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Fernandez SB, Dawit R, Nawfal ES, Ward MK, Ramirez-Ortiz D, Sheehan DM, Trepka MJ. Psychosocial and socioeconomic changes among low-income people with HIV during the COVID-19 pandemic in Miami-Dade County, Florida: racial/ethnic and gender differences. HIV Res Clin Pract 2024; 25:2363129. [PMID: 38907537 PMCID: PMC11256985 DOI: 10.1080/25787489.2024.2363129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/29/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND COVID-19 profoundly and uniquely impacted people with HIV. People with HIV experienced significant psychosocial and socioeconomic impacts, yet a limited amount of research has explored potential differences across gender and racial/ethnic groups of people with HIV. OBJECTIVE The objective of this study was to examine psychosocial and socioeconomic stressors related to the COVID-19 pandemic among a diverse sample of people with HIV in South Florida and to determine if the types of stressors varied across gender and racial/ethnic groups. METHODS We analyzed data from a cross-sectional survey with Miami-Dade County, Ryan White Program recipients. Outcomes included mental health, socioeconomic, drug/alcohol, and care responsibility/social support changes. Weighted descriptive analyses provided an overview of stressors by gender and racial/ethnic group and logistic regressions estimated associations between demographics and stressors. RESULTS Among 291 participants, 39% were Non-Hispanic Black, 18% were Haitian, and 43% were Hispanic. Adjusting for age, sex, language, and foreign-born status, Hispanics were more likely to report several worsened mental health (i.e. increased loneliness, anxiety) and socioeconomic stressors (i.e. decreased income). Spanish speakers were more likely to report not getting the social support they needed. Women were more likely to report spending more time caring for children. CONCLUSIONS Findings highlight ways in which cultural and gender expectations impacted experiences across people with HIV and suggest strategies to inform interventions and resources during lingering and future public health emergencies. Results suggest that public health emergencies have different impacts on different communities. Without acknowledging and responding to differences, we risk losing strides towards progress in health equity.
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Affiliation(s)
- Sofia B. Fernandez
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
| | - Rahel Dawit
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ekpereka Sandra Nawfal
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Melissa K. Ward
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Daisy Ramirez-Ortiz
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
| | - Diana M. Sheehan
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, FL, USA
| | - Mary Jo Trepka
- Research Center for Minority Institutions, Florida International University, Miami, FL, USA
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Asakitogum DA, Nutor JJ, Thompson RGA, Alhassan RK, Gyamerah AO. Impact of COVID-19 on people living with HIV and HIV care: A qualitative study in the Volta Region of Ghana. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003017. [PMID: 38489328 PMCID: PMC10942089 DOI: 10.1371/journal.pgph.0003017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 02/25/2024] [Indexed: 03/17/2024]
Abstract
The COVID-19 pandemic caused significant social changes and challenges globally, including economic slowdown and limitation of essential services. Our study explored the impact of the COVID-19 pandemic on the HIV treatment experiences and lives of people living with HIV in Ghana. Between October 2021 and January 2022, we conducted four focus group discussions with 24 people living with HIV and six in-depth interviews with healthcare providers to understand the impact of the COVID-19 epidemic on their lives and HIV treatment and care. Transcribed interviews were analyzed using thematic analysis. The COVID-19 pandemic most impacted people living with HIV economically and psychosocially. Economic challenges included loss of income/economic support, financial hardship, and material insecurities. The psychosocial impact included fear of the health impact of COVID-19 on people living with HIV and social isolation. The pandemic also impacted participants' HIV treatment and care services including change in their site of care and non-adherence to antiretroviral therapy. Clinics in particular modified HIV care services to maintain treatment and care during the pandemic. Healthcare providers also implemented direct antiretroviral therapy service delivery to clients, which reduced patient overcrowding but increased providers' workload and expenses. The COVID-19 pandemic caused economic hardship, social isolation, and changes in HIV treatment and care services for people living with HIV. It also imposed a work and financial burden on healthcare providers. However, service changes made by providers helped sustain HIV care and treatment for clients and should inform future pandemic responses in HIV services.
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Affiliation(s)
- David Ayangba Asakitogum
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, United States of America
| | - Jerry John Nutor
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, United States of America
| | - Rachel G. A. Thompson
- Language Center, College of Humanities, University of Ghana, Accra, Ghana
- Africa Interdisciplinary Research Institute, Accra, Ghana
| | - Robert K. Alhassan
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
| | - Akua O. Gyamerah
- Department of Community Health and Health Behavior, University of Buffalo, Buffalo, New York, United States of America
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Celeste-Villalvir A, Then-Paulino A, Armenta G, Jimenez-Paulino G, Palar K, Wallace DD, Derose KP. Exploring feasibility and acceptability of an integrated urban gardens and peer nutritional counselling intervention for people with HIV in the Dominican Republic. Public Health Nutr 2023; 26:3134-3146. [PMID: 37905447 PMCID: PMC10755388 DOI: 10.1017/s1368980023002264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 08/04/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVE Food security interventions with people living with HIV (PLHIV) are needed to improve HIV outcomes. This process evaluation of a pilot intervention involving urban gardening and peer nutritional counselling with PLHIV assesses feasibility, acceptability and implementation challenges to inform scale-up. DESIGN Mixed methods were used, including quantitative data on intervention participation and feasibility and acceptability among participants (n 45) and qualitative data from a purposive sample of participants (n 21). Audio-recorded interviews were transcribed and coded using a codebook developed iteratively. SETTING An HIV clinic in the northwest-central part of the Dominican Republic. RESULTS The intervention was feasible for most participants: 84 % attended a garden workshop and 71 % established an urban garden; 91 % received all three core nutritional counselling sessions; and 73 % attended the cooking workshop. The intervention was also highly acceptable: nearly, all participants (93-96 %) rated the gardening as 'helpful' or 'very helpful' for taking HIV medications, their mental/emotional well-being and staying healthy; similarly, high percentages (89-97 %) rated the nutrition counselling 'helpful' or 'very helpful' for following a healthy diet, reducing unhealthy foods and increasing fruit/vegetable intake. Garden barriers included lack of space and animals/pests. Transportation barriers impeded nutritional counselling. Harvested veggies were consumed by participants' households, shared with neighbours and family, and sold in the community. Many emphasised that comradery with other PLHIV helped them cope with HIV-related marginalisation. CONCLUSION An urban gardens and peer nutritional counselling intervention with PLHIV was feasible and acceptable; however, addressing issues of transportation, pests and space is necessary for equitable participation and benefit.
