1
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Skinner A, Nolen S, Cerdá M, Rich JD, Marshall BDL. A simple heuristic for allocating opioid settlement funding to reduce overdose mortality in the United States. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-7. [PMID: 38940829 DOI: 10.1080/00952990.2024.2364338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 06/01/2024] [Indexed: 06/29/2024]
Abstract
As resolution for opioid-related claims and litigation against pharmaceutical manufacturers and other stakeholders, state and local governments are newly eligible for millions of dollars of settlement funding to address the overdose crisis in the United States. To inform effective use of opioid settlement funds, we propose a simple framework that highlights the principal determinants of overdose mortality: the number of people at risk of overdose each year, the average annual number of overdoses per person at risk, and the average probability of death per overdose event. We assert that the annual number of overdose deaths is a function of these three determinants, all of which can be modified through public health intervention. Our proposed heuristic depicts how each of these drivers of drug-related mortality - and the corresponding interventions designed to address each term - operate both in isolation and in conjunction. We intend for this framework to be used by policymakers as a tool for identifying and evaluating public health interventions and funding priorities that will most effectively address the structural forces shaping the overdose crisis and reduce overdose deaths.
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Affiliation(s)
- Alexandra Skinner
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Shayla Nolen
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Magdalena Cerdá
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Josiah D Rich
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
- The Center for Health and Justice Transformation, The Miriam Hospital, Providence, RI, USA
- Department of Medicine, Rhode Island Hospital, Providence, RI, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
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2
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Simha S, Ahmed Y, Brummett CM, Waljee JF, Englesbe MJ, Bicket MC. Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review. Reg Anesth Pain Med 2024; 49:361-362. [PMID: 36427903 DOI: 10.1136/rapm-2022-104169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Siddartha Simha
- Anesthesiology, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
| | - Yusuf Ahmed
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Chad M Brummett
- Anesthesiology, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
- Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan, USA
| | - Jennifer F Waljee
- Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan, USA
- Surgery, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
| | - Michael J Englesbe
- Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan, USA
- Surgery, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
| | - Mark C Bicket
- Anesthesiology, University of Michigan Michigan Medicine, Ann Arbor, Michigan, USA
- Michigan Opioid Prescribing Engagement Network, Ann Arbor, Michigan, USA
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3
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Harsono D, Deng Y, Chung S, Barakat LA, Friedland G, Villanueva M, Yager JE, Justen M, Edelman EJ. Prevalence and Correlates of Physical Inactivity Among Individuals with HIV During the First COVID-19 Wave: A Cross-sectional Survey. AIDS Behav 2024; 28:1531-1545. [PMID: 37824037 DOI: 10.1007/s10461-023-04170-5] [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] [Accepted: 09/08/2023] [Indexed: 10/13/2023]
Abstract
Physical activity is associated with improved health outcomes among people with HIV (PWH). In the recent pandemic context, policies designed to mitigate COVID-19 transmission may result in an increase in sedentary lifestyle and decreased physical activity. In this study, we aimed to characterize self-reported physical activity and factors associated with physical inactivity during the first wave of the COVID-19 pandemic among a sample of PWH engaged in care. We also described whether psychological coping strategies measured by the Brief COPE differed based on physical activity levels. Among 260 surveyed PWH in two HIV clinics in the US Northeast, 28.5% (n = 74) met the criteria for being physically active according to the Centers for Disease Control and Prevention (CDC)'s physical activity guidelines. Receiving care in New Haven, CT, presence of a detectable HIV viral load, every day tobacco use, and unhealthy alcohol use were associated with physical inactivity. Problem-focused coping, emotion-focused coping, and avoidance-focused coping strategies were found to be protective against physical inactivity. In adjusted analysis, only problem-focused coping continued to be significantly associated with lower odds of reporting physical inactivity. Efforts are urgently needed to promote physical activity among PWH, including among those without problem-focused coping strategies.
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Affiliation(s)
- Dini Harsono
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA.
| | - Yanhong Deng
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Sangyun Chung
- Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Lydia A Barakat
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Gerald Friedland
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA
| | - Merceditas Villanueva
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- AIDS Care Program, Section of Infectious Disease, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Jessica E Yager
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - E Jennifer Edelman
- Center for Interdisciplinary Research on AIDS, Yale School of Public Health, 135 College St, Suite 200, New Haven, CT, 06510, USA
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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4
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Spinelli MA, Christopoulos KA, Moreira CV, Jain JP, Lisha N, Glidden DV, Burkholder GA, Crane HM, Shapiro AE, Jacobson JM, Cachay ER, Mayer KH, Napravnik S, Moore RD, Gandhi M, Johnson MO. Viral Suppression Trajectories Destabilized After Coronavirus Disease 2019 Among US People With Human Immunodeficiency Virus: An Interrupted Time Series Analysis. Clin Infect Dis 2024; 78:991-994. [PMID: 37963086 PMCID: PMC11006098 DOI: 10.1093/cid/ciad657] [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: 07/26/2023] [Accepted: 10/24/2023] [Indexed: 11/16/2023] Open
Abstract
We examined changes in the proportion of people with human immunodeficiency virus (PWH) with virologic suppression (VS) in a multisite US cohort before and since the coronavirus disease 2019 (COVID-19) pandemic. Overall, prior gains in VS slowed during COVID-19, with disproportionate impacts on Black PWH and PWH who inject drugs.
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Affiliation(s)
- Matthew A Spinelli
- Division of HIV, ID, and Global Medicine, University of California, SanFrancisco, California, USA
| | - Katerina A Christopoulos
- Division of HIV, ID, and Global Medicine, University of California, SanFrancisco, California, USA
| | - Carlos V Moreira
- Division of HIV, ID, and Global Medicine, University of California, SanFrancisco, California, USA
| | - Jennifer P Jain
- Division of Prevention Science, University of California, SanFrancisco, California, USA
| | - Nadra Lisha
- Department of Epidemiology and Biostatistics, University of California, SanFrancisco, California, USA
| | - David V Glidden
- Department of Epidemiology and Biostatistics, University of California, SanFrancisco, California, USA
| | - Greer A Burkholder
- Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham,Alabama, USA
| | - Heidi M Crane
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
| | - Adrienne E Shapiro
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Jeffrey M Jacobson
- Divsion of Infectious Diseases, Case Western Reserve University, Cleveland, Ohio, USA
| | - Edward R Cachay
- Division of Infectious Diseases, University of California, San Diego, California, USA
| | - Kenneth H Mayer
- Department of Medicine, Harvard University and the Fenway Institute/Fenway Health, Boston, Massachusetts, USA
| | - Sonia Napravnik
- Division of Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Richard D Moore
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
| | - Monica Gandhi
- Division of HIV, ID, and Global Medicine, University of California, SanFrancisco, California, USA
| | - Mallory O Johnson
- Division of Prevention Science, University of California, SanFrancisco, California, USA
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5
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Tao X, Yip T, Fisher CB. Employment, coronavirus victimization distress, and substance use disorders among black and non-Hispanic White young adults during the COVID-19 pandemic. J Ethn Subst Abuse 2024; 23:320-339. [PMID: 35758224 DOI: 10.1080/15332640.2022.2091702] [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: 10/17/2022]
Abstract
Substance abuse among young adults increased during the COVID-19 pandemic. Although pre-pandemic data indicate non-Hispanic White adults had higher levels of substance use disorder (SUD), Black adults suffered more serious consequences. The COVID-19 pandemic has introduced new stressors that may contribute to SUD, especially among Black young adults, including employment as essential workers, which may be related to victimization distress associated with the coronavirus (i.e., coronavirus victimization distress). The current study administered an anonymous, cross-sectional, online survey to a national sample of 132 Black and 141 non-Hispanic White adults 18 - 25 years to assess the relationship between health, economic disparities, employment, coronavirus victimization distress, and substance use during the first wave of the pandemic. Controlling for COVID-19 health risks and income, structural equation models indicated that coronavirus victimization distress fully accounted for the positive association between employment and SUD risk, and this association was more pronounced among Black young adults. Findings underscore the urgency of considering disease-related victimization in SUD interventions involving employed young adults during infectious disease pandemics.
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Affiliation(s)
- Xiangyu Tao
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Tiffany Yip
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Celia B Fisher
- Department of Psychology, Fordham University, Bronx, NY, USA
- Center for Ethics Education, Fordham University, Bronx, NY, USA
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Mars SG, Spinelli MA, Ondocsin J, Koester KA, Rodriguez ES, Jain J, Arreguin M, Johnson MO, Gandhi M. Pandemic expertise: qualitative findings on the experiences of living with HIV during the COVID-19 pandemic. AIDS Care 2024; 36:382-389. [PMID: 37621106 PMCID: PMC10891295 DOI: 10.1080/09540121.2023.2248579] [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] [Indexed: 08/26/2023]
Abstract
This qualitative study explored the experiences of people living with HIV (PLWH) in the San Francisco Bay Area, United States, during the COVID-19 pandemic and subsequent public health restrictions at a safety net HIV clinic. Patients (N = 30) were recruited for Spanish/English language semi-structured interviews (n = 30), translated when necessary, and analyzed thematically. The recurring theme of "pandemic expertise" emerged from the data: skills and attitudes developed through living with HIV helped PLWH cope with the COVID-19 pandemic, including effective strategies for dealing with anxiety and depression; appreciation for life; and practical experience of changing behavior to protect their health. A subset did not consider living with HIV helped them adapt to the COVID-19 pandemic, with some describing their lives as chaotic due to housing issues and/or ongoing substance use. Overall, interviewees reported finding trustworthy health information that helped them follow COVID-19 prevention strategies. Although living with HIV is associated with a higher prevalence of mental health concerns, substance use, and stigma, these challenges can also contribute to increased self-efficacy, adaptation, and resilience. Addressing structural issues such as housing appears to be key to responding to both pandemics.
