Mortality among antiretroviral-eligible patients in an urban public clinic.

Among 1651 antiretroviral therapy (ART)-eligible patients attending an urban United States HIV clinic, four-year mortality was 10.0% in 2000–2004 and 11.0% in 2005–2009. Despite universal ART availability, only 72 (42%) of 172 patients who died, compared to 69% of survivors, ever achieved an HIV viral load <400 copies/mm3. Leading causes of death were AIDS (56%), violence/overdose (16%), and pulmonary disease (6%). Disadvantaged sub-populations in the developed world can experience high mortality rates despite accessing specialty HIV clinical services with full ART availability. New strategies are needed to improve outcomes in these populations.