Background mortality trends in eastern and southern Africa: evidence from the ALPHA network of demographic and HIV surveillance sites

Georges Reniers, London School of Hygiene and Tropical Medicine (LSHTM)
Rob Newton, MRC/UVRI Uganda Research Unit on AIDS
Mark Urassa, National Institute for Medical Research, Tanzania
Kobus Herbst, Africa Centre for Health and Population Studies
Mia Crampin, London School of Hygiene and Tropical Medicine (LSHTM)
Amek Nyaguara, KEMRI/CDC Research and Public Health Collaboration
Tom Lutalo, Rakai Health Sciences Program
Emma Slaymaker, London School of Hygiene and Tropical Medicine (LSHTM)
Jeff Eaton, Imperial College London
Basia Zaba, London School of Hygiene and Tropical Medicine (LSHTM)

Changes in HIV-related mortality have dominated adult mortality trends in populations with generalized epidemics, and our understanding of the underlying or background mortality is limited. Mortality among HIV negative men and women provide an empirical estimate of background mortality, and we study this using data from six demographic and HIV surveillances sites in eastern and southern Africa. We present (i) estimates of trends in the person-years lived in adulthood by gender and HIV status, (ii) describe changes in age-specific mortality rates, and (iii) use parametric survival analysis to test gender differences in the mortality trends of HIV negative adults. Estimates cover the period 2000-2013. Preliminary findings suggest that all study sites have registered important gains in adult life expectancy, some exceeding an average of one year per annum. The contribution of the HIV negative population to the overall reduction in adult mortality has, however, been small for women and negligible for men.