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Affiliation(s)
- Sarah G Mars
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Matthew A Spinelli
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Jeff Ondocsin
- Department of Family and Community Medicine, University of California, San Francisco, CA, USA
| | - Kim A Koester
- Department of Medicine, University of California, San Francisco, CA, USA
| | | | - Jennifer Jain
- Department of Psychiatry and Behavior Sciences, University of California, San Francisco, CA, USA
| | - Mireya Arreguin
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Mallory O Johnson
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Monica Gandhi
- Department of Medicine, University of California, San Francisco, CA, USA
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7
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Forero-Peña DA, Carrión-Nessi FS, Forero-Peña JL, Camejo-Ávila NA, Mendoza-Millán DL, Omaña-Ávila ÓD, Maricuto AL, Velásquez VL, Mejía-Bernard MD, Rodriguez-Saavedra CM, Marcano-Rojas MV, Contreras Y, Guerra LJ, Alvarado MF, Carballo M, Caldera J, Guevara RN, Redondo MC, Landaeta ME. The impact of the COVID-19 pandemic on people living with HIV: a cross-sectional study in Caracas, Venezuela. BMC Infect Dis 2024; 24:87. [PMID: 38225550 PMCID: PMC10789023 DOI: 10.1186/s12879-023-08967-6] [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] [Received: 07/31/2023] [Accepted: 12/29/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela. METHODS We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022. RESULTS A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31-55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations. CONCLUSION This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.
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Affiliation(s)
- David A Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela.
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela.
| | - Fhabián S Carrión-Nessi
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela.
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela.
| | - José L Forero-Peña
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | | | - Daniela L Mendoza-Millán
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Óscar D Omaña-Ávila
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | - Andrea L Maricuto
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Viledy L Velásquez
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Mario D Mejía-Bernard
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
- "Luis Razetti" School of Medicine, Central University of Venezuela, Caracas, Venezuela
| | | | | | - Yoesmir Contreras
- Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela
| | - Luis J Guerra
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - María F Alvarado
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Martín Carballo
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Jocays Caldera
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - Rafael N Guevara
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - María C Redondo
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
| | - María E Landaeta
- Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela
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8
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Chakrabarti R, Agasty D, Majumdar A, Talukdar R, Bhatta M, Biswas S, Dutta S. Syndemic effect of COVID-19 outbreak on HIV care delivery around the globe: A systematic review using narrative synthesis. Health Promot Perspect 2023; 13:243-253. [PMID: 38235007 PMCID: PMC10790127 DOI: 10.34172/hpp.2023.30] [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] [Received: 06/02/2023] [Accepted: 07/10/2023] [Indexed: 01/19/2024] Open
Abstract
Background The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis. Methods This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies. Results In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article. Conclusion Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat. Registration Open Science Framework (DOI: 10.17605/OSF.IO/74GHM).
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Affiliation(s)
| | - Debdutta Agasty
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Agniva Majumdar
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Rounik Talukdar
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Mihir Bhatta
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Subrata Biswas
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shanta Dutta
- ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
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Matsumoto S, Nagai M, Tran LK, Yamaoka K, Nguyen HDT, Dinh Van T, Tanuma J, Pham TN, Oka S, Van Tran G. Multicenter observational survey on psychosocial and behavioral impacts of COVID-19 in people living with HIV in Northern Vietnam. Sci Rep 2023; 13:20321. [PMID: 37989776 PMCID: PMC10663486 DOI: 10.1038/s41598-023-47577-9] [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: 03/20/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023] Open
Abstract
Socially marginalized groups, including people living with HIV/AIDS (PLHIV), could be disproportionately affected by Coronavirus disease 2019 (COVID-19). Following an initial single-center survey conducted in 2020, we conducted a second survey of 11 antiretroviral therapy (ART) sites in Northern Vietnam between June 2021 and January 2022. We tested anti-SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) nucleocapsid IgG antibodies and assessed prevention against COVID-19 and impacts of COVID-19 on access to ART, economic security, risky health behaviors, and mental health using self-reported questionnaires. In total, 7808 PLHIV on ART participated in the second survey. The overall prevalence of SARS-CoV-2 antibody was as low as 1.2%. There was no clear upward trend in COVID-19 infection among PLHIV compared with the rate of infection among the general population. HIV treatment was generally maintained and no increase in risky health behaviors was observed. The economic impacts were significant, with high unemployment rate, poorer economic security, and binge drinking strongly associated with depression. However, the prevalence of depression decreased by 11.2% compared with pre-COVID-19 levels. Social support, including for patients to continue HIV treatment and effective employment/financial assistance, may help to alleviate the negative socioeconomic impacts of COVID-19 and improve mental health among PLHIV.
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Affiliation(s)
- Shoko Matsumoto
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Moeko Nagai
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Linh Khanh Tran
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazue Yamaoka
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | | | | | - Junko Tanuma
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Shinichi Oka
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Giang Van Tran
- National Hospital for Tropical Diseases, Hanoi, Vietnam.
- Hanoi Medical University, Hanoi, Vietnam.
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10
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Mehra K, Rup J, Wiese JL, Watson TM, Bonato S, Rueda S. Changes in self-reported cannabis use during the COVID-19 pandemic: a scoping review. BMC Public Health 2023; 23:2139. [PMID: 37915021 PMCID: PMC10621278 DOI: 10.1186/s12889-023-17068-7] [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: 01/27/2023] [Accepted: 10/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic is affecting mental health and substance use (MHSU) issues worldwide. The purpose of this study was to characterize the literature on changes in cannabis use during the pandemic and the factors associated with such changes. METHODS We conducted a scoping review by searching peer-reviewed databases and grey literature from January 2020 to May 2022 using the Arksey and O'Malley Framework. Two independent reviewers screened a total of 4235 documents. We extracted data from 129 documents onto a data extraction form and collated results using content analytical techniques. RESULTS Nearly half (48%) of the studies reported an increase/initiation of cannabis use, while 36% studies reported no change, and 16% reported a decrease/cessation of cannabis use during the pandemic. Factors associated with increased cannabis use included socio-demographic factors (e.g., younger age), health related factors (e.g., increased symptom burden), MHSU factors (e.g., anxiety, depression), pandemic-specific reactions (e.g., stress, boredom, social isolation), cannabis-related factors (e.g., dependence), and policy-related factors (e.g., legalization of medical/recreational cannabis). CONCLUSION Public health emergencies like the COVID-19 pandemic have the potential to significantly impact cannabis use. The pandemic has placed urgency on improving coping mechanisms and supports that help populations adapt to major and sudden life changes. To better prepare health care systems for future pandemics, wide-reaching education on how pandemic-related change impacts cannabis use is needed.
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Affiliation(s)
- Kamna Mehra
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jennifer Rup
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Jessica L Wiese
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada
| | - Tara Marie Watson
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON, M5S 2S1, Canada.
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada.
- Institute of Health Policy, Management and Evaluation, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A1, Canada.
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11
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Qiao S, Zhang J, Liang C, Li X. Using All of Us data to examine the mental health change during COVID-19 pandemic among people living with HIV: A longitudinal study protocol. BMJ Open 2023; 13:e071285. [PMID: 37788923 PMCID: PMC10551941 DOI: 10.1136/bmjopen-2022-071285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 09/12/2023] [Indexed: 10/05/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic has negatively affected people's mental health around the globe. Such effects may be especially compounded among some vulnerable populations such as people living with HIV (PLWH). However, large-scale data on mental health outcomes among PLWH are limited. Few studies have also identified potential protective factors for mental health outcomes. METHODS AND ANALYSIS Guided by theories of resilience and socioecology, we will leverage multiple datasets from National Institutes of Health's Cloud-based All of Us Programme including electronic health records (EHRs), a series of COVID-19 Participant Experience (COPE) Surveys conducted from May 2020 to February 2021, and other self-reported survey data to achieve two specific aims: (1) to examine the mental health outcome changes during COVID-19 pandemic among PLWH by employing both EHR data (2018-2022) and survey data (2020-2021) in the All of Us Programme; and (2) to identify potential protective factors based on COPE Survey data for mental health outcomes at multiple socioecological levels including individual level (eg, coping strategy), interpersonal level (eg, social support) and health institutional level (eg, health service accessibility), adjusting for pre-existing health conditions including psychiatric disorders and other relevant factors (eg, COVID-19 infection). Interaction terms will be included in the multivariable analysis to identify different socially disadvantaged or stigmatised subgroups. ETHICS AND DISSEMINATION The study has been approved by the institutional review board at the University of South Carolina (Pro00124044). Study findings will be disseminated through presentations at academic conferences and publications in peer-reviewed journals.