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Affiliation(s)
- Alane Celeste-Villalvir
- University of Massachusetts Amherst, Department of Health Promotion and Policy, Amherst, MA01003, USA
| | - Amarilis Then-Paulino
- Universidad Autónoma de Santo Domingo, Facultad de Ciencias de la Salud, Av. Alma Mater, Santo Domingo, Dominican Republic
| | - Gabriela Armenta
- RAND Corporation and Pardee RAND Graduate School, Santa Monica, CA90401, USA
| | - Gipsy Jimenez-Paulino
- Universidad Autónoma de Santo Domingo, Facultad de Ciencias de la Salud, Av. Alma Mater, Santo Domingo, Dominican Republic
| | - Kartika Palar
- University of California, San Francisco, Department of Medicine, San Francisco, CA94143, USA
| | - Deshira D Wallace
- University of North Carolina at Chapel Hill, Department of Health Behavior, Chapel Hill, NC27599, USA
| | - Kathryn P Derose
- University of Massachusetts Amherst, Department of Health Promotion and Policy, Amherst, MA01003, USA
- RAND Corporation and Pardee RAND Graduate School, Santa Monica, CA90401, USA
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Li Z, Qiao S, Ning H, Sun X, Zhang J, Olatosi B, Li X. Place Visitation Data Reveals the Geographic and Racial Disparities of COVID-19 Impact on HIV Service Utilization in the Deep South. AIDS Behav 2023:10.1007/s10461-023-04163-4. [PMID: 37792234 DOI: 10.1007/s10461-023-04163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND The COVID-19 pandemic has posed unprecedented pressure to health care systems, and interrupted health care delivery and access including HIV care in the United States' Deep South, which endures a double epidemic of HIV and COVID-19. Ryan White programs cover HIV care services for over half of PLWH in the Deep South. Given the important role of Ryan White programs, examining the visitation changes to Ryan White facilities during the pandemic offers insights into the impact of the pandemic on HIV healthcare utilization. OBJECTIVES Analyze the geographic distribution of HIV facility visitors at the county level before and during the pandemic in the nine US states of Deep South (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas) to reveal the geographic and racial disparity in visitation disruption caused by the pandemic. METHODS We first extracted mobile device-based visitation data for Ryan White HIV facilities in the Deep South during 2019 and 2020. To quantify the disruption in visitations during 2020, we calculated the visitation reduction rate (VRR) for each county, using 2019 data as the baseline. Next, we conducted a spatial analysis of the VRR values to uncover geographical disparities in visitation interruptions. To investigate racial disparities, we performed spatial regression analyses with VRR as the dependent variable, and the percentages of Black, Hispanic, and Asian populations as the independent variables. In this analysis, we controlled for potential confounders. RESULTS Geographic disparities in visitation reduction were observed, with all nine Deep South states experiencing significant drops. Georgia experienced the highest visitation loss (VRR = -0.58), followed by Texas (-0.47), Alabama (0.47), and Tennessee (-0.46), while South Carolina had the smallest reductions (-0.11). All the regression models consistently revealed racial disparities in visitation interruption. That is, counties with a higher proportion of Black population tended to have higher RW facility visitation reductions. CONCLUSIONS Our analysis revealed distinct geographic disparities in visitation interruptions at Ryan White HIV facilities in the Deep South during the COVID-19 pandemic in 2020. Furthermore, we found that the Black/African American population experienced a greater disruption at the county level in the Deep South during this period.
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Affiliation(s)
- Zhenlong Li
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, 29208, USA.
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA.
| | - Shan Qiao
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Huan Ning
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, 29208, USA
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Geography, The Pennsylvania State University, University Park, PA, 16801, USA
| | - Xiaowen Sun
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Jiajia Zhang
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Bankole Olatosi
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Xiaoming Li
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Ramírez-Ortiz D, Ward MK, Sheehan DM, Fernandez SB, Jean-Gilles M, Ladner R, Trepka MJ. Increased alcohol use during the COVID-19 pandemic among people with HIV from racial/ethnic minority groups in South Florida. J Ethn Subst Abuse 2023:1-12. [PMID: 37729468 PMCID: PMC10950834 DOI: 10.1080/15332640.2023.2259340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
People with HIV (PWH) from racial/ethnic minority groups may be particularly vulnerable to the effects of the COVID-19 Pandemic. Exacerbated COVID-19-related stressors may lead to maladaptive coping mechanisms such as increased alcohol use. This study examined socioeconomic and psychosocial predictors of increased alcohol use during the first year of the COVID-19 Pandemic among PWH from racial/ethnic minority groups in South Florida. Data were collected from Ryan White Program clients during October 2020-January 2021 using a cross-sectional phone survey, and were analyzed using logistic regression modeling. Among 139 participants, 20% reported increased alcohol use. Findings showed that being unable to buy needed food (adjusted odds ratio [aOR]: 3.37; 95% confidence interval [CI]: 1.01-11.31) and spending more time caring for children (aOR: 5.22, 95% CI: 1.61-16.88) was associated with increased alcohol use during the Pandemic. Providing support to alleviate food insecurity and manage caregiving burden during public health crises like the COVID-19 Pandemic might help prevent increases in alcohol use among PWH.
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Affiliation(s)
- Daisy Ramírez-Ortiz
- Florida International University, Department of Epidemiology, Miami, Florida, USA
- Florida International University, Research Center for Minority Institutions, Miami, Florida, USA
| | - Melissa K. Ward
- Florida International University, Department of Epidemiology, Miami, Florida, USA
- Florida International University, Research Center for Minority Institutions, Miami, Florida, USA
| | - Diana M. Sheehan
- Florida International University, Department of Epidemiology, Miami, Florida, USA
- Florida International University, Research Center for Minority Institutions, Miami, Florida, USA
| | - Sofia B. Fernandez
- Florida International University, Research Center for Minority Institutions, Miami, Florida, USA
- Florida International University, School of Social Work, Miami, Florida, USA
| | - Michele Jean-Gilles
- Florida International University, Department of Health Promotion and Disease Prevention, Miami, Florida, USA
| | - Robert Ladner
- Behavioral Science Research Corporation, Coral Gables, Florida, USA
| | - Mary Jo Trepka
- Florida International University, Department of Epidemiology, Miami, Florida, USA
- Florida International University, Research Center for Minority Institutions, Miami, Florida, USA
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Bleasdale J, Liu Y, Leone LA, Morse GD, Przybyla SM. The impact of food insecurity on receipt of care, retention in care, and viral suppression among people living with HIV/AIDS in the United States: a causal mediation analysis. Front Public Health 2023; 11:1133328. [PMID: 37601182 PMCID: PMC10433761 DOI: 10.3389/fpubh.2023.1133328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Attaining The Joint United Nations Programme on HIV/AIDS 95-95-95 targets to end the HIV epidemic by 2030 will require a greater understanding of the underlying mechanisms influencing care engagement among people living with HIV/AIDS (PLWHA). One such mechanism is food insecurity, defined as limited or uncertain access to food. Food insecurity has been shown to significantly impact HIV outcomes. Yet, few studies have examined the mechanisms through which food insecurity may influence these outcomes. We aimed to examine the effects of nutritional, behavioral, and mental health mechanisms through which food insecurity may impact HIV care continuum outcomes: receipt of care, retention in care, and viral suppression. Methods We conducted a cross-sectional study of 200 PLWHA in New York State, United States from May-August 2022. Participants were recruited using convenience sampling methods. Multivariable logistic regression models were conducted to examine the associations between food insecurity and care continuum outcomes (receipt of care, retention in care, viral suppression), adjusting for age, race, ethnicity, education, income, and marital status. Individual causal mediation analyses were conducted to assess whether behavioral, mental health, and nutritional mechanisms mediated the hypothesized associations. Results The median age of participants was 30 years (IQR: 27-37 years). The majority self-identified as Black (54.0%), male (55.5%) and straight/heterosexual (63.0%). Increasing severity of food insecurity was associated with greater odds of non-retention in care (aOR: 1.35, 95% CI: 1.07, 1.70) and viral non-suppression (aOR: 1.29, 95% CI: 1.08, 1.54). For the impact of food insecurity on non-retention in care, there was an indirect relationship (natural indirect effect; NIE) mediated through Body Mass Index (BMI) (ORNIE: 1.08, 95% CI: 1.00, 1.18). For viral non-suppression, there was an indirect relationship mediated through BMI (ORNIE: 1.07, 95% CI: 1.00,1.16) and an indirect relationship mediated through depression (ORNIE: 1.27, 95% CI: 1.07, 1.47). Discussion Food insecurity was associated with greater odds of non-retention in care and viral non-suppression among PLWHA. Nutritional and mental health pathways are important mediators of these relationships. Results highlight the need for interventions to target these pathways to address food insecurity as an underlying mechanism influencing engagement in HIV care.
