Sinai Urban Health Institute, Chicago, IL, USA.
Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
AIDS Care. 2022 Jul;34(7):916-925. doi: 10.1080/09540121.2021.1939849. Epub 2021 Jun 14.
Despite decreases in overall HIV mortality in the U.S., large racial inequities persist. Most previous analyses of HIV mortality and mortality inequities have utilized national- or state-level data.
Using vital statistics mortality data and American Community Survey population estimates, we calculated HIV mortality rates and Black:White HIV mortality rate ratios (RR) for the 30 most populous U.S. cities at two time points, 2010-2014 (T1) and 2015-2019 (T2).
Almost all cities (28) had HIV mortality rates higher than the national rate at both time points. At T2, HIV mortality rates ranged from 0.8 per 100,000 (San Jose, CA) to 15.2 per 100,000 (Baltimore, MD). Across cities, Black people were approximately 2-8 times more likely to die from HIV compared to White people at both time points. Over the decade, these racial disparities decreased at the national level (T1: RR = 11.0, T2: RR = 9.8), and in one city (Charlotte, NC).
We identified large geographic and racial inequities in HIV mortality in U.S. urban areas. These city-specific data may motivate change in cities and can help guide city leaders and other health advocates as they implement, test, and support policies and programming to decrease HIV mortality.
尽管美国的整体 HIV 死亡率有所下降，但仍存在较大的种族不平等。之前大多数关于 HIV 死亡率和死亡率不平等的分析都利用了国家级或州级的数据。
我们使用人口统计死亡率数据和美国社区调查的人口估计数，计算了美国 30 个人口最多的城市在两个时间点（2010-2014 年[T1]和 2015-2019 年[T2]）的 HIV 死亡率和黑人和白人 HIV 死亡率比率（RR）。
几乎所有城市（28 个）在两个时间点的 HIV 死亡率都高于全国平均水平。在 T2 时，HIV 死亡率从每 100,000 人中 0.8 人（加利福尼亚州圣何塞）到每 100,000 人中 15.2 人（马里兰州巴尔的摩）不等。在所有城市中，黑人和白人相比，在两个时间点都更有可能因 HIV 而死亡，比率约为 2 至 8 倍。在这十年中，这些种族差异在全国范围内有所缩小（T1：RR=11.0，T2：RR=9.8），在一个城市（北卡罗来纳州夏洛特）也有所缩小。
我们发现美国城市地区的 HIV 死亡率存在很大的地域和种族不平等。这些特定于城市的数据可能会促使城市发生变化，并帮助指导城市领导人和其他卫生倡导者在实施、测试和支持减少 HIV 死亡率的政策和方案时提供参考。