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Affiliation(s)
- Shan Qiao
- Department of Health Promotion Education and Behavior, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, USA
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, USA
| | - Chen Liang
- Department of Health Services Policy and Management, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, USA
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, USA
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López CM, Goodrum NM, Brown TP, O'Brien A, Davies F, Moreland A. The REACH (Resiliency, Engagement, and Accessibility for Comorbid HIV/PTSD/SUD populations) Protocol: Using a Universal Screener to Improve Mental Health and Enhance HIV Care Outcomes. J Behav Health Serv Res 2023; 50:452-467. [PMID: 37524892 DOI: 10.1007/s11414-023-09850-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 08/02/2023]
Abstract
Among people living with HIV (PLWH), 50% report substance use disorders (SUDs), and 30-61% report posttraumatic stress disorder (PTSD). Comorbid PTSD/SUD/HIV has been linked to faster HIV progression and twice the rate of death, lower medical adherence and retention, and increased viral load compared to PLWH without co-occurring PTSD or SUD. A critical first step in establishing comprehensive mental health services for PLWH is the implementation of an evidence-based screening protocol for PTSD and SUDs to facilitate referrals to specialty mental health providers. Guided by the Consolidated Framework for Implementation Research, this mixed-methods study aimed to examine the feasibility of delivering the REACH (Resiliency, Engagement, and Accessibility for Comorbid HIV/PTSD/SUD populations) Screening protocol. Three case managers were instructed to provide the REACH screening electronically to all patients that they saw for enrollment or re-enrollment appointments over 3 months (n=102). Of the 70 patients who completed the screener, 27% had clinically significant PTSD symptoms and 48.6% had SUD concerns. Qualitative feedback revealed themes related to beliefs about SU and PTSD, attitudes toward screening, comfort in the discussion of SU and PTSD, and referral and treatment considerations. Discussion includes lessons learned for implementation of this assessment of PTSD/SUD in PLWH as a novel approach to increase mental health engagement and promote health equity, with the potential long-term impact of improving HIV care outcomes via ameliorating mental health/SUD, and implications for prevention of HIV transmission. Implementation science can be leveraged to understand the gap in the utilization of existing evidence-based screening tools in HIV care settings.
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Affiliation(s)
- Cristina M López
- Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC, 29425, USA.
| | | | | | - Aaron O'Brien
- Roper St. Francis Ryan White Wellness Center, Charleston, SC, USA
| | - Faraday Davies
- Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC, 29425, USA
| | - Angela Moreland
- Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC, 29425, USA
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13
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Lo SWK, Muschialli L, Fernandez T, Smith C, Peppa D, Burns F. Investigation into the psychological impact of the COVID-19 pandemic for people living with HIV. Int J STD AIDS 2023; 34:777-784. [PMID: 37269326 PMCID: PMC10240304 DOI: 10.1177/09564624231179275] [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] [Received: 02/27/2023] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND People living with HIV (PLWH) report high levels of anxiety. This study assessed the prevalence of COVID-19-related anxiety in PLWH. METHODS Participants were recruited from two UK HIV clinics (01/03/2020 - 30/05/2022) and asked to complete the Coronavirus Anxiety Scale. The proportion with scores ≥9 (cut-off for dysfunctional pandemic-related anxiety) and ≥1 (reporting of any pandemic-related anxiety) were analysed. RESULTS 115 PLWH were included, predominantly identifying as male (83.5%, n = 96), white (58.3%, n = 67) and reporting post-secondary education (82.6%, n = 95), with a median age of 51 years (range 22-93). Median CAS score was 0, with 4.4% scoring ≥9 (n = 5). More women scored ≥9 than men (16.7% (n = 3) and 2.1% (n = 2) respectively). Black African (13.6%, n = 3) and Other Ethnic Minority PLWH (25%, n = 2) had a greater proportion of scores ≥9 than White/Asian PLWH (both 0%). SARS-CoV-2 exposure was associated with scores greater than 1 but not greater than 9. CAS score was not associated with lower CD4 (<350 cells/mm3), detectable HIV viral load (≥50 copies/ml), or a history of pre-pandemic anxiety. CONCLUSIONS Pandemic-related anxiety was low, but we identified a sub-population reporting dysfunctional pandemic related anxiety. Future work should further investigate the psychological impact of the pandemic on this group.
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Affiliation(s)
- Sze Wing Karina Lo
- University College London, Division of Infection and Immunity, London UK
| | - Luke Muschialli
- University College London, Division of Infection and Immunity, London UK
| | | | - Colette Smith
- University College London, Division of Infection and Immunity, London UK
- Institute for Global Health, University College London, London, UK
- Mortimer Market Centre, Department of HIV, CNWL NHS Trust, London UK
| | - Dimitra Peppa
- HIV Medicine, Royal Free London NHS Foundation Trust, London UK
| | - Fiona Burns
- Institute for Global Health, University College London, London, UK
- HIV Medicine, Royal Free London NHS Foundation Trust, London UK
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14
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Puyat JH, Fowokan A, Wilton J, Janjua NZ, Wong J, Grennan T, Chambers C, Kroch A, Costiniuk CT, Cooper CL, Lauscher D, Strong M, Burchell AN, Anis AH, Samji H. Risk of COVID-19 hospitalization in people living with HIV and HIV-negative individuals and the role of COVID-19 vaccination: A retrospective cohort study. Int J Infect Dis 2023; 135:49-56. [PMID: 37419410 DOI: 10.1016/j.ijid.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVE To examine the risk of hospitalization within 14 days of COVID-19 diagnosis among people living with HIV (PLWH) and HIV-negative individuals who had laboratory-confirmed SARS-CoV-2 infection. METHODS We used Cox proportional hazard models to compare the relative risk of hospitalization in PLWH and HIV-negative individuals. Then, we used propensity score weighting to examine the influence of sociodemographic factors and comorbid conditions on risk of hospitalization. These models were further stratified by vaccination status and pandemic period (pre-Omicron: December 15, 2020, to November 21, 2021; Omicron: November 22, 2021, to October 31, 2022). RESULTS The crude hazard ratio (HR) for risk of hospitalization in PLWH was 2.44 (95% confidence interval [CI]: 2.04-2.94). In propensity score-weighted models that included all covariates, the relative risk of hospitalization was substantially attenuated in the overall analyses (adjusted HR [aHR]: 1.03; 95% CI: 0.85-1.25), in vaccinated (aHR 1.00; 95% CI: 0.69-1.45), inadequately vaccinated (aHR: 1.04; 95% CI: 0.76-1.41) and unvaccinated individuals (aHR: 1.15; 95% CI: 0.84-1.56). CONCLUSION PLWH had about two times the risk of COVID-19 hospitalization than HIV-negative individuals in crude analyses which attenuated in propensity score-weighted models. This suggests that the risk differential can be explained by sociodemographic factors and history of comorbidity, underscoring the need to address social and comorbid vulnerabilities (e.g., injecting drugs) that were more prominent among PLWH.
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Affiliation(s)
- Joseph H Puyat
- British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada.
| | - Adeleke Fowokan
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - James Wilton
- British Columbia Centre for Disease Control, Vancouver, Canada
| | - Naveed Z Janjua
- British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada
| | - Jason Wong
- British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Troy Grennan
- British Columbia Centre for Disease Control, Vancouver, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Catharine Chambers
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Cecilia T Costiniuk
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada
| | - Curtis L Cooper
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | | | | | - Ann N Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada; MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Aslam H Anis
- School of Population and Public Health, University of British Columbia, Vancouver, Canada; Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, Canada; CIHR Canadian HIV Trials Network, Vancouver, Canada
| | - Hasina Samji
- British Columbia Centre for Disease Control, Vancouver, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
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15
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Masters MC, Rivera J, Calamari M, Wright K, Janulis P, Rusie L, Bannon J, Milne P, Galvin SR, Molina EG, Hirschhorn LR, Palella FJ, Kumar R, Brown C, Hawkins C. Telemedicine and HIV Care Quality Measures During the COVID-19 Pandemic. J Acquir Immune Defic Syndr 2023; 94:46-52. [PMID: 37368925 PMCID: PMC10526734 DOI: 10.1097/qai.0000000000003238] [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: 12/21/2022] [Accepted: 05/08/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, telemedicine was adopted to ensure continuity of HIV care. We examined how introducing televisits affected technical quality of care for people with HIV (PWH) during this time. METHODS PWH receiving HIV care at Howard Brown Health Centers and Northwestern University in Chicago, Illinois were included. HIV care quality indicators were calculated using data extracted from electronic medical records during 4 timepoints every 6 months from March, March 1, 2020 to September 1, 2021. Generalized linear mixed models estimated differences in indicators across timepoints within each site while controlling for multiple observations of individuals. Generalized linear mixed models were also used to compare differences in outcomes among PWH who attended all versus a combination of in-person and televisits versus no televisits across the study time periods. RESULTS 6447 PWH were included in the analysis. Compared with prepandemic levels, there were significant declines in care utilization and processes of care measures. Measures of HIV virologic suppression, blood pressure control, and HbA1C <7% (in both people with and without diabetes) were stable with no significant differences noted across the study timepoints. Similar trends were observed across all age, race, and sex subgroups. In multivariable models, televisits were not associated with decreased HIV viral suppression. CONCLUSIONS During the COVID-19 pandemic and rapid implementation of televisits, indicators of care utilization and processes of care decreased compared with prepandemic levels. Among PWH who remained in care, televisits were not associated with worse virologic, blood pressure, and glycemic control in PWH.