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Affiliation(s)
- Jacob Bleasdale
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Yu Liu
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States
| | - Lucia A. Leone
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Gene D. Morse
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
- Center for Integrated Global Biomedical Sciences, Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Sarahmona M. Przybyla
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
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Gutiérrez-Velilla E, Barrientos-Casarrubias V, Gómez-Palacio Schjetnan M, Perrusquia-Ortiz LE, Cruz-Maycott R, Alvarado-de la Barrera C, Ávila-Ríos S, Caballero-Suárez NP. Mental health and adherence to antiretroviral therapy among Mexican people living with HIV during the COVID-19 pandemic. AIDS Res Ther 2023; 20:34. [PMID: 37287023 PMCID: PMC10245356 DOI: 10.1186/s12981-023-00532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). METHODS We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. RESULTS 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p < 0.001). Vulnerable patients were more likely to be women, with low educational level and unemployed (p < 0.001). CONCLUSIONS It is important to address mental health of PLWH during the COVID-19 pandemic, with special attention to the most vulnerable individuals. Future studies are needed to understand the relationship between mental health and ART adherence.
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Affiliation(s)
- Ester Gutiérrez-Velilla
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Vania Barrientos-Casarrubias
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - María Gómez-Palacio Schjetnan
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Lydia E Perrusquia-Ortiz
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Rosa Cruz-Maycott
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Claudia Alvarado-de la Barrera
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Nancy Patricia Caballero-Suárez
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México.
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Clarke A, Mannette J, Hamilton-Hinch B, Lynch M, Williams P, Grant S, Joy P. The Cost of a Nutritious Diet for Households Including People Living with HIV/AIDS in Nova Scotia: Findings and Lessons Learned by FoodNOW 2020 to 2022. CAN J DIET PRACT RES 2023; 84:98-106. [PMID: 36876852 DOI: 10.3148/cjdpr-2022-037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Purpose: FoodNOW (Food to eNhance Our Wellness) engaged in assessment of simulated households that include a person living with HIV/AIDS (PLWHA) in Nova Scotia to determine if a basic nutritious diet is affordable.Methods: We used supermarket websites to cost food and beverage items listed in the National Nutritious Food Basket (NNFB) for simulated households, each with a PLWHA. Food costing methodologies were co-developed and adapted with community members in response to barriers presented by the COVID-19 pandemic.Results: We found that simulated households, each with one PLWHA, that had a potential deficit after monthly expenses were a household of four on Income Assistance (-$1,058.70), a lone mother with two children on Income Assistance (-$973.65), a lone man on Income Assistance (-$677.40), and a household of four with one minimum-wage earner (-$383.45).Conclusions: Nova Scotia households with a PLWHA living on Income Assistance or with a minimum-wage earner cannot reasonably afford a nutritious diet in addition to basic household expenses. Using these food costing data can allow dietitians to efficiently inform government action and policy change to improve the health and wellness of individuals and families.
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Affiliation(s)
- Abigail Clarke
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Jessica Mannette
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
| | - Barb Hamilton-Hinch
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Mary Lynch
- Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS, Canada
- QEII Health Sciences Centre, Halifax, NS, Canada
- Founder (Pain Medicine), The Royal College of Physicians and Surgeons of Canada, Ottawa, ON, Canada
| | | | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
- Departments Obstetrics and Gynaecology, IWK Health Centre, Halifax, NS, Canada
- Departments Pediatrics, Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
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Kalichman SC, Eaton LA, Kalichman MO, Sam SS, Caliendo AM. Prepandemic Predictors of Medication Adherence and HIV Viral Load During the First Year of COVID-19. J Acquir Immune Defic Syndr 2023; 92:242-249. [PMID: 36730771 PMCID: PMC9911104 DOI: 10.1097/qai.0000000000003129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 10/24/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Studies have reported significant immediate impacts of the COVID-19 pandemic on the social relationships and health care of people living with HIV. This study followed a closed cohort of young people living with HIV over the first year of the COVID-19 pandemic. Participants were men and women (N = 140) age 36 years and younger who were living with HIV and had demonstrated suboptimal adherence to antiretroviral therapy, unsuppressed HIV viral load, or active substance use in a run-in study. The results confirmed that participants continued to experience significant disruptions to their social relationships and health care over the course of the first year of the COVID-19 pandemic. There was evidence for sustained impacts on transportation, housing stability, and food security during the first year of COVID-19. Multivariable models showed that greater pre-COVID-19 social support predicted greater antiretroviral therapy adherence and greater HIV suppression (lower viral load) over the first year of the COVID-19 pandemic. Efforts to plan and prepare people living with HIV for future social crises, including future pandemics, should emphasize building and sustaining social support.
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Affiliation(s)
- Seth C. Kalichman
- Institute for Collaborative Health Intervention and Policy, University of Connecticut, Storrs, CT
| | - Lisa A. Eaton
- Institute for Collaborative Health Intervention and Policy, University of Connecticut, Storrs, CT
| | - Moira O. Kalichman
- Institute for Collaborative Health Intervention and Policy, University of Connecticut, Storrs, CT
| | - Soya S. Sam
- Division of Infectious Diseases, The Miriam Hospital, Providence, RI; and
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI
| | - Angela M. Caliendo
- Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI
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Derose KP, Then-Paulino A, Han B, Armenta G, Palar K, Jimenez-Paulino G, Sheira LA, Acevedo R, Fulcar MA, Lugo Bernard C, Veloz Camacho I, Donastorg Y, Wagner GJ. Preliminary Effects of an Urban Gardens and Peer Nutritional Counseling Intervention on HIV Treatment Adherence and Detectable Viral Load Among People with HIV and Food Insecurity: Evidence from a Pilot Cluster Randomized Controlled Trial in the Dominican Republic. AIDS Behav 2023; 27:864-874. [PMID: 36066760 PMCID: PMC9446649 DOI: 10.1007/s10461-022-03821-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/01/2022]
Abstract
A pilot cluster randomized controlled trial involving two HIV clinics in the Dominican Republic assessed preliminary efficacy of an urban garden and peer nutritional counseling intervention. A total of 115 participants (52 intervention, 63 control) with moderate or severe food insecurity and sub-optimal antiretroviral therapy (ART) adherence and/or detectable viral load were assessed at baseline, 6- and 12-months. Longitudinal multivariate regression analysis controlling for socio-demographics and accounting for serial cluster correlation found that the intervention: reduced the prevalence of detectable viral load by 20 percentage points at 12 months; reduced any missed clinic appointments by 34 and 16 percentage points at 6 and 12 months; increased the probability of "perfect" ART adherence by 24 and 20 percentage points at 6 and 12 months; and decreased food insecurity at 6 and 12 months. Results are promising and warrant a larger controlled trial to establish intervention efficacy for improving HIV clinical outcomes.Trial registry Clinical Trials Identifier: NCT03568682.
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Affiliation(s)
- Kathryn P Derose
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA.
- Department of Health Promotion and Policy, University of Massachusetts Amherst, 715 N. Pleasant St., Amherst, MA, 01003, USA.
