HIV / STI
Social vulnerability increases age-adjusted years of potential life lost among people with HIV in Florida, 2020 Giselle A. Barreto* Giselle Barreto Tendai Gwanzura Tan Li Diana M. Sheehan Mary Jo Trepka
Community susceptibility to the adverse impacts of multiple physical, social, and systemic stressors, termed social vulnerability, reduces community resilience to epidemics and pandemics leading to higher rates of morbidity and mortality; this may be especially true for people with HIV (PWH), who may experience additional hardship accessing healthcare and support services. Therefore, this study aimed to measure the age-adjusted rate of years of potential life lost (aYPLL) and 95% gamma confidence intervals (95%CI) by ZIP Code level social vulnerability tertials (low, medium, high) among PWH during the first year of the COVID-19 pandemic (2020). Data utilized for this study included: (1) HIV surveillance data for the state of Florida, (2) ZIP Code level Social Vulnerability Index (SVI) calculated from American Community Survey data at the ZIP code level following Centers for Disease Control and Prevention methods, (3) US female and male life tables (2020), and (4) U.S. standard population (2000). PWH living in communities with high social vulnerability lost 6 and 5 more aYPLL per 100 persons due to all-cause mortality compared to those living in communities of medium or low social vulnerability, respectively, (H=32.2, 95%CI= 31.5-32.9; M= 27.2, 95%CI=26.5-28.0; L= 26.2, 95%CI=25.0-27.8). Additionally, as community vulnerability increased, aYPLL lost due to HIV/AIDS and COVID-19 specific mortality also increased (HIV/AIDS L= 6.4, 95%CI=5.8-7.2; M=9.4, 95%CI=8.9-10.0; H=12.5, 95%CI= 11.9-13.2; COVID-19 L= 1.0, 95%CI=0.7-1.7; M=1.4 95%CI=1.2-1.8; H=1.9, 95%CI= 1.9-2.1). In 2020, PWH living in communities with higher social vulnerability relative to those living in less vulnerable communities experienced greater aYPLL due to all-cause, HIV-, and COVID-19 specific mortality, underscoring the urgent need for improved public health resource allocation and policies to ensure continuity of healthcare and social services during disasters.