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Affiliation(s)
| | | | - Mia Calamari
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Patrick Janulis
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Jacqueline Bannon
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Patrick Milne
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shannon R. Galvin
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | | | - Frank J. Palella
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | | | - Claudia Hawkins
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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16
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Parisi CE, Wang Y, Varma DS, Vaddiparti K, Ibañez GE, Carrillo LC, Cook RL. Changes in frequency of cannabis use among people with HIV during the COVID-19 pandemic: a multi-methods study to explore the underlying reasons for change. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:470-480. [PMID: 36898081 PMCID: PMC10695005 DOI: 10.1080/00952990.2023.2176234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 03/12/2023]
Abstract
Background: People with HIV (PWH) report higher rates of cannabis use than the general population. It is unclear how cannabis use among PWH has been impacted by the COVID-19 pandemic and the implications for the health and wellbeing of PWH.Objectives: To describe changes in frequency of cannabis use among a sample of PWH during the pandemic, reasons for those changes, and implications of the findings.Methods: The data are cross-sectional and come from questions asked in a follow-up phone survey administered to a prospective cohort of PWH in Florida between May 2020 and March 2021. Participants who used cannabis were asked about changes in their frequency of cannabis use in a quantitative survey and reasons for changes in a qualitative open-ended question. Qualitative data were analyzed using thematic analysis.Results: Among 227 PWH (mean age 50, 50% men, 69% Black/African American, 14% Hispanic/Latino), 13% decreased frequency of cannabis, 11% increased frequency, and 76% reported no change. The most common reasons for increasing frequency of cannabis use were reducing anxiety/stress, trying to relax, coping with grief or reducing symptoms of depression, and reducing boredom during the pandemic. Supply or access issues, health concerns, and having already wanted to reduce cannabis use were common reasons for decreased frequency.Conclusion: Nearly 25% of the sample changed their cannabis use frequency during the pandemic. These findings shed light on the behaviors and motivations of PWH who use cannabis and can inform clinical practice and interventions during public health emergencies and beyond.
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Affiliation(s)
| | - Yan Wang
- Department of Epidemiology, University of Florida, Gainesville, FL USA
| | - Deepthi S. Varma
- Department of Epidemiology, University of Florida, Gainesville, FL USA
| | | | - Gladys E. Ibañez
- Department of Epidemiology, Florida International University, Miami, FL USA
| | | | - Robert L. Cook
- Department of Epidemiology, University of Florida, Gainesville, FL USA
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Kim JYH, Barth SK, Monroe AK, Ahsan S, Kovacic J, Senn S, Castel AD. The impact of COVID-19 on the HIV continuum of care: challenges, innovations, and opportunities. Expert Rev Anti Infect Ther 2023; 21:831-846. [PMID: 37470436 DOI: 10.1080/14787210.2023.2239503] [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] [Received: 04/05/2023] [Revised: 06/23/2023] [Accepted: 07/18/2023] [Indexed: 07/21/2023]
Abstract
INTRODUCTION In February 2019, the United States (US) launched the Ending the HIV Epidemic (EHE) initiative with emphasis on improving the various steps of the Human Immunodeficiency Virus (HIV) prevention and care continuum. However, in March 2020, the Coronavirus Disease 2019 (COVID-19) pandemic was declared, curtailing efforts to end the epidemic in the US. AREAS COVERED To describe the impact of the pandemic on EHE in the US, the authors performed a comprehensive literature review focusing on outcomes at each step of the HIV care continuum. Simultaneously, they identified examples of pandemic-era innovations that may help EHE. EXPERT OPINION Numerous studies demonstrated pandemic-related disruptions across the care continuum as well as the impact on preexisting barriers to care among People with HIV (PWH) at higher risk for poor outcomes. As the pandemic progressed, innovative approaches to delivering healthcare and providing essential services emerged, including widespread use of telemedicine, expansion of home-based care, self-collected sexually transmitted infection (STI) and HIV testing, and co-located testing for COVID-19 and HIV/STIs. While the COVID-19 pandemic initially hindered achieving EHE in the US, the ability to be agile, flexible, and creative led to innovation in HIV care delivery that may ultimately assist in meeting EHE goals as we transition into the post-pandemic era.
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Affiliation(s)
- Jenny Yeon Hee Kim
- Department of Global Health, The George Washington University Milken School of Public Health, 950 New Hampshire Ave NW, 4th Floor, Washington, DC, 20052, USA
| | - Shannon K Barth
- Department of Epidemiology, The George Washington University Milken School of Public Health, 950 New Hampshire Ave NW, 5th Floor, Washington DC, 20052, USA
| | - Anne K Monroe
- Department of Epidemiology, The George Washington University Milken School of Public Health, 950 New Hampshire Ave NW, 5th Floor, Washington DC, 20052, USA
| | - Sarah Ahsan
- Department of Epidemiology, The George Washington University Milken School of Public Health, 950 New Hampshire Ave NW, 5th Floor, Washington DC, 20052, USA
| | - Janja Kovacic
- Department of Epidemiology, The George Washington University Milken School of Public Health, 950 New Hampshire Ave NW, 5th Floor, Washington DC, 20052, USA
| | - Siena Senn
- Department of Epidemiology, The George Washington University Milken School of Public Health, 950 New Hampshire Ave NW, 5th Floor, Washington DC, 20052, USA
| | - Amanda D Castel
- Department of Epidemiology, The George Washington University Milken School of Public Health, 950 New Hampshire Ave NW, 5th Floor, Washington DC, 20052, USA
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Lea AN, Levine TM, Davy-Mendez T, Leibowitz A, Altschuler A, Flamm J, Hare CB, N Luu M, Silverberg MJ, Satre DD. Mental health and substance use screening in HIV primary care before and during the early COVID-19 pandemic. BMC Health Serv Res 2023; 23:494. [PMID: 37194051 PMCID: PMC10186313 DOI: 10.1186/s12913-023-09477-6] [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: 10/25/2022] [Accepted: 04/28/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Mental health and substance use disorders disproportionately affect people with HIV (PWH), and may have been exacerbated during COVID-19. The Promoting Access to Care Engagement (PACE) trial was designed to assess the effectiveness of electronic screening for mental health and substance use in HIV primary care and enrolled PWH from October 2018 to July 2020. Our objective here was to compare screening rates and results for PWH before (October 2018 - February 2020) and early in the COVID-19 pandemic (March-July 2020). METHODS Adult (≥ 18 years) PWH from 3 large HIV primary care clinics in a US-based integrated healthcare system were offered electronic screening online or via in-clinic tablet computer every 6 months. Screening completion and results (for depression, suicidal ideation, anxiety, and substance use) were analyzed using logistic regression with generalized estimating equations to estimate prevalence ratios (PR) before and after the start of the regional COVID-19 shelter-in-place orders on March 17, 2020. Models adjusted for demographics (age, sex, race/ethnicity), HIV risk factors (men who have sex with men, injection drug use, heterosexual, other), medical center, and modality of screening completion (online or tablet). We conducted qualitative interviews with providers participating in the intervention to evaluate how the pandemic impacted patient care. RESULTS Of 8,954 eligible visits, 3,904 completed screenings (420 during COVID, 3,484 pre-COVID), with lower overall completion rates during COVID (38% vs. 44%). Patients completing screening during COVID were more likely to be White (63% vs. 55%), male (94% vs. 90%), and MSM (80% vs., 75%). Adjusted PRs comparing COVID and pre-COVID (reference) were 0.70 (95% CI), 0.92 (95% CI), and 0.54 (95% CI) for tobacco use, any substance use, and suicidal ideation, respectively. No significant differences were found by era for depression, anxiety, alcohol, or cannabis use. These results were in contrast to provider-reported impressions of increases in substance use and mental health symptoms. CONCLUSION Findings suggest PWH had modest declines in screening rates early in the COVID-19 pandemic which may have been affected by the shift to telemedicine. There was no evidence that mental health problems and substance use increased for PWH in primary care. TRIAL REGISTRATION NCT03217058 (First registration date: 7/13/2017); https://clinicaltrials.gov/ct2/show/NCT03217058.