| | - Amarilis Then-Paulino
- Facultad de Ciencias de la Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic
- Ministerio de Salud Pública, Santo Domingo, Dominican Republic
| | - Bing Han
- Economics, Sociology, & Statistics Department, RAND Corporation, Santa Monica, CA, USA
- Division of Biostatistics Research, Department of Research & Evaluations, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Gabriela Armenta
- Pardee RAND Graduate School, RAND Corporation, Santa Monica, CA, USA
| | - Kartika Palar
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Gipsy Jimenez-Paulino
- Facultad de Ciencias de la Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic
| | - Lila A Sheira
- Division of HIV, Infectious Disease, and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Ramón Acevedo
- Consejo Nacional para el VIH y Sida (CONAVIHSIDA), Santo Domingo, Dominican Republic
| | - María A Fulcar
- World Food Programme, Country Office for the Dominican Republic, Santo Domingo, Dominican Republic
| | - Claudio Lugo Bernard
- Facultad de Ciencias de la Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic
| | - Isidro Veloz Camacho
- Facultad de Ciencias de la Salud, Universidad Autónoma de Santo Domingo, Santo Domingo, Dominican Republic
| | - Yeycy Donastorg
- Unidad de Vacunas e Investigación, Instituto Dermatológico Dominicano y Cirugía de Piel Dr. Huberto Bogaert Díaz, Santo Domingo, Dominican Republic
| | - Glenn J Wagner
- Behavioral and Policy Sciences Department, RAND Corporation, Santa Monica, CA, USA
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11
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MacCarthy S, Wagner Z, Saya U, Ghai I, Karamagi Y, Odiit M, Mukasa B, Linnemayr S. Food Insecurity During the COVID-19 Pandemic: A Longitudinal Mixed-Methods Study from a Cohort of HIV Clients in Uganda. AIDS Behav 2023; 27:2216-2225. [PMID: 36629972 PMCID: PMC9838483 DOI: 10.1007/s10461-022-03953-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/12/2023]
Abstract
The COVID-19 pandemic threatens the food security of people in low-income countries. This is important for people living with HIV (PLWH) because HIV medication should be taken with food to avoid side-effects. We used survey data (n = 314) and qualitative interviews (n = 95) to longitudinally explore how the pandemic impacted food insecurity among PLWH in Kampala, Uganda. Prior to March 2020, 19.7% of respondents were food insecure. Our regression models estimate that food insecurity rose by 9.1 percentage points in our first round of surveys (June-September 2020; p < 0.05; t = 2.17), increasing to 17.2 percentage points in the second round of surveys (July-November 2021; p < 0.05; t = 2.32). Qualitative interviews reveal that employment loss and deteriorating support systems led to reduced meals and purchasing of cheaper foods. Respondents reported continuing to take their HIV medication even in the presence of food insecurity. Strategies for ensuring that PLWH have enough food should be prioritized so that the millions of PLWH in sub-Saharan Africa can take their medication without experiencing uncomfortable side-effects.Clinical Trials Registration Number NCT03494777.
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Affiliation(s)
- Sarah MacCarthy
- grid.265892.20000000106344187Department of Health Behavior, University of Alabama, Birmingham, Birmingham, AL USA
| | - Zachary Wagner
- grid.34474.300000 0004 0370 7685RAND Corporation, Santa Monica, CA 90401 USA
| | - Uzaib Saya
- grid.34474.300000 0004 0370 7685RAND Corporation, Santa Monica, CA 90401 USA
| | - Ishita Ghai
- grid.468886.c0000 0001 0683 0038Pardee RAND Graduate School, Santa Monica, USA
| | - Yvonne Karamagi
- grid.463428.f0000 0004 0648 1159Mildmay Uganda, Kampala, Uganda
| | - Mary Odiit
- grid.463428.f0000 0004 0648 1159Mildmay Uganda, Kampala, Uganda
| | - Barbara Mukasa
- grid.463428.f0000 0004 0648 1159Mildmay Uganda, Kampala, Uganda
| | - Sebastian Linnemayr
- grid.34474.300000 0004 0370 7685RAND Corporation, Santa Monica, CA 90401 USA
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12
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Kalichman SC. Ending HIV Hinges on Reducing Poverty. AIDS Behav 2023; 27:1-3. [PMID: 35794431 DOI: 10.1007/s10461-022-03766-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Seth C Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, 06269, 2006 Hillside Road, Storrs, CT, USA.
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13
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Jarolimova J, Yan J, Govere S, Bunda BA, Wara NJ, Bogart LM, Ngobese N, Shazi ZM, Khumalo AR, Zionts D, Thulare H, Parker RA, Bassett IV. Experiences of participants in a decentralized antiretroviral therapy program in South Africa during the COVID-19 pandemic. AIDS Care 2022; 34:1413-1419. [PMID: 35877987 PMCID: PMC9873830 DOI: 10.1080/09540121.2022.2095333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/23/2022] [Indexed: 01/27/2023]
Abstract
The COVID-19 pandemic and associated restrictions could adversely affect long-term HIV care. We evaluated the experiences of people receiving antiretroviral therapy (ART) through a decentralized delivery program in South Africa during the COVID-19 pandemic. We telephoned a random subsample of participants enrolled in a prospective cohort study in KwaZulu-Natal in April and May 2020 and administered a semi-structured telephone interview to consenting participants. We completed interviews with 303 of 638 contacted participants (47%); 66% were female, with median age 36y. The most common concerns regarding the COVID-19 pandemic were food running out (121, 40%), fear of becoming infected with COVID-19 (103, 34%), and being unable to work/losing employment or income (102, 34%). Twenty-five (8%) participants had delayed ART pick-up due to the pandemic, while 212 (70%) had new concerns about ART access going forward. Mental health scores were worse during the pandemic compared to baseline (median score 65.0 vs 80.0, p < 0.001). Decentralized ART distribution systems have the potential to support patients outside of health facilities during the COVID-19 pandemic, but economic concerns and mental health impacts related to the pandemic must also be recognized and addressed.
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Affiliation(s)
- Jana Jarolimova
- Massachusetts General Hospital, Division of Infectious Diseases, Boston, United States
- Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, United States
| | - Joyce Yan
- Massachusetts General Hospital, Biostatistics Center, Boston, United States
| | | | - Bridget A Bunda
- Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, United States
| | - Nafisa J Wara
- Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, United States
| | | | | | | | | | - Dani Zionts
- Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, United States
| | | | - Robert A Parker
- Massachusetts General Hospital, Biostatistics Center, Boston, United States
- Harvard University, Center for AIDS Research (CFAR), Boston, United States
- Harvard Medical School, Boston, United States
| | - Ingrid V Bassett
- Massachusetts General Hospital, Division of Infectious Diseases, Boston, United States
- Massachusetts General Hospital, Medical Practice Evaluation Center, Boston, United States
- Harvard University, Center for AIDS Research (CFAR), Boston, United States
- Harvard Medical School, Boston, United States
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14
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Bleasdale J, Leone LA, Morse GD, Liu Y, Taylor S, Przybyla SM. Socio-Structural Factors and HIV Care Engagement among People Living with HIV during the COVID-19 Pandemic: A Qualitative Study in the United States. Trop Med Infect Dis 2022; 7:259. [PMID: 36288000 PMCID: PMC9607497 DOI: 10.3390/tropicalmed7100259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 08/22/2023] Open
Abstract
Achieving HIV prevention goals will require successful engagement in each stage of the HIV continuum. The present study sought to understand the ways in which socio-structural factors influence HIV care engagement among people living with HIV (PLH) within the context of the ongoing COVID-19 pandemic. Twenty-five PLH were recruited from January to October 2021. Semi-structured interviews discussed various socio-contextual factors that influenced engagement in HIV-related care as a result of the pandemic. A thematic content analysis reported semantic level themes describing factors influencing HIV care following an integrated inductive-deductive approach. Qualitative analysis revealed three themes that either supported or hindered engagement in care within the context of the COVID-19 pandemic: (1) social determinants of health, (2) social support, and (3) modes of healthcare delivery. The results underscore the need to assess socio-structural factors of health as means to promote successful engagement in the HIV care continuum and shed new insights to guide future practice in the era of COVID-19.
