Life Expectancy and Life Years Lost After HIV or AIDS Diagnosis:  A Retrospective Cohort Study

ABSTRACT: The AIDS pandemic on average took a life every minute in 2021 despite effective HIV treatment and tools to prevent, detect, and treat opportunistic infections. The objective of this study was to estimate the average life expectancy and life years lost (LYL) in people diagnosed with HIV or AIDS in Puerto Rico from 2000-2020. The epidemiological design was a retrospective cohort study of 24,143 people diagnosed with HIV or AIDS and received services under the Eligible Metropolitan Area (EMA) of San Juan, Puerto Rico. The population with a diagnosis of HIV or AIDS was described using socioeconomic characteristics with frequencies and proportions by category. We estimated the LYL by matching the expected residual lifetime for someone diagnosed with the disease with the life expectancy of the general population at that specific age as the null model. Average years of life lost (LYL) is a measure that reflects expected earlier death as a result of a condition. The number of LYL is dependent on the year of onset of the condition. In general, the earlier the onset of HIV or AIDS results in a larger impact of LYL. For individuals diagnosed at the age of 30 with AIDS the LYL is approximately 35.5 years, whereas for an individual where the onset is at age 70 years, being diagnosed with HIV or AIDS results in approximately 2.7 years lost. In our study, we found a greater number of LYL in patients diagnosed with AIDS in this population compared to those diagnosed with HIV. This study confirms the dramatic impact of HIV and AIDS on the lifespan of individuals and how the age of onset of the conditions impacts LYL