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Affiliation(s)
- Alexandra N Lea
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
| | - Tory M Levine
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Thibaut Davy-Mendez
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Amy Leibowitz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Andrea Altschuler
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jason Flamm
- Sacramento Medical Center, Kaiser Permanente Northern California, Sacramento, CA, USA
| | - C Bradley Hare
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA
| | - Mitchell N Luu
- Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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Filippone P, Serrano S, Gwadz M, Cleland CM, Freeman R, Linnemayr S, Cluesman SR, Campos S, Rosmarin-DeStefano C, Amos B, Israel K. A virtual pilot optimization trial for African American/Black and Latino persons with non-suppressed HIV viral load grounded in motivational interviewing and behavioral economics. Front Public Health 2023; 11:1167104. [PMID: 37234760 PMCID: PMC10205984 DOI: 10.3389/fpubh.2023.1167104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/18/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction Virtual and low-touch behavioral interventions are needed for African American/Black and Latino persons living with HIV (PLWH) with barriers to HIV viral suppression, particularly during COVID-19. Guided by the multiphase optimization strategy, we explored three components for PLWH without viral suppression, grounded in motivational interviewing and behavioral economics: (1) motivational interviewing counseling, (2) 21-weeks of automated text messages and quiz questions about HIV management, and (3) financial rewards for viral suppression (lottery prize vs. fixed compensation). Methods This pilot optimization trial used sequential explanatory mixed methods to explore the components' feasibility, acceptability, and preliminary evidence of effects using an efficient factorial design. The primary outcome was viral suppression. Participants engaged in baseline and two structured follow-up assessments over an 8-month period, and provided laboratory reports to document HIV viral load. A subset engaged in qualitative interviews. We carried out descriptive quantitative analyses. Then, qualitative data were analyzed using directed content analysis. Data integration used the joint display method. Results Participants (N = 80) were 49 years old, on average (SD = 9), and 75% were assigned male sex at birth. Most (79%) were African American/Black, and the remainder were Latino. Participants were diagnosed with HIV 20 years previously on average (SD = 9). Overall, components were feasible (>80% attended) and acceptability was satisfactory. A total of 39% (26/66) who provided laboratory reports at follow-up evidenced viral suppression. Findings suggested no components were entirely unsuccessful. The lottery prize compared to fixed compensation was the most promising component level. In qualitative analyses, all components were seen as beneficial to individual wellbeing. The lottery prize appeared more interesting and engaging than fixed compensation. However, structural barriers including financial hardship interfered with abilities to reach viral suppression. The integrated analyses yielded areas of convergence and discrepancy and qualitative findings added depth and context to the quantitative results. Conclusions The virtual and/or low-touch behavioral intervention components tested are acceptable and feasible and show enough potential to warrant refinement and testing in future research, particularly the lottery prize. Results must be interpreted in the context of the COVID-19 pandemic. Trial registration NCT04518241 (https://clinicaltrials.gov/ct2/show/NCT04518241).
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Affiliation(s)
- Prema Filippone
- Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States
- Center for Drug Use and HIV Research, School of Global Public Health, New York University, New York, NY, United States
| | - Samantha Serrano
- Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States
| | - Marya Gwadz
- Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States
- Center for Drug Use and HIV Research, School of Global Public Health, New York University, New York, NY, United States
| | - Charles M. Cleland
- Center for Drug Use and HIV Research, School of Global Public Health, New York University, New York, NY, United States
- Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | | | | | - Sabrina R. Cluesman
- Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States
| | | | | | - Brianna Amos
- Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States
| | - Khadija Israel
- Intervention Innovations Team Lab (IIT-Lab), New York University Silver School of Social Work, New York, NY, United States
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Monroe AK, Kulie PE, Byrne ME, Wilbourn BC, Barth SK, Resnik JB, Huebner DM, Horberg MA, Castel AD, Greenberg AE. Psychosocial impacts of the COVID-19 pandemic from a cross-sectional Survey of people living with HIV in Washington, DC. AIDS Res Ther 2023; 20:27. [PMID: 37161481 PMCID: PMC10169119 DOI: 10.1186/s12981-023-00517-z] [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: 10/24/2022] [Accepted: 04/03/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND COVID-19 has not only taken a staggering toll in terms of cases and lives lost, but also in its psychosocial effects. We assessed the psychosocial impacts of the COVID-19 pandemic in a large cohort of people with HIV (PWH) in Washington DC and evaluated the association of various demographic and clinical characteristics with psychosocial impacts. METHODS From October 2020 to December 2021, DC Cohort participants were invited to complete a survey capturing psychosocial outcomes influenced by the COVID-19 pandemic. Some demographic variables were also collected in the survey, and survey results were matched to additional demographic data and laboratory data from the DC Cohort database. Data analyses included descriptive statistics and multivariable logistic regression models to evaluate the association between demographic and clinical characteristics and psychosocial impacts, assessed individually and in overarching categories (financial/employment, mental health, decreased social connection, and substance use). RESULTS Of 891 participants, the median age was 46 years old, 65% were male, and 76% were of non-Hispanic Black race/ethnicity. The most commonly reported psychosocial impact categories were mental health (78% of sample) and financial/employment (56% of sample). In our sample, older age was protective against all adverse psychosocial impacts. Additionally, those who were more educated reported fewer financial impacts but more mental health impacts, decreased social connection, and increased substance use. Males reported increased substance use compared with females. CONCLUSIONS The COVID-19 pandemic has had substantial psychosocial impacts on PWH, and resiliency may have helped shield older adults from some of these effects. As the pandemic continues, measures to aid groups vulnerable to these psychosocial impacts are critical to help ensure continued success towards healthy living with HIV.
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Affiliation(s)
- Anne K. Monroe
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - Paige E. Kulie
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - Morgan E. Byrne
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - Brittany C. Wilbourn
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - Shannon K. Barth
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - Jenna B. Resnik
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - David M. Huebner
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | | | - Amanda D. Castel
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - Alan E. Greenberg
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
| | - the DC Cohort Executive Committee
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, Washington, DC, NW 20052 USA
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
- Kaiser Permanente Mid Atlantic States, Rockville, MD, USA
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21
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Dutta D, Liu J, Xiong H. The Impact of COVID-19 on People Living with HIV-1 and HIV-1-Associated Neurological Complications. Viruses 2023; 15:1117. [PMID: 37243203 PMCID: PMC10223371 DOI: 10.3390/v15051117] [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: 04/12/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen of the coronavirus disease 2019 (COVID-19) pandemic, a fatal respiratory illness. The associated risk factors for COVID-19 are old age and medical comorbidities. In the current combined antiretroviral therapy (cART) era, a significant portion of people living with HIV-1 (PLWH) with controlled viremia is older and with comorbidities, making these people vulnerable to SARS-CoV-2 infection and COVID-19-associated severe outcomes. Additionally, SARS-CoV-2 is neurotropic and causes neurological complications, resulting in a health burden and an adverse impact on PLWH and exacerbating HIV-1-associated neurocognitive disorder (HAND). The impact of SARS-CoV-2 infection and COVID-19 severity on neuroinflammation, the development of HAND and preexisting HAND is poorly explored. In the present review, we compiled the current knowledge of differences and similarities between SARS-CoV-2 and HIV-1, the conditions of the SARS-CoV-2/COVID-19 and HIV-1/AIDS syndemic and their impact on the central nervous system (CNS). Risk factors of COVID-19 on PLWH and neurological manifestations, inflammatory mechanisms leading to the neurological syndrome, the development of HAND, and its influence on preexisting HAND are also discussed. Finally, we have reviewed the challenges of the present syndemic on the world population, with a particular emphasis on PLWH.
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Affiliation(s)
- Debashis Dutta
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198-5880, USA
| | | | - Huangui Xiong
- Department of Pharmacology and Experimental Neuroscience, College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198-5880, USA
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22
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Des Jarlais DC, Weng CA, Feelemyer J, McKnight C. COVID-19 vaccination and HIV transmission among persons who inject drugs during the first two years of the COVID-19 pandemic in New York City. Harm Reduct J 2023; 20:63. [PMID: 37138304 PMCID: PMC10156073 DOI: 10.1186/s12954-023-00791-0] [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: 10/24/2022] [Accepted: 04/29/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND To examine COVID-19 vaccination and HIV transmission among persons who inject drugs (PWID) during the COVID-19 pandemic (2020-2022) in New York City (NYC). METHODS Two hundred and seventy five PWID were recruited from October 2021 to September 2022. A structured questionnaire was used to measure demographics, drug use behaviors, overdose experiences, substance use treatment history, COVID-19 infection, vaccination, and attitudes. Serum samples were collected for HIV, HCV, and SARS-CoV-2 (COVID-19) antibody testing. RESULTS Participants were: 71% male, the mean age was 49 (SD 11), 81% reported at least one COVID-19 immunization, 76% were fully vaccinated and 64% of the unvaccinated had antibodies for COVID-19. Self-reported injection risk behaviors were very low. HIV seroprevalence was 7%. Eighty-nine percent of the HIV seropositive respondents reported knowing they were HIV seropositive and being on antiretroviral therapy prior to the COVID-19 pandemic. There were two likely seroconversions in 518.83 person-years at risk from the March 2020 start of the pandemic to the times of interviews, for an estimated incidence rate of 0.39/100 person-years, 95% Poisson CI 0.05-1.39/100 person-years. CONCLUSIONS There is concern that the COVID-19 pandemic disruptions to HIV prevention services and the psychological stress of the pandemic may lead to increased risk behavior and increased HIV transmission. These data indicate adaptive/resilient behaviors in both obtaining COVID-19 vaccination and maintaining a low rate of HIV transmission among this sample of PWID during the first two years of the COVID-19 pandemic in NYC.
