Short-term exposure to traffic-related air pollution and cause-specific mortality among AIDS patients in Anhui, China: A case-crossover study

Abstract Background Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major global health concern. However, the short-term effects of transportation-related air pollution on mortality from leading causes among people living with HIV/AIDS have not been well characterized. Methods A time-stratified case-crossover study was conducted using mortality records of AIDS-related deaths in Anhui Province, China, from 2015 to 2022. Daily concentrations of traffic-related pollution, including fine particulate matter (PM₂.₅), inhalable particles (PM₁₀), nitrogen dioxide (NO₂), and carbon monoxide (CO), along with meteorological data, were incorporated into conditional logistic regression models.Lagged effects and exposure-response relationships were assessed, and subgroup analyses were stratified by sex, age, marital status, and educational level. Results Among the 2,739 recorded deaths, the leading causes were neoplasms (20.6%), respiratory diseases (20.3%), and circulatory diseases (16.9%). On case days, concentrations of PM₂.₅, PM₁₀, and NO₂ were modestly elevated compared to control days. Significant associations were observed between pollutant exposure and mortality risk, with PM₂.₅, PM₁₀, and NO₂ linked to increased risk in the neoplasm and respiratory groups, and CO exposure associated with circulatory-related deaths. Dose–response curves indicated monotonic increases in risk beyond pollutant-specific thresholds. Subgroups including males, individuals under 65 years, those with lower education, and unmarried individuals were more vulnerable. Conclusions Short-term exposure to traffic-related air pollution significantly increases the risk of death from major comorbidities among HIV/AIDS patients. These findings highlight the need for targeted environmental health interventions addressing vulnerable populations.