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Affiliation(s)
- Jacob Bleasdale
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Lucia A. Leone
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Gene D. Morse
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
- Center for Integrated Global Biomedical Sciences, Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Yu Liu
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY 14642, USA
| | - Shelby Taylor
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
| | - Sarahmona M. Przybyla
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA
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15
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Low A, Gummerson E, Schwitters A, Bonifacio R, Teferi M, Mutenda N, Ayton S, Juma J, Ahpoe C, Ginindza C, Patel H, Biraro S, Sachathep K, Hakim AJ, Barradas D, Hassani AS, Kirungi W, Jackson K, Goeke L, Philips N, Mulenga L, Ward J, Hong S, Rutherford G, Findley S. Food insecurity and the risk of HIV acquisition: findings from population-based surveys in six sub-Saharan African countries (2016-2017). BMJ Open 2022; 12:e058704. [PMID: 35820770 PMCID: PMC9277378 DOI: 10.1136/bmjopen-2021-058704] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To assess the potential bidirectional relationship between food insecurity and HIV infection in sub-Saharan Africa. DESIGN Nationally representative HIV impact assessment household-based surveys. SETTING Zambia, Eswatini, Lesotho, Uganda and Tanzania and Namibia. PARTICIPANTS 112 955 survey participants aged 15-59 years with HIV and recency test results. MEASURES Recent HIV infection (within 6 months) classified using the HIV-1 limited antigen avidity assay, in participants with an unsuppressed viral load (>1000 copies/mL) and no detectable antiretrovirals; severe food insecurity (SFI) defined as having no food in the house ≥three times in the past month. RESULTS Overall, 10.3% of participants lived in households reporting SFI. SFI was most common in urban, woman-headed households, and in people with chronic HIV infection. Among women, SFI was associated with a twofold increase in risk of recent HIV infection (adjusted relative risk (aRR) 2.08, 95% CI 1.09 to 3.97). SFI was also associated with transactional sex (aRR 1.28, 95% CI 1.17 to 1.41), a history of forced sex (aRR 1.36, 95% CI 1.11 to 1.66) and condom-less sex with a partner of unknown or positive HIV status (aRR 1.08, 95% CI 1.02 to 1.14) in all women, and intergenerational sex (partner ≥10 years older) in women aged 15-24 years (aRR 1.23, 95% CI 1.03 to 1.46). Recent receipt of food support was protective against HIV acquisition (aRR 0.36, 95% CI 0.14 to 0.88). CONCLUSION SFI increased risk for HIV acquisition in women by twofold. Heightened food insecurity during climactic extremes could imperil HIV epidemic control, and food support to women with SFI during these events could reduce HIV transmission.
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Affiliation(s)
- Andrea Low
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, New York, New York, USA
| | - Elizabeth Gummerson
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
- Bill and Melinda Gates Institute for Population and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Amee Schwitters
- Strategic Information, Division of Global HIV and Tuberculosis, Ctr Dis Control, Maseru, Lesotho
| | | | - Mekleet Teferi
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of Epidemiology, Mailman School of Public Health, New York, New York, USA
| | - Nicholus Mutenda
- Directorate for Special Programs, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Sarah Ayton
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - James Juma
- The Ministry of Health, Community Development, Gender, Elderly and Children, National AIDS Control Program, Dar es Salaam, United Republic of Tanzania
| | - Claudia Ahpoe
- Needs Assessment and Analysis, World Food Programme, Rome, Italy
| | | | - Hetal Patel
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Samuel Biraro
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Karam Sachathep
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Avi J Hakim
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Danielle Barradas
- Center for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Ahmed Saadani Hassani
- Center for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | - Keisha Jackson
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Leah Goeke
- Centers for Disease Control and Prevention, Dar es Salaam, United Republic of Tanzania
| | - Neena Philips
- ICAP at Columbia, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Lloyd Mulenga
- Zambia Ministry of Health, Lusaka, Zambia
- School of Medicine, University of Zambia, Lusaka, Zambia
| | - Jennifer Ward
- Centers for Disease Control and Prevention, Kampala, Uganda
| | - Steven Hong
- Centers for Disease Control and Prevention, Windhoek, Namibia
| | - George Rutherford
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Sally Findley
- Population and Family Health, Mailman School of Public Health, New York, NY, USA
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16
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From crisis to crisis: impacts of the COVID-19 pandemic on people living with HIV and HIV/AIDS service organizations in Indiana. BMC Health Serv Res 2022; 22:622. [PMID: 35534824 PMCID: PMC9081957 DOI: 10.1186/s12913-022-07998-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
Background The COVID-19 pandemic thrust people living with HIV (PLWH) and HIV/AIDS service organizations into an environment ripe with uncertainty. This study examined Indiana HIV/AIDS service provider perceptions of how COVID-19 affected the overall health and access to care of their clients, and how the organizations prepared for, adapted, and responded to the needs of PLWH during the pandemic. Methods Guided by the socioecological model, fifteen semi-structured interviews were conducted with ten different HIV/AIDS service organizations across the state of Indiana. Results Despite the profound disruptions experienced by HIV programs, HIV/AIDS service organizations responded quickly to the challenges posed by the COVID-19 pandemic through myriad innovative strategies, largely informed by prior experiences with the HIV epidemic. Conclusions The lessons provided by HIV/AIDS service organizations are invaluable to informing future pandemic response for PLWH. Service delivery innovations in response to the COVID-19 crisis may provide insights to improve HIV care continuity strategies for vulnerable populations far beyond the pandemic. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07998-0.
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17
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Spring C, Garthwaite K, Fisher A. Containing Hunger, Contesting Injustice? Exploring the Transnational Growth of Foodbanking- and Counter-responses- Before and During the COVID-19 Pandemic. FOOD ETHICS 2022; 7:6. [PMID: 35340530 PMCID: PMC8934159 DOI: 10.1007/s41055-022-00099-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 01/20/2022] [Indexed: 11/24/2022]
Abstract
COVID-19 caused levels of household food insecurity to spike, but the precarity of so many people in wealthy countries is an outgrowth of decades of eroding public provisions and labour protections that once protected people from hunger, setting the stage for the virus' unevenly-distributed harms. The prominence of corporate-sponsored foodbanking as a containment response to pandemic-aggravated food insecurity follows decades of replacing rights with charity. We review structural drivers of charity's growth to prominence as a hunger solution in North America, and of its spread to countries including the UK. By highlighting pre-pandemic pressures shaping foodbanking, including charities' efforts to retool themselves as health providers, we ask whether anti-hunger efforts during the pandemic serve to contain ongoing socioeconomic crises and the unjust living conditions they cause, or contest them through transformative pathways to a just food system. We suggest that pandemic-driven philanthropic and state funding flows have bolstered foodbanking and the food system logics that support it. By contextualising the complex and variegated politics of foodbanking in broader movements, from community food security to food sovereignty, we reframe simplistic narratives of charity and highlight the need for justice-oriented structural changes in wealth redistribution and food system organisation if we are to prevent the kinds of emergency-within-emergency that we witnessed as COVID-19 revealed the proximity of many to hunger.