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Affiliation(s)
- Don C Des Jarlais
- School of Global Public Health, New York University, 708 Broadway, 7th Floor, NY, 10003, New York, USA.
| | - Chenziheng Allen Weng
- School of Global Public Health, New York University, 708 Broadway, 7th Floor, NY, 10003, New York, USA
| | - Jonathan Feelemyer
- School of Global Public Health, New York University, 708 Broadway, 7th Floor, NY, 10003, New York, USA
| | - Courtney McKnight
- School of Global Public Health, New York University, 708 Broadway, 7th Floor, NY, 10003, New York, USA
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23
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Jaafari Z, Mirzaei H, Moradi Y, Nasiri N, Mehmandoost S, Khezri M, Tavakoli F, Abbaszadeh S, Sharifi H. The impact of the COVID-19 pandemic on the provision of HIV/AIDS-related services in Iran: a qualitative study. BMC Health Serv Res 2023; 23:430. [PMID: 37138294 PMCID: PMC10155158 DOI: 10.1186/s12913-023-09407-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/15/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Providing services to people living with HIV (PLWH) faced many challenges during the COVID-19 pandemic. This study aimed to examine the impact of the COVID-19 pandemic on providing HIV/AIDS-related services in Iran. METHODS In this qualitative study, the participants were included by purposive sampling between November 2021 and February 2022. Virtually focused group discussion (FGD) meetings were conducted with the first group including policymakers, service providers, and researchers (n = 17), and the interviews were conducted telephonic and face-to-face using a semi-structured guide with the second group including people who received services (n = 38). Data were analyzed by content analysis using the inductive method in MAXQDA 10 software. RESULTS Six categories were obtained, including mostly affected services, ways of the effect of COVID-19, healthcare systems reaction, effects on social inequality, opportunities created by the pandemic, and suggestions for the future. In addition, people who received services believed the COVID-19 pandemic has affected their life in several ways, including getting COVID-19, mental and emotional problems during the pandemic, financial problems, changes in the care plan, and changes in high-risk behaviors. CONCLUSION Considering the level of community involvement with the issue of COVID-19 and the shock caused by the pandemic, as mentioned by the world health organization, it is necessary to improve health systems' resilience for better preparedness for similar conditions.
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Affiliation(s)
- Zahra Jaafari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Mirzaei
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Naser Nasiri
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheil Mehmandoost
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Khezri
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA
| | - Fatemeh Tavakoli
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Samaneh Abbaszadeh
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Abbasi SAA, Noor T, Mylavarapu M, Sahotra M, Bashir HA, Bhat RR, Jindal U, Amin U, V A, Siddiqui HF. Double Trouble Co-Infections: Understanding the Correlation Between COVID-19 and HIV Viruses. Cureus 2023; 15:e38678. [PMID: 37288215 PMCID: PMC10243673 DOI: 10.7759/cureus.38678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/09/2023] Open
Abstract
A global outbreak of coronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mounted a substantial threat to public health worldwide. It initially emerged as a mere outbreak in Wuhan, China, in December 2019 and quickly engulfed the entire world, evolving into a global pandemic, consuming millions of lives and leaving a catastrophic effect on our lives in ways unimaginable. The entire healthcare system was significantly impacted and HIV healthcare was not spared. In this article, we reviewed the effect of HIV on COVID-19 disease and the ramifications of the recent COVID-19 pandemic over HIV management strategies. Our review highlights that contrary to the instinctive belief that HIV should render patients susceptible to COVID-19 infection, the studies depicted mixed results, although comorbidities and other confounders greatly affected the results. Few studies showed a higher rate of in-hospital mortality due to COVID-19 among HIV patients; however, the use of antiretroviral therapy had no consequential effect. COVID-19 vaccination was deemed safe among HIV patients in general. The recent pandemic can destabilize the HIV epidemic control as it hugely impacted access to care and preventive services and led to a marked reduction in HIV testing. The collision of these two disastrous pandemics warrants the need to materialize rigorous epidemiological measures and health policies, but most importantly, brisk research in prevention strategies to mitigate the combined burden of the two viruses and to battle similar future pandemics.
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Affiliation(s)
| | - Tarika Noor
- Department of Medicine, Government Medical College, Patiala, Ludhiana, IND
| | | | - Monika Sahotra
- Department of Medicine, Bukovinian State Medical University, Chernivtsi, UKR
| | - Hunmble A Bashir
- Forensic Medicine, Combined Military Hospital (CMH) Lahore Medical College and Institute of Dentistry, Lahore, PAK
| | - Rakshita Ramesh Bhat
- Medical Oncology, Mangalore Institute of Oncology, Mangalore, IND
- Internal Medicine, Bangalore Medical College and Research Institute, Bangalore, IND
| | - Urmi Jindal
- Department of Medicine, Karamshi Jethabhai Somaiya Medical College, Mumbai, IND
| | - Uzma Amin
- Pathology, Rawalpindi Medical University, Rawalpindi, PAK
| | - Anushree V
- Department of Medicine, Jagadguru Jayadeva Murugarajendra (JJM) Medical College, Davangere, IND
| | - Humza F Siddiqui
- Department of Medicine, Jinnah Sindh Medical University, Karachi, PAK
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25
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Smarony S, Parlier-Ahmad AB, Shadowen H, Thakkar B, Scheikl MO, Martin CE. Assessment of COVID-19-Driven Changes in an Integrated OBGYN-Addiction Treatment Clinic and Future Implications. J Addict Med 2023; 17:e183-e191. [PMID: 37267180 PMCID: PMC10248187 DOI: 10.1097/adm.0000000000001122] [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] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The COVID-19 pandemic prompted healthcare delivery changes, but the associated impacts on substance use disorder treatment outcomes among pregnant and parenting people are unknown. This study aims to (1) describe COVID-19-driven clinical practice changes, (2) evaluate clinic-level visit attendance patterns, and (3) compare patient-level treatment engagement outcomes across 3 COVID-19 pandemic phases in an OBGYN-addiction treatment clinic. METHODS COVID-19 phases include pre-COVID-19 (August 2019-February 2020), early COVID-19 (March-December 2020), and COVID-19 vaccine (January-July 2021). OBGYN-addiction treatment clinical practice changes were summarized. Clinic-level attended medical provider visits were analyzed. Patient-level treatment engagement outcomes (buprenorphine continuation, visit attendance, and virtual visits) were assessed in a cohort of pregnant and parenting people enrolled in a clinic research registry. Mixed-level logistic regression models determined the relationship between the COVID-19 phases and the patient-level outcomes. RESULTS The study site made several COVID-19-driven clinical practice changes, including implementing a hybrid virtual/in-person system for medical visits. Clinic-level medical provider appointments increased between the first and second COVID-19 phases and remained high in the third phase. Among participants included in patient-level outcome analyses (N = 27), there were no differences in the early COVID-19 phase compared with the pre-COVID-19 phase in buprenorphine continuation, any visits, or medical visits. There was a decrease in all patient-level outcomes in the COVID-19 vaccine phase compared with pre-COVID-19 ( P < 0.05). Virtual visits increased between the first 2 phases and remained high during the third. CONCLUSION Within our OBGYN-addiction treatment clinic, implementation of tailored, patient-centered treatment strategies supported clinic- and patient-level treatment engagement throughout the pandemic.
