Comparison of Premature Cause-Specific Mortality Among People With HIV in Florida Pre-(2019) and Early (2020) COVID-19 Pandemic: Disparities by Race and Ethnicity, Sex, Rurality, and Social Vulnerability.

OBJECTIVE

Using State-level surveillance records we assessed disparities in premature mortality among people with HIV (PWH) in Florida during pre- (2019) and early COVID-19 pandemic (2020).

METHODS

We calculated age-standardized rates of years of potential life lost per 100 persons (aYPLL) stratified by sex, race and ethnicity, rural/urban residence, and social vulnerability index (SVI).

RESULTS

PWH in Florida during 2020 experienced a significant increase in aYPLL (2019: 29.0, 95% CI [28.1, 30.0]; 2020: 32.8, 95% CI [31.8, 33.9]). HIV/AIDS contributed the most aYPLL in 2020 (13.4, 95% CI [12.4, 14.4]), especially among females (15.8, 95% CI [15.2, 16.4]), rural communities (14.5, 95% CI [12.7, 17.6]), and high SVI communities (12.5, 95% CI [11.9, 13.2]). aYPLL due to external causes increased significantly from 2019 to 2020 (4.1, 95% CI [4.0, 4.3] vs 5.4, 95% CI [5.2, 5.5]), especially for females (3.6, 95% CI [3.3, 3.9] vs 7.8, 95% CI [7.4, 8.3]) and those living in low SVI communities (3.1, 95% CI [2.7, 3.8] vs 7.1, 95% CI [6.5, 8.1]). aYPLL due to COVID-19 was greatest for females (2.3, 95% CI [2.1, 2.6]) and residents of high SVI communities (2.0, 95% CI [1.9, 2.1]).

CONCLUSIONS

PWH experienced increased individual- and neighborhood-level disparities in premature mortality from HIV/AIDS from 2019 to 2020, especially among females and those in rural and socially vulnerable communities. External causes and COVID-19 were also associated with an increased premature mortality during this time frame, with disparities noted by sex and community social vulnerability. Pandemic planning should include targeted outreach programs which prepare for vulnerable populations' healthcare needs and mitigate mortality.