Socioeconomic inequalities in HIV/AIDS mortality in urban areas of three Spanish cities

This study analyzed socioeconomic inequalities in three Spanish cities (Alicante, Castellón, and Valencia), according to the level of deprivation of small urban areas, and assessed their impact on mortality due to HIV and AIDS. This ecological study used census tracts as the unit of analysis. A deprivation index score, based on employment, education, and housing indicators, was calculated for each census tract. Mortality rates were calculated by sex, age group, level of deprivation, and period (2000-2015), and relative risks were estimated. Between 2000 and 2015, 967 deaths related to HIV and AIDS were recorded in the three cities, with a substantial reduction in mortality from 600 deaths in 2000-2007 to 340 in 2008-2015, especially among people aged 0 to 44 years. Mortality remained consistently higher among men and in areas with greater socioeconomic deprivation. The results show that, despite the overall decline in mortality, living in deprived urban areas continues to be a key determinant of deaths due to HIV and AIDS. The study provides new evidence on the persistent impact of structural social inequalities on avoidable mortality in urban settings, even in a context of general epidemiological improvement.