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Affiliation(s)
- Sumaya Smarony
- Department of Obstetrics and Gynecology, Virginia Commonwealth University
| | | | - Hannah Shadowen
- Department of Health Behavior and Policy, Virginia Commonwealth University
| | - Bhushan Thakkar
- Department of Obstetrics and Gynecology, Virginia Commonwealth University
| | | | - Caitlin E. Martin
- Department of Obstetrics and Gynecology, Virginia Commonwealth University
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University
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26
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Hong C, Queiroz A, Hoskin J. The impact of the COVID-19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review. J Int AIDS Soc 2023; 26:e26060. [PMID: 36912238 PMCID: PMC10009802 DOI: 10.1002/jia2.26060] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/19/2023] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic and associated measures implemented by authorities have created additional stressors and increased the risk of psychological illnesses among people living with HIV (PLWH). Yet, there is no collective evidence on the mental health status of this population during the global pandemic and associated factors. This scoping review aimed to synthesize the evidence in the current literature related to the mental health outcomes and challenges faced by PLWH during the COVID-19 pandemic, identify the associated factors with psychological distress and summarize various coping strategies to ease these psychological distresses used by this population. METHODS We conducted a scoping review following the PRISMA-ScR guideline and a literature search in four electronic databases in August 2022. Three reviewers independently screened all the search records and extracted the data from studies that met the inclusion criteria. Factors associated with worsened mental health outcomes were synthesized according to the socio-ecological framework. RESULTS Among 1100 research records, 45 articles met the eligibility criteria and were included in the final review and data extraction, most of which were quantitative analyses. PLWH reported high rates of mental health problems during the pandemic. Multi-level factors were associated with increased psychological distress, including substance use, antiretroviral adherence, social support, financial hardship and economic vulnerability during the pandemic. PLWH used social media as a coping strategy to foster social support to deal with growing mental distress. Increased mental health illnesses were associated with increased substance use, it was also found associated with suboptimal medication adherence and antiretroviral therapy (ART) care engagement. DISCUSSION PLWH experienced high rates of mental health illnesses, such as depression during the global COVID-19 pandemic. There is an urgent need to provide comprehensive HIV treatment and mental health services as the pandemic continues to evolve. CONCLUSIONS The review summarized how the mental health of PLWH was affected during the COVID-19 pandemic. Future work in the implementation of effective interventions to promote mental health in this population is needed, not only to ensure their quality of life but also to help them maintain ART adherence and healthcare during more unprecedented times.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, California, USA
| | - Artur Queiroz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
| | - Jordan Hoskin
- State of California Department of Rehabilitation, Los Angeles, California, USA
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27
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Ward MK, Aleite S, Sheehan DM, Li T, Gbadamosi SO, Jean-Gilles M, Ladner RA, Trepka MJ. Self-reported Nonadherence to Antiretroviral Therapy Among Miami-Dade Ryan White Program Clients During the COVID-19 Pandemic: A Cross-sectional Study. J Assoc Nurses AIDS Care 2023; 34:198-206. [PMID: 36607312 PMCID: PMC10062022 DOI: 10.1097/jnc.0000000000000382] [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: 06/28/2022] [Indexed: 01/07/2023]
Abstract
This study examined factors associated with self-reported ART nonadherence during the COVID-19 pandemic among Miami-Dade County Ryan White HIV/AIDS Program (RWHAP) clients. A cross-sectional survey was conducted from October 2020-January 2021 in English, Spanish, and Haitian Creole. The survey included questions on self-reported ART adherence, HIV care access (compared to before the pandemic), social and economic pandemic impacts, and demographics. We carried out descriptive bivariate analyses and weighted logistic regression to estimate unadjusted and adjusted odds ratios (aORs) for self-reported nonadherence. 12.7% of participants reported ART nonadherence. Adjusting for age, sex, race/ethnicity, and nativity, factors associated with nonadherence included greater difficulty accessing an HIV doctor compared with before the COVID-19 pandemic (aOR=3.6, 95% CI: 1.4–9.2) and experiencing financial impacts due to the pandemic (aOR=4.2, 95% CI: 1.5–12.2). Ensuring RWHAP clients maintain access to HIV medical care providers and receive support for financial shocks are critical to sustaining ART adherence.
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Affiliation(s)
- Melissa K Ward
- Melissa K. Ward, PhD, MPH, is an Assistant Professor, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, and Research Center in Minority Institutions, Florida International University, Miami, Florida, USA. Stephanie Aleite, BA, is an MSW Student, School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Diana M. Sheehan, PhD, MPH, is an Assistant Professor, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Research Center in Minority Institutions, and Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida, USA. Tan Li, PhD, is an Associate Professor, Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Semiu O. Gbadamosi, PhD, MBBS, MPH, was a PhD Candidate, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Michèle Jean-Gilles, PhD, is a Research Associate Professor, Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA. Robert A. Ladner, PhD, is President, Behavioral Science Research Corporation, Miami, Florida, USA. Mary Jo Trepka, MD, MSPH, is a Professor, Department of Epidemiology, Robert Stempel College of Public Health and Social Work, and Research Center in Minority Institutions, Florida International University, Miami, Florida, USA
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28
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SeyedAlinaghi S, Mirzapour P, Pashaei Z, Afzalian A, Tantuoyir MM, Salmani R, Maroufi SF, Paranjkhoo P, Maroufi SP, Badri H, Varshochi S, Vahedi F, Mehraeen E, Dadras O. The impacts of COVID-19 pandemic on service delivery and treatment outcomes in people living with HIV: a systematic review. AIDS Res Ther 2023; 20:4. [PMID: 36609313 PMCID: PMC9821373 DOI: 10.1186/s12981-022-00496-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The COVID-19 epidemic and various control and mitigation measures to combat the widespread outbreak of the disease may affect other parts of health care systems. There is a concern that the COVID-19 pandemic could disrupt HIV services. Therefore, this study aimed to systematically evaluate the effect of the COVID-19 pandemic on service delivery and treatment outcomes in people with HIV. METHODS In this study, a systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, and Cochrane databases. The retrieved articles underwent a two-step title/abstract and full-text review process, and the eligible papers were selected and included in the qualitative synthesis. RESULT We selected 16 studies out of 529 retrieved records that met the inclusion criteria for this review. Study populations of the selected studies were either HIV-positive patients or HIV clinics and healthcare providers. Most studies were focused on adhering to and obtaining medication and attending clinical appointments and their decrement during the pandemic. Other aspects of HIV care (alternative healthcare settings, viral suppression, psychological care, etc.) were discussed to a lesser extent by the included studies. CONCLUSION Interruption in in-person visits and medical follow-up services, loss of adherence to treatment, and subsequent increase in mortality due to the COVID-19 pandemic complications in PLHIV have led to growing concerns. Other challenges were psychological disorders such as anxiety and depression, an increase in substance abuse, and a rise in experienced stigma and discrimination. However, the use of telemedicine in some countries helps to alleviate the situation to some extent and is recommended in similar settings in the future.
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Affiliation(s)
- SeyedAhmad SeyedAlinaghi
- grid.411705.60000 0001 0166 0922Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Mirzapour
- grid.411705.60000 0001 0166 0922Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pashaei
- grid.411705.60000 0001 0166 0922Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Arian Afzalian
- grid.411705.60000 0001 0166 0922School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Marcarious M. Tantuoyir
- grid.411705.60000 0001 0166 0922School of Medicine, Tehran University of Medical Sciences, Tehran, Iran ,grid.8652.90000 0004 1937 1485Biomedical Engineering Unit, University of Ghana Medical Center (UGMC), Accra, Ghana
| | - Roghayeh Salmani
- Department of Midwifery, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Seyed Farzad Maroufi
- grid.411705.60000 0001 0166 0922School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Paranjkhoo
- grid.78780.300000 0004 0613 1044Turpanjian College of Health Sciences, American University of Armenia, 0019 Yerevan, Armenia
| | - Seyede Parmis Maroufi
- grid.486769.20000 0004 0384 8779Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Hajar Badri
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, 5681761351 Iran
| | - Sanaz Varshochi
- grid.411705.60000 0001 0166 0922School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Vahedi
- grid.411705.60000 0001 0166 0922School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, 5681761351 Iran
| | - Omid Dadras
- grid.411705.60000 0001 0166 0922Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran ,grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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29
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Kunzler AM, Lindner S, Röthke N, Schäfer SK, Metzendorf MI, Sachkova A, Müller-Eberstein R, Klinger C, Burns J, Coenen M, Lieb K. Mental Health Impact of Early Stages of the COVID-19 Pandemic on Individuals with Pre-Existing Mental Disorders: A Systematic Review of Longitudinal Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:948. [PMID: 36673705 PMCID: PMC9858748 DOI: 10.3390/ijerph20020948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
In view of disease-related threats, containment measures, and disrupted healthcare, individuals with pre-existing mental illness might be vulnerable to adverse effects of the COVID-19 pandemic. Previous reviews indicated increased mental distress, with limited information on peri-pandemic changes. In this systematic review, we aimed to identify longitudinal research investigating pre- to peri-pandemic and/or peri-pandemic changes of mental health in patients, focusing on the early phase and considering specific diagnoses. PsycINFO, Web of Science, the WHO Global literature on coronavirus disease database, and the Cochrane COVID-19 Study Register weresearched through 31 May 2021. Studies were synthesized using vote counting based on effect direction. We included 40 studies mostly from Western, high-income countries. Findings were heterogeneous, with improving and deteriorating mental health observed compared to pre-pandemic data, partly depending on underlying diagnoses. For peri-pandemic changes, evidence was limited, with some suggestion of recovery of mental distress. Study quality was heterogeneous; only few studies investigated potential moderators (e.g., chronicity of mental illness). Mental health effects on people with pre-existing conditions are heterogeneous within and across diagnoses for pre- to peri-pandemic and peri-pandemic comparisons. To improve mental health services amid future global crises, forthcoming research should understand medium- and long-term effects, controlling for containment measures.