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Affiliation(s)
- Charlotte Spring
- Laurier Centre for Sustainable Food Systems, Wilfrid Laurier University, Waterloo, Canada
| | - Kayleigh Garthwaite
- Department of Social Policy, Sociology and Criminology, University of Birmingham, Birmingham, UK
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18
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Logie CH, Coelho M, Kohrt B, Tsai AC, Mendenhall E. Context, COVID-19 and comorbidities: exploring emergent directions in syndemics and HIV research. Curr Opin HIV AIDS 2022; 17:46-54. [PMID: 35081555 PMCID: PMC11045292 DOI: 10.1097/coh.0000000000000722] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to identify themes across articles that aimed to explore HIV-related syndemics in 2020 and 2021 and to discuss their implications for research on syndemics. RECENT FINDINGS We identified 189 articles on syndemics between 2020 and 2021. Key themes across studies included COVID-19; mental health and psychosocial challenges; substance use; socio-structural factors; protective factors; and methodological approaches. COVID-19's implications for HIV syndemic research were discussed. Mental health and substance use research largely examined linkages with sexual practices or reduced HIV care retention. Researchers examined associations between socio-structural variables (e.g. poverty) and elevated HIV exposure, reduced HIV testing and poorer health. Concepts of water insecurity and 'ecosyndemics' were also raised, as was the importance of attending to noncommunicable diseases and comorbidities. Most studies did not assess interactions between health conditions, signalling the need for methodological grounding in the foundational concepts of syndemic theory. SUMMARY Most studies recommended that HIV prevention and care research attend to the interplay between poor mental health, substance use and multidimensional violence. Increased attention to structural factors, particularly exacerbated poverty in the COVID-19 pandemic, is required. Research can identify protective factors to harness to advance HIV prevention and care.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
- United Nations University Institute for Water, Environment & Health, Hamilton, Canada
| | - Madelaine Coelho
- Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada
| | - Brandon Kohrt
- Department of Psychiatry and Behavioral Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Alexander C Tsai
- Center for Global Health and Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Emily Mendenhall
- Edmund A. Walsh School of Foreign Service, Georgetown University, Washington, District of Columbia, USA
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19
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Magnani RJ, Wirawan DN, Sawitri AAS, Mahendra IGAA, Susanti D, Utami Ds NKAD, Asanab D, Yunus JO, Setiabudi CH, Nugroho A, Widihastuti AS, Mukuan OS, Januraga PP. The short-term effects of COVID-19 on HIV and AIDS control efforts among female sex workers in Indonesia. BMC Womens Health 2022; 22:21. [PMID: 35081950 PMCID: PMC8791089 DOI: 10.1186/s12905-021-01583-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 10/07/2021] [Indexed: 12/21/2022] Open
Abstract
Background The COVID-19 pandemic has raised concerns as to its impact on other health programs. One program that appears particularly vulnerable is HIV and AIDS. We undertook an assessment of COVID-19 impact on HIV control efforts in Indonesia for a sub-population that has received little attention in the global literature—female sex workers (FSW). Methods The study was undertaken in 23 National AIDS program priority districts. Four sources of monthly data during January–July 2020 were considered. COVID-19 infection data were extracted from national and district surveillance systems. Combination prevention program outputs were reported by civil society organizations (CSOs) providing community support services to FSW. These organizations also undertook monthly scans of levels of commercial sex activity and HIV testing availability. We also considered data from an ongoing HIV community screening trial. The primary mode of analysis entailed comparisons of levels and trends of indicators from the four data series. Results Commercial sex activity was severely curtailed in April–May in many districts. While recovering to pre-COVID-19 levels in “Localization” areas, the number of active FSW in July was one-third below that in February. HIV testing service availability declined by 50% at health facilities before recovering slowly, while mobile clinic services largely ceased during April–June. Numbers of FSW reached, condoms distributed, FSW tested for HIV, HIV cases detected, and FSW starting treatment all declined precipitously in April/May but had largely recovered to pre-COVID-19 levels by July. We found only a temporary dip in treatment initiation rates among HIV positive FSW and no discernible impact on treatment retention. The HIV community screening trial data revealed significant demand for HIV testing among FSW that was not being met even before the onset of COVID-19. Conclusions COVID-19 has had at least short-run economic effects on FSW and the national response to HIV and AIDS targeting FSW. However, the effects appear to have been cushioned by community-based services and support in study districts. The findings make a compelling case for the expansion of community-based services irrespective of the future trajectory of COVID-19. As COVID-19 has not yet been contained, the trajectory of economic activity and service delivery is uncertain.
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Affiliation(s)
- Robert J Magnani
- Faculty of Public Health, University of Indonesia, Jakarta, Indonesia
| | - Dewa Nyoman Wirawan
- Kerti Praja Foundation, Denpasar, Bali, Indonesia.,Department of Community and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Anak Agung Sagung Sawitri
- Kerti Praja Foundation, Denpasar, Bali, Indonesia.,Department of Community and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - I Gusti Agung Agus Mahendra
- Kerti Praja Foundation, Denpasar, Bali, Indonesia.,Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
| | - Dewi Susanti
- Kerti Praja Foundation, Denpasar, Bali, Indonesia
| | | | | | | | | | - Adi Nugroho
- School of Public Health, Faculty of Medicine, University of Lambung Mangkurat, Banjarbaru, South Kalimantan, Indonesia
| | | | | | - Pande Putu Januraga
- Kerti Praja Foundation, Denpasar, Bali, Indonesia. .,Center for Public Health Innovation, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia.
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20
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S FA, Madhu M, Udaya Kumar V, Dhingra S, Kumar N, Singh S, Ravichandiran V, Murti K. Nutritional Aspects of People Living with HIV (PLHIV) Amidst COVID-19 Pandemic: an Insight. CURRENT PHARMACOLOGY REPORTS 2022; 8:350-364. [PMID: 35966952 PMCID: PMC9362559 DOI: 10.1007/s40495-022-00301-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 04/16/2023]
Abstract
PURPOSE OF REVIEW This review elaborates the role of malnutrition in PLHIV (people living with HIV) in the context of COVID-19 and emphasis the need of supplementation, dietary intervention, and nutritional counselling in the post-COVID era. One of the most critical challenges among HIV/AIDS patients is malnutrition since it weakens the immune system and increases risk to opportunistic infections. In HIV (human immunodeficiency virus) infection, weight loss is prevalent due to reduced nutritional consumption, malabsorption, abnormal metabolism, and antiretroviral therapy. Sufficient nutrition is required for optimal immune function, as a result, food therapy is now considered an important adjuvant in the treatment of HIV patients. RECENT FINDINGS Nutritional intervention, such as the use of dietary supplements, can help to prevent nutrient deficiency, lowering the death risk among malnourished HIV population. Immunocompromised individuals are at very high risk for COVID-19 and malnutrition increases the risk of infection by multiple folds. Interventions, such as nutrition education and counselling are important, to improve the condition of HIV Patients by optimising their nutritional status. SUMMARY A balanced diet should be one of the most important priorities in preventing PLHIV against the potentially deadly consequences of COVID-19. It is to be ensured that HIV-positive persons continue to get enough and appropriate assistance, such as nutrition and psychological counselling, in the context of COVID-19 infection. The use of telemedicine to maintain nutritional intervention can be beneficial. To meet their nutritional needs and minimise future difficulties, PLHIV infected with COVID-19 should get specialised nutritional education and counselling.
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Affiliation(s)
- Fathima A. S
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
| | - Maxima Madhu
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
| | - V Udaya Kumar
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
| | - Sanjiv Singh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
| | - V. Ravichandiran
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, Bihar 844102 India
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Wagner Z, Mukasa B, Nakakande J, Stecher C, Saya U, Linnemayr S. Impact of the COVID-19 Pandemic on Use of HIV Care, Antiretroviral Therapy Adherence, and Viral Suppression: An Observational Cohort Study From Uganda. J Acquir Immune Defic Syndr 2021; 88:448-456. [PMID: 34757973 PMCID: PMC8575089 DOI: 10.1097/qai.0000000000002811] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/27/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Recent studies project thousands of additional AIDS-related deaths because of COVID-19-related disruptions in HIV care. However, the extent to which disruptions in care have materialized since the start of the pandemic is not well understood. METHODS We use electronic health records to investigate how the pandemic has affected clinic visits, patients' antiretroviral therapy (ART) supply, and viral suppression for a cohort of 14,632 HIV clients from a large HIV clinic in Kampala, Uganda. We complement this with an analysis of electronically measured longitudinal ART adherence data from a subcohort of 324 clients. RESULTS Clinic visits decreased by more than 50% after a national lockdown started. The risk of patients running out of ART on a given day increased from 5% before the lockdown to 25% 3 months later (Relative Risk Ratio of 5.11, 95% confidence interval: 4.99 to 5.24) and remained higher than prelockdown 6 months later at 13% (Relative Risk Ratio of 2.60; 95% confidence interval: 2.52 to 2.70). There was no statistically significant change in electronically measured adherence or viral suppression. CONCLUSION We document substantial gaps in HIV care after the start of the COVID-19 pandemic in Uganda. This suggests that measures to improve access should be explored as the pandemic persists. However, ART adherence was unaffected for the subcohort for whom we measured electronic adherence. This suggests that some clients may have stockpiles of ART tablets from previous prescriptions that allowed them to keep taking their medication even when they could not visit the clinic for ART refills.
