Social deprivation among people living with HIV in the French-swiss Cross-border area: the need for targeted interventions

Social deprivation is a major determinant of health inequalities and may affect the trajectory of people living with HIV (PLWH), even in high-income countries with universal healthcare coverage such as France. We conducted a cross-sectional study in 2022 among PLWH followed in rural and urban settings in the French Alps to characterize social deprivation and assess the impact of the Covid-19 pandemic on their socioeconomic situation. Data from 639 participants were collected through medical records and standardized questionnaires, including the EPICES score, a validated measure of individual social deprivation. Among the 595 participants with complete data, 61.5% were classified as socially deprived. Deprivation was independently associated with unstable employment and a monthly income below €1500. During the first Covid-19 lockdown, 10% of initially non-deprived participants became deprived, and the median EPICES score increased by five points. Sub-Saharan African origin, low income and unstable employment were independently associated with this deterioration. These findings indicate that a majority of PLWH in this region experience social deprivation, which was further exacerbated by the Covid-19 pandemic, highlighting the need for locally adapted public health and social interventions targeting the most vulnerable populations.