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Affiliation(s)
- Angela M. Kunzler
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany
- Institute for Evidence in Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Saskia Lindner
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Nikolaus Röthke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Sarah K. Schäfer
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany
| | - Maria-Inti Metzendorf
- Institute of General Practice (ifam), Medical Faculty, Heinrich Heine University Düsseldorf, 40225 Düsseldorf, Germany
| | - Alexandra Sachkova
- Department of Anesthesiology, University Medical Center of the Georg August University Göttingen, 37075 Göttingen, Germany
| | - Roxana Müller-Eberstein
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Munich, 81377 Munich, Germany
- Pettenkofer School of Public Health, 81377 Munich, Germany
| | - Carmen Klinger
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Munich, 81377 Munich, Germany
- Pettenkofer School of Public Health, 81377 Munich, Germany
| | - Jacob Burns
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Munich, 81377 Munich, Germany
- Pettenkofer School of Public Health, 81377 Munich, Germany
| | - Michaela Coenen
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), LMU Munich, 81377 Munich, Germany
- Pettenkofer School of Public Health, 81377 Munich, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
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Kelly D, Koay A, Mineva G, Volz M, McCool A, McLoughlin E, Ó Conluain R, Sharma M, Kerr A, Franklin BD, Grimes T. A scoping review of non-professional medication practices and medication safety outcomes during public health emergencies. Public Health 2023; 214:50-60. [PMID: 36521272 DOI: 10.1016/j.puhe.2022.10.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/06/2022] [Accepted: 10/18/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Public health emergencies (PHE) can disrupt personal medication practices and increase the risk of medication-related harm and other negative medication-related outcomes. Our aim was to examine the extent and nature of published research on this topic to guide future research and practice. STUDY DESIGN Scoping review. METHODS Standard electronic databases were searched. PRISMA-ScR guidelines were followed. Extracted data were organised in response to review questions and narrative accounts developed. RESULTS A total of 129 studies were included, conducted across 32 countries, mostly in the USA (n = 42). Sixty-eight (53%) reported on infectious events, 49 (39%) climatological or ecological events and the remainder a mixture of terrorism, war or other disasters. The studies described several medication safety outcomes (medication-related harm, adherence, supply) and adaptive medication practices (self-altering prescribed medications, sharing medications and changing healthcare providers). Challenges to maintaining routine medication practices during a PHE included transport, finance, quarantine and knowledge-related issues. Twenty-eight studies (22%) examined health inequalities pertaining to adverse medication-related outcomes, with findings suggesting that gender, age, ethnicity, educational and socio-economic status may be related to inequalities. Research gaps identified included carers', children's and minority communities' experiences and intervention studies. CONCLUSIONS There is considerable evidence of disruptions to routine personal medication practices during PHEs and of medication-related harm and other negative outcomes. Maintaining medication supply for the management of chronic conditions is a universal problem across all emergency types. Research is needed to address these disruptions, particularly amongst people who experience health inequalities who may need additional support.
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Affiliation(s)
- Dervla Kelly
- School of Medicine, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - Aaron Koay
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Gabriela Mineva
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Monika Volz
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Aoibhin McCool
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Eavan McLoughlin
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | | | - Manuj Sharma
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - Aisling Kerr
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | - Bryony Dean Franklin
- Imperial College Healthcare NHS Trust, London, UK; NIHR Imperial Patient Safety Translational Research Centre, Imperial College London, UK; UCL School of Pharmacy, London, UK
| | - Tamasine Grimes
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland.
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Piton M, Della Vecchia C, Mabire R, Alain T, Salcedo Robledo M, Charpentier N, Puppo C, Petit AS, Carpentier C, Perray M, Mabire X, Michels D, Préau M. Facteurs associés à la crainte de l’infection par la COVID-19 chez des personnes vivant avec le VIH. SANTE PUBLIQUE (VANDOEUVRE-LES-NANCY, FRANCE) 2023; 34:771-781. [PMID: 37019790 DOI: 10.3917/spub.226.0771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
INTRODUCTION People living with HIV (PLHIV) who may have experienced biographical disruptions in their life trajectory may have a vulnerability to risk that differs from the general population, particularly in the context of an infectious health crisis. This study aimed to understand the factors associated with concerns about being infected with COVID-19 among PLHIV during the first period of the health crisis. METHODS This was an online cross-sectional study using an online self-administered questionnaire in the context of the COVID-19 epidemic in France among a population of PLHIV. The recruitment was done via social networks and through various actors in the fight against HIV. The self-questionnaire was available from July 2020 to September 2020. RESULTS The ACOVIH study collected 249 responses, 202 men and 47 women, with a mean age of 46.6 ± 12.9 years. The most represented socio-professional categories were employees (n=73.29%), followed by managers, professionals and artists (n=59.24%). The PLHIV most worried about being infected by COVID-19 had a level of education lower than or equal to the baccalaureate, family difficulties related to HIV and a deterioration in the relationship of trust with the HIV medical team. CONCLUSION Feelings of anxiety can have a health and psychosocial impact on PLHIV. It is necessary to consider these negative factors by proposing adapted support and by carrying out preventive actions aiming in particular at improving the literacy of the PLHIV.
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Affiliation(s)
- Maëva Piton
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | | | - Renaud Mabire
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | - Tristan Alain
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. AIDES – Pantin – France
| | - Manuela Salcedo Robledo
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. AIDES – Pantin – France
| | - Nicolas Charpentier
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. Laboratoire de recherche communautaire Coalition – Pantin – France
| | - Costanza Puppo
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | - Anne Sophie Petit
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France. Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France
| | | | - Mathilde Perray
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France
| | - Xavier Mabire
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France. Institut de recherches sociologiques (IRS) – Université de Genève – Genève – Suisse
| | - David Michels
- Inserm U1296 Radiations : Défense, Santé, Environnement – Lyon – France. AIDES – Pantin – France
| | - Marie Préau
- Inserm U1296 Radiations : Défense, Santé, Environnement – Bron – France. Laboratoire PHASE – Université de Lausanne – Lausanne – Suisse
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Simha S, Ahmed Y, Brummett CM, Waljee JF, Englesbe MJ, Bicket MC. Impact of the COVID-19 pandemic on opioid overdose and other adverse events in the USA and Canada: a systematic review. Reg Anesth Pain Med 2023; 48:37-43. [DOI: 10.1136/rapm-2022-103591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 09/07/2022] [Indexed: 02/19/2023]
Abstract
ImportanceThe COVID-19 pandemic impacted healthcare beyond COVID-19 infections. A better understanding of how COVID-19 worsened the opioid crisis has potential to inform future response efforts.ObjectiveTo summarize changes from the COVID-19 pandemic on outcomes regarding opioid use and misuse in the USA and Canada.Evidence reviewWe searched MEDLINE via PubMed, EMBASE, and CENTRAL for peer-reviewed articles published between March 2020 and December 2021 that examined outcomes relevant to patients with opioid use, misuse, and opioid use disorder by comparing the period before vs after COVID-19 onset in the USA and Canada. Two reviewers independently screened studies, extracted data, assessed methodological quality and bias via Newcastle-Ottawa Scale, and synthesized results.FindingsAmong 20 included studies, 13 (65%) analyzed service utilization, 6 (30%) analyzed urine drug testing results, and 2 (10%) analyzed naloxone dispensation. Opioid-related emergency medicine utilization increased in most studies (85%, 11/13) for both service calls (17% to 61%) and emergency department visits (42% to 122%). Urine drug testing positivity results increased in all studies (100%, 6/6) for fentanyl (34% to 138%), most (80%, 4/5) studies for heroin (-12% to 62%), and most (75%, 3/4) studies for oxycodone (0% to 44%). Naloxone dispensation was unchanged and decreased in one study each.InterpretationSignificant increases in surrogate measures of the opioid crisis coincided with the onset of COVID-19. These findings serve as a call to action to redouble prevention, treatment, and harm reduction efforts for the opioid crisis as the pandemic evolves.PROSPERO registration numberCRD42021236464.
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Meyer D, Slone SE, Ogungbe O, Duroseau B, Farley JE. Impact of the COVID-19 Pandemic on HIV Healthcare Service Engagement, Treatment Adherence, and Viral Suppression in the United States: A Systematic Literature Review. AIDS Behav 2023; 27:344-357. [PMID: 35916951 PMCID: PMC9344234 DOI: 10.1007/s10461-022-03771-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 01/24/2023]
Abstract
The COVID-19 pandemic has necessitated adaptations in how healthcare services are rendered. However, it is unclear how these adaptations have impacted HIV healthcare services across the United States. We conducted a systematic review to assess the impacts of the pandemic on service engagement, treatment adherence, and viral suppression. We identified 26 total studies spanning the beginning of the pandemic (March 11, 2020) up until November 5, 2021. Studies were conducted at the national, state, and city levels and included representation from all four CDC HIV surveillance regions. Studies revealed varying impacts of the pandemic on HIV healthcare retention/engagement, medication adherence, and viral suppression rates, including decreases in HIV healthcare visits, provider cancellations, and inability to get prescription refills. Telehealth was critical to ensuring continued access to care and contributed to improved retention and engagement in some studies. Disparities existed in who had access to the resources needed for telehealth, as well as among populations living with HIV whose care was impacted by the pandemic.
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Affiliation(s)
- Diane Meyer
- Center for Health Security, Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD USA 621 East Pratt Street, Suite 210, 21202 ,Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 511, 21205 Baltimore, MD USA
| | - Sarah E. Slone
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 511, 