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Affiliation(s)
- Zachary Wagner
- Department of Economics, Sociology and Statistics, RAND Corporation, Santa Monica, CA
- Pardee RAND Graduate School, Santa Monica, CA
| | | | | | - Chad Stecher
- College of Health Solutions, Arizona State University, Tempe, AZ
| | - Uzaib Saya
- Pardee RAND Graduate School, Santa Monica, CA
| | - Sebastian Linnemayr
- Department of Economics, Sociology and Statistics, RAND Corporation, Santa Monica, CA
- Pardee RAND Graduate School, Santa Monica, CA
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22
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Winwood JJ, Fitzgerald L, Gardiner B, Hannan K, Howard C, Mutch A. Exploring the Social Impacts of the COVID-19 Pandemic on People Living with HIV (PLHIV): A Scoping Review. AIDS Behav 2021; 25:4125-4140. [PMID: 34019203 PMCID: PMC8137806 DOI: 10.1007/s10461-021-03300-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 01/05/2023]
Abstract
Understanding the clinical impact of COVID-19 has been central to emerging research in the HIV field, but in focusing on the biomedical, researchers must not overlook the socially embedded nature of HIV and the potential social impacts of this new pandemic on PLHIV. We conducted a scoping review to explore emerging research examining the social impacts of COVID-19 on PLHIV in OECD countries over the first 12 months of the pandemic. Twenty articles were identified and included for review. Key themes included: impacts on HIV care access/telehealth; stress and mental health; social isolation and loneliness; food insecurity; changes to sexual behaviour; changes to substance use; impacts on income, education and employment; and racial and social inequality. Results from this review can help guide research into areas where it is needed to help minimise the negative social impacts of the COVID-19 pandemic.
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Affiliation(s)
- Jordan J Winwood
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia.
| | - Lisa Fitzgerald
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Bernard Gardiner
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Kate Hannan
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Chris Howard
- Queensland Positive People (QPP), 21 Manilla St, East Brisbane, QLD, 4169, Australia
| | - Allyson Mutch
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
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Social and Behavioral Impacts of COVID-19 on People Living with HIV: Review of the First Year of Research. Curr HIV/AIDS Rep 2021; 19:54-75. [PMID: 34826067 PMCID: PMC8617547 DOI: 10.1007/s11904-021-00593-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/25/2022]
Abstract
Purpose of the Review The SARS-CoV-2 (COVID-19) pandemic brought unprecedented social change with the most severe impacts on the most vulnerable populations, including people living with HIV (PLWH). This review examined findings from empirical studies of social and behavioral impacts of COVID-19 on PLWH in the first year of the pandemic. Recent Findings Impacts of COVID-19 on PLWH fit within an HIV syndemics framework, with overlapping COVID-19 and HIV comorbid conditions concerning mental health and structural inequality. Early impacts of COVID-19 on social isolation, emotional distress, stigma, and substance use varied across studies with few consistent patterns. Structural inequalities, particularly impacts on food security and housing stability, were observed more consistently and globally. Summary COVID-19 intersects with HIV infection along with multiple interlocking comorbidities that are best characterized and understood within a syndemics framework.
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Wells JCK, Marphatia AA, Amable G, Siervo M, Friis H, Miranda JJ, Haisma HH, Raubenheimer D. The future of human malnutrition: rebalancing agency for better nutritional health. Global Health 2021; 17:119. [PMID: 34627303 PMCID: PMC8500827 DOI: 10.1186/s12992-021-00767-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 09/15/2021] [Indexed: 01/11/2023] Open
Abstract
The major threat to human societies posed by undernutrition has been recognised for millennia. Despite substantial economic development and scientific innovation, however, progress in addressing this global challenge has been inadequate. Paradoxically, the last half-century also saw the rapid emergence of obesity, first in high-income countries but now also in low- and middle-income countries. Traditionally, these problems were approached separately, but there is increasing recognition that they have common drivers and need integrated responses. The new nutrition reality comprises a global ‘double burden’ of malnutrition, where the challenges of food insecurity, nutritional deficiencies and undernutrition coexist and interact with obesity, sedentary behaviour, unhealthy diets and environments that foster unhealthy behaviour. Beyond immediate efforts to prevent and treat malnutrition, what must change in order to reduce the future burden? Here, we present a conceptual framework that focuses on the deeper structural drivers of malnutrition embedded in society, and their interaction with biological mechanisms of appetite regulation and physiological homeostasis. Building on a review of malnutrition in past societies, our framework brings to the fore the power dynamics that characterise contemporary human food systems at many levels. We focus on the concept of agency, the ability of individuals or organisations to pursue their goals. In globalized food systems, the agency of individuals is directly confronted by the agency of several other types of actor, including corporations, governments and supranational institutions. The intakes of energy and nutrients by individuals are powerfully shaped by this ‘competition of agency’, and we therefore argue that the greatest opportunities to reduce malnutrition lie in rebalancing agency across the competing actors. The effect of the COVID-19 pandemic on food systems and individuals illustrates our conceptual framework. Efforts to improve agency must both drive and respond to complementary efforts to promote and maintain equitable societies and planetary health.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, Population Policy and Practice Research and Teaching Programme, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, UK.
| | | | - Gabriel Amable
- Department of Geography, University of Cambridge, Cambridge, UK
| | - Mario Siervo
- School of Life Sciences, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - J Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.,Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hinke H Haisma
- Population Research Centre, Department of Demography, University of Groningen, Groningen, the Netherlands
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25
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Pereira M, Magno L, da Silva Gonçalves L, Dourado I. HIV Infections and Food Insecurity Among Pregnant Women from Low- and Middle-Income Countries: A Systematic Review and Meta-analysis. AIDS Behav 2021; 25:3183-3193. [PMID: 33903996 PMCID: PMC8075027 DOI: 10.1007/s10461-021-03280-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/30/2022]
Abstract
There are few studies on the occurrence of food insecurity (FI) in pregnant women living with HIV/AIDS (PrWLWHA). Our objective was to estimate the prevalence of food insecurity among PrWLWHA and to analyse the association between HIV and FI. For this we searched eight databases. We used the prevalence and prevalence ratio (PR) with a 95% confidence interval (CI) as the summary measurements for the meta-analysis. We identified 300 studies, 13 of which were eligible. The prevalence of FI was 64%, ranging between 26% (mild), 33% (moderate) and 27% (severe). People living with HIV/AIDS (PLWHA) had a 23% greater chance of facing FI (PR = 1.23, 95% CI 1.16-1.38) compared to those not living with HIV. The results revealed a high prevalence and positive association with FI among PLWHA, which suggests the need for food security assessments in HIV/AIDS clinical care.
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Affiliation(s)
- Marcos Pereira
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil.
| | - Laio Magno
- Department of Life Sciences, Bahia State University, Rua Silveira Martins, 2555, Cabula, Salvador, Bahia, Brazil
| | - Luana da Silva Gonçalves
- Center for Biological and Health Sciences, Federal University of Western Bahia, Barreiras, Bahia, Brazil
| | - Inês Dourado
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, Salvador, 45760-030, Bahia, Brazil
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Men F, Tarasuk V. Food Insecurity amid the COVID-19 Pandemic: Food Charity, Government Assistance, and Employment. CANADIAN PUBLIC POLICY. ANALYSE DE POLITIQUES 2021; 47:202-230. [PMID: 36039314 PMCID: PMC9395161 DOI: 10.3138/cpp.2021-001] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
To mitigate the effects of the coronavirus disease 2019 (COVID-19) pandemic, the federal government has implemented several financial assistance programs, including unprecedented funding to food charities. Using the Canadian Perspectives Survey Series 2, we examine the demographic, employment, and behavioural characteristics associated with food insecurity in April-May 2020. We find that one-quarter of job-insecure individuals experienced food insecurity that was strongly associated with pandemic-related disruptions to employment income, major financial hardship, and use of food charity, yet the vast majority of food-insecure households did not report receiving any charitable food assistance. Increased financial support for low-income households would reduce food insecurity and mitigate negative repercussions of the pandemic.
