expert consensus

Sara E Croxford; Veronique Martin; Sebastian B Lucas; Robert F Miller; Frank A Post; Jane Anderson; Vanessa J Apea; David Asboe; Garry Brough; David R Chadwick; Simon Collins; Helen Corkin; Gillian Dean; Valerie C Delpech; Maka Gogia; Deborah Gold; Anna Kafkalias; Marilena Korkodilos; Justyna D Kowalska; Jacqueline Lindo; Jens D Lundgren; Lucy Lynch; Esteban Martinez; Niall McDougall; Sarah North; Juergen K Rockstroh; Caroline Sabin; Maria Vidal-Read; Laura J Waters; Ann K Sullivan

doi:10.1016/S2352-3018(22)00363-0

Recommendations for defining preventable HIV-related mortality for public health monitoring in the era of Getting to Zero: an expert consensus

Lancet HIV. 2023 Mar;10(3):e195-e201. doi: 10.1016/S2352-3018(22)00363-0. Epub 2023 Jan 4.

Authors

Sara E Croxford¹, Veronique Martin², Sebastian B Lucas³, Robert F Miller⁴, Frank A Post⁵, Jane Anderson⁶, Vanessa J Apea⁷, David Asboe⁸, Garry Brough⁹, David R Chadwick¹⁰, Simon Collins¹¹, Helen Corkin², Gillian Dean¹², Valerie C Delpech², Maka Gogia¹³, Deborah Gold¹⁴, Anna Kafkalias¹⁵, Marilena Korkodilos¹⁶, Justyna D Kowalska¹⁷, Jacqueline Lindo¹⁵, Jens D Lundgren¹⁸, Lucy Lynch², Esteban Martinez¹⁹, Niall McDougall²⁰, Sarah North¹³, Juergen K Rockstroh²¹, Caroline Sabin²², Maria Vidal-Read²³, Laura J Waters²⁴, Ann K Sullivan²⁵

Affiliations

¹ UK Health Security Agency, London, UK. Electronic address: drsaracroxford@gmail.com.
² UK Health Security Agency, London, UK.
³ Guy's and St Thomas' NHS Foundation Trust, London, UK.
⁴ Central and North West London NHS Foundation Trust, London, UK; Royal Free London NHS Foundation Trust, London, UK; Institute of Global Health, University College London, London, UK.
⁵ King's College Hospital NHS Foundation Trust, London, UK; Department of Inflammation Biology, King's College London, London, UK.
⁶ Fast-Track Cities Initiative London, London, UK.
⁷ Barts Health NHS Trust, London, UK; British Association for Sexual Health and HIV, London, UK.
⁸ Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
⁹ Fast-Track Cities Initiative London, London, UK; Positively UK, London, UK; UK Community Advisory Board, London, UK.
¹⁰ British HIV Association, London, UK; South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
¹¹ UK Community Advisory Board, London, UK; HIV i-Base, London, UK.
¹² University Hospitals Sussex NHS Trust, Brighton, UK.
¹³ European AIDS Treatment Group, Brussels, Belgium.
¹⁴ National AIDS Trust, London, UK.
¹⁵ NHS England Specialised Commissioning, London, UK.
¹⁶ Office for Health Improvement and Disparities, London, UK.
¹⁷ Medical University of Warsaw, Warsaw, Poland; European AIDS Clinical Society, Brussels, Belgium.
¹⁸ European AIDS Clinical Society, Brussels, Belgium; Centre of Excellence of Health, Immunity and Infections, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
¹⁹ European AIDS Clinical Society, Brussels, Belgium; Hospital Clínic Barcelona, Barcelona, Spain.
²⁰ Public Health, Sutton Council, Sutton, UK.
²¹ European AIDS Clinical Society, Brussels, Belgium; University Hospital Bonn, Bonn, Germany.
²² Institute of Global Health, University College London, London, UK; British HIV Association, London, UK; National Institute for Health and Care Research Health Protection Research Unit in Blood-Borne and Sexually Transmitted Infections, London, UK.
²³ Healthy London Partnership, London, UK.
²⁴ Central and North West London NHS Foundation Trust, London, UK; British HIV Association, London, UK.
²⁵ UK Health Security Agency, London, UK; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK; British HIV Association, London, UK; European AIDS Clinical Society, Brussels, Belgium.

PMID: 36610439
DOI: 10.1016/S2352-3018(22)00363-0

Abstract

Getting to Zero is a commonly cited strategic aim to reduce mortality due to both HIV and avoidable deaths among people with HIV. However, no clear definitions are attached to these aims with regard to what constitutes HIV-related or preventable mortality, and their ambition is limited. This Position Paper presents consensus recommendations to define preventable HIV-related mortality for a pragmatic approach to public health monitoring by use of national HIV surveillance data. These recommendations were informed by a comprehensive literature review and agreed by 42 international experts, including clinicians, public health professionals, researchers, commissioners, and community representatives. By applying the recommendations to 2019 national HIV surveillance data from the UK, we show that 30% of deaths among people with HIV were HIV-related or possibly HIV-related, and at least 63% of these deaths were preventable or potentially preventable. The application of these recommendations by health authorities will ensure consistent monitoring of HIV elimination targets and allow for the identification of inequalities and areas for intervention.

Publication types

Review

MeSH terms

Consensus
HIV Infections*
Health Personnel
Humans
Public Health