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Peer-reviewedCC BYAJPM focus

Increases in Overdose Deaths Among People With HIV Across 14 U.S. Jurisdictions, 2014–2023

  • Amy I. Zlot1
  • Steven Erly2
  • Leticia Lawson2
  • Kate Drezner3
  • Cheryl A. Barber4
  • Danica E. Kuncio5
  • O. Ena Omoike5
  • Janae Benning6
  • Alagie Jatta7
  • Joyce Mbugua7
  • Annabel Nicholas8
  • Eleanor Garlow8
8 more authors
  • Riley Gulbronson9
  • Laura Kersanske10
  • Maxwell Short11
  • Randall Collura12
  • Megan Duffy13
  • Melissa M. Kim14
  • Kathleen A. Brady14
  • Jeff Capizzi1
14 affiliations
  1. 1Oregon Health Authority, Portland, Oregon
  2. 2Office of Infectious Disease, Washington State Department of Health, Olympia, Washington
  3. 3DC Department of Health, Washington, District of Columbia
  4. 4Minnesota Department of Health, St. Paul, Minnesota
  5. 5New Jersey Department of Health, Trenton, New Jersey
  6. 6Michigan Department of Health and Human Services, Lansing, Michigan
  7. 7Iowa Department of Health and Human Services, Des Moines, Iowa
  8. 8Division of Epidemiology, Georgia Department of Public Health, Atlanta, Georgia
  9. 9Tennessee Department of Health, Nashville, Tennessee
  10. 10Massachusetts Department of Public Health, Boston, Massachusetts
  11. 11Arizona Department of Health Services, Phoenix, Arizona
  12. 12New York State Department of Health, Albany, New York
  13. 13Colorado Department of Public Health and Environment, Denver, Colorado
  14. 14Division of HIV Health, Philadelphia Department of Public Health, Philadelphia, Pennsylvania
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Abstract

Introduction

Although overall overdose deaths in the U.S. have plateaued in recent years, there is limited information about how recent changes in the drug landscape have affected people with HIV at regional and national levels. The purpose of this analysis was to describe trends in the cause of death among people with HIV, with a focus on drug-related mortality in this population.Methods

The authors aggregated cause of death data from HIV surveillance systems in 14 jurisdictions across the U.S. to compare regional trends among people with HIV from 2014 to 2023. Causes of death were categorized as fatal overdose, HIV-related disease, or all other causes based on the underlying ICD-10 codes. Demographic characteristics, HIV care indicators, and substance use trends were also evaluated.Results

Among people with HIV, the number of overdose deaths increased from 225 in 2014 to 993 in 2023, accounting for 15.6% of all deaths, whereas HIV-related deaths declined from 1,904 to 1,312, representing 20.6% of all deaths in 2023. In the Pacific Northwest and on the East Coast, overdose deaths surpassed HIV-related deaths in 2023. The proportion of overdose deaths among people with HIV attributable to opioids increased in nearly all regions.Conclusions

Fatal overdose was a major contributor to mortality among people with HIV and, in some regions, exceeded HIV-related mortality. These findings underscore the importance of overdose prevention for people with HIV, who may benefit from syndemic approaches that integrate HIV care with mental health services, social support, and harm reduction interventions.

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Cite

BibTeXRIS
BibTeX
@article{zlot2026increases,
  title = {{Increases in Overdose Deaths Among People With HIV Across 14 U.S. Jurisdictions, 2014–2023}},
  author = {Amy I. Zlot and Steven Erly and Leticia Lawson and Kate Drezner and Cheryl A. Barber and Danica E. Kuncio and O. Ena Omoike and Janae Benning and Alagie Jatta and Joyce Mbugua and Annabel Nicholas and Eleanor Garlow and Riley Gulbronson and Laura Kersanske and Maxwell Short and Randall Collura and Megan Duffy and Melissa M. Kim and Kathleen A. Brady and Jeff Capizzi},
  journal = {AJPM focus},
  year = {2026},
  month = aug,
  doi = {10.1016/j.focus.2026.100544},
  url = {https://europepmc.org/article/PMC/PMC13753568},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Increases in Overdose Deaths Among People With HIV Across 14 U.S. Jurisdictions, 2014–2023
AU  - Amy I. Zlot
AU  - Steven Erly
AU  - Leticia Lawson
AU  - Kate Drezner
AU  - Cheryl A. Barber
AU  - Danica E. Kuncio
AU  - O. Ena Omoike
AU  - Janae Benning
AU  - Alagie Jatta
AU  - Joyce Mbugua
AU  - Annabel Nicholas
AU  - Eleanor Garlow
AU  - Riley Gulbronson
AU  - Laura Kersanske
AU  - Maxwell Short
AU  - Randall Collura
AU  - Megan Duffy
AU  - Melissa M. Kim
AU  - Kathleen A. Brady
AU  - Jeff Capizzi
PY  - 2026
DA  - 2026/08/12
JO  - AJPM focus
DO  - 10.1016/j.focus.2026.100544
UR  - https://europepmc.org/article/PMC/PMC13753568
AB  - Introduction  Although overall overdose deaths in the U.S. have plateaued in recent years, there is limited information about how recent changes in the drug landscape have affected people with HIV at regional and national levels. The purpose of this analysis was to describe trends in the cause of death among people with HIV, with a focus on drug-related mortality in this population.Methods  The authors aggregated cause of death data from HIV surveillance systems in 14 jurisdictions across the U.S. to compare regional trends among people with HIV from 2014 to 2023. Causes of death were categorized as fatal overdose, HIV-related disease, or all other causes based on the underlying ICD-10 codes. Demographic characteristics, HIV care indicators, and substance use trends were also evaluated.Results  Among people with HIV, the number of overdose deaths increased from 225 in 2014 to 993 in 2023, accounting for 15.6% of all deaths, whereas HIV-related deaths declined from 1,904 to 1,312, representing 20.6% of all deaths in 2023. In the Pacific Northwest and on the East Coast, overdose deaths surpassed HIV-related deaths in 2023. The proportion of overdose deaths among people with HIV attributable to opioids increased in nearly all regions.Conclusions  Fatal overdose was a major contributor to mortality among people with HIV and, in some regions, exceeded HIV-related mortality. These findings underscore the importance of overdose prevention for people with HIV, who may benefit from syndemic approaches that integrate HIV care with mental health services, social support, and harm reduction interventions.
SN  - 2773-0654
ER  -