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Affiliation(s)
- Fei Men
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada, and Department of Consumer Sciences, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Valerie Tarasuk
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
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27
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Brown LB, Spinelli MA, Gandhi M. The interplay between HIV and COVID-19: summary of the data and responses to date. Curr Opin HIV AIDS 2021; 16:63-73. [PMID: 33186229 PMCID: PMC7735216 DOI: 10.1097/coh.0000000000000659] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW We examine the interplay between the HIV and COVID-19 epidemics, including the impact of HIV on COVID-19 susceptibility and severe disease, the effect of the COVID-19 epidemic on HIV prevention and treatment, and the influence of the HIV epidemic on responses to COVID-19. RECENT FINDINGS Evidence to date does not suggest that people living with HIV (PLWH) have a markedly higher susceptibility to SARS-CoV-2 infection, with disparities in the social determinants of health and comorbidities likely having a greater influence. The majority of literature has not supported a higher risk for severe disease among PLWH in Europe and the United States, although a large, population-based study in South Africa reported a higher rate of death due to COVID-19. Higher rates of comorbidities associated with COVID-19 disease severity among PLWH is an urgent concern. COVID-19 is leading to decreased access to HIV prevention services and HIV testing, and worsening HIV treatment access and virologic suppression, which could lead to worsening HIV epidemic control. CONCLUSION COVID-19 is threatening gains against the HIV epidemic, including the U.S. Ending the HIV Epidemic goals. The ongoing collision of these two global pandemics will continue to need both study and interventions to mitigate the effects of COVID-19 on HIV efforts worldwide.
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Affiliation(s)
- Lillian B. Brown
- Division of HIV, ID, and Global Medicine, University of California, San Francisco
| | - Matthew A. Spinelli
- Division of HIV, ID, and Global Medicine, University of California, San Francisco
| | - Monica Gandhi
- Division of HIV, ID, and Global Medicine, University of California, San Francisco
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Mejia A, Bhattacharya M, Miraglia J. Community Gardening as a Way to Build Cross-Cultural Community Resilience in Intersectionally Diverse Gardeners: Community-Based Participatory Research and Campus-Community-Partnered Proposal. JMIR Res Protoc 2020; 9:e21218. [PMID: 33026358 PMCID: PMC7578813 DOI: 10.2196/21218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/05/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Community-based agriculture has been found to decrease food insecurity and alleviate health inequities. Furthermore, it provides a sense of ownership, resources to help integrate new communities, and a space to nurture existing cultural identities for intersectionally diverse gardeners. This sense of belonging in connection with access to growing plots has been linked to psychological well-being and resilience. However, little is known about how the psychosocial benefits of plot ownership affect resilience and which aspects of this resilience are salient. OBJECTIVE This community-based participatory research (CBPR) project will examine the role of community gardens in decreasing food insecurity and facilitating various forms of resilience in food-insecure groups in Rochester, Minnesota. Since participation in community gardens nurtures various forms of resilience along individual, group, and community dimensions, our research seeks to understand how dimensions of resilience vary along intersectional lines. In addition to mapping the psychosocial benefits linked to plot ownership, we find that examining which forms of resilience are fostered in community-based agricultural projects addresses an important gap in the academic literature. This can help us propose policy-level practices that reduce health inequities connected to food and nutrition at the local level. METHODS Using a mixed methods approach, this ongoing community-campus partnership will examine the experiences of current and new plot owners. As a CBPR project, our data collection plan, from design to dissemination, incorporates the intellectual and creative labor of the individuals representing members of the campus community (ie, college students and faculty members engaged in other citizen science projects hosted by the garden), community growers, individuals involved in the community garden's board, and representatives of various organizational bodies. Data collection activities will consist of surveys, in-depth interviews, and photovoice. RESULTS This project was funded in January 2020 and approved by the University of Minnesota's Institutional Review Board in March 2020. For the 2020 growing season, we will conduct evaluative interviews about the effect of COVID-19 on community gardeners, including their experiences during this growing season. For the 2021 growing season, data collection, via pre- and postsurveys, is projected to begin in March 2021 and end in November 2021. We will also conduct in-depth interviews from January to April 2021. Data analysis will commence in April 2021. Photovoice activities (ie, data collection, analysis, synthesis, and dissemination) are expected to take place during the spring and summer of 2021. CONCLUSIONS Findings emerging from this study will provide the preliminary data to foreground community gardening projects and initiatives to improve physical and mental health outcomes in food-insecure communities. Also, the data collected will highlight the role of CBPR methods in disseminating information about the organizational practices of the community garden; this will assist others in planning and implementing similar projects. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/21218.
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Affiliation(s)
- Angie Mejia
- Center for Learning Innovation, University of Minnesota Rochester, Rochester, MN, United States
| | - Manami Bhattacharya
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States
| | - Joshua Miraglia
- Research Information Systems, Office of the VP for Research, University of Minnesota, Minneapolis, MN, United States
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Abstract
This article discusses the relationship between both poverty and food insecurity (FI) and the COVID-19 pandemic, as well as presenting possible strategies and actions for increasing social protection in the fight against these conditions in the current epidemiological context, especially for low-income countries. This is a narrative review concerning COVID-19, poverty, and food and nutritional insecurity. The COVID-19 pandemic may increase poverty and FI levels, resulting from the absence of or weak political, economic and social interventions to maintain jobs, as well as compromised food production and distribution chains and reduced access to healthy foods in different countries around the world, especially the poorest ones, where social and economic inequality was already historically high; the pandemic heightens and uncovers the vulnerability of poor populations. Public policies focused on guaranteeing the human right to adequate food must be improved and implemented for populations in contexts of poverty with the aim of providing food security.
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30
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Colebunders R, Siewe Fodjo JN, Vanham G, Van den Bergh R. A call for strengthened evidence on targeted, non-pharmaceutical interventions against COVID-19 for the protection of vulnerable individuals in sub-Saharan Africa. Int J Infect Dis 2020; 99:482-484. [PMID: 32861825 PMCID: PMC7451006 DOI: 10.1016/j.ijid.2020.08.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/14/2020] [Accepted: 08/22/2020] [Indexed: 12/12/2022] Open
Abstract
Curbing the transmission of SARS-CoV-2, the causative agent of COVID-19, may be difficult in sub-Saharan Africa. Overall COVID-19-related mortality remains low because of the young population. Protecting vulnerable individuals from severe disease should be a priority.
Following the easing of lockdown measures in many sub-Saharan African countries, coronavirus disease 2019 (COVID-19) cases have been on the rise. As the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, may be difficult to stop in these settings, we propose that the existing COVID-19 prevention strategies aimed at reducing overall transmission are complemented with more targeted strategies to protect people at risk of severe COVID-19 disease. We suggest investigating the feasibility, acceptability, and efficacy of distributing COVID-19 prevention kits to households with persons at increased risk of severe COVID-19 disease.
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Affiliation(s)
- Robert Colebunders
- Global Health Institute, University of Antwerp, Gouverneur Kinsbergen Centrum, Doornstraat 331, 2610 Antwerp, Belgium.
| | - Joseph Nelson Siewe Fodjo
- Global Health Institute, University of Antwerp, Gouverneur Kinsbergen Centrum, Doornstraat 331, 2610 Antwerp, Belgium.
| | - Guido Vanham
- Department of Biomedical Science, University of Antwerp, Campus drie Eiken, 2610 Antwerp, Belgium.
| | - Rafael Van den Bergh
- Global Health Institute, University of Antwerp, Gouverneur Kinsbergen Centrum, Doornstraat 331, 2610 Antwerp, Belgium.
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Intersecting Pandemics: Impact of SARS-CoV-2 (COVID-19) Protective Behaviors on People Living With HIV, Atlanta, Georgia. J Acquir Immune Defic Syndr 2020; 85:66-72. [PMID: 32530862 PMCID: PMC7447002 DOI: 10.1097/qai.0000000000002414] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
COVID-19 and its social responses threaten the health of people living with HIV. We conducted a rapid-response interview to assess COVID-19 protective behaviors of people living with HIV and the impact of their responses on HIV-related health care.
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