Clarification of AIDS Mortality in Women

To the Editor.— In our recently published study inJAMA,1we documented the rapidly increasing effect of human immunodeficiency virus (HIV) infection on mortality in young women. We also noted that 35% of death certificates in women 15 to 44 years of age that indicated HIV infection or the acquired immunodeficiency syndrome (AIDS) also listed specific AIDS-indicator illnesses. These data have been misinterpreted as evidence that only 35% of HIV-infected women who die have an AIDS-defining illness and that the surveillance case definition is less inclusive of women than men. In fact, the number of women who were reported to the Centers for Disease Control with AIDS-defining illness and who died in 1987 exceeds the number of deaths in 1987 in women that were attributed to HIV or AIDS on death certificates (Figure). The misinterpretation may reflect a confusion about the differences between the information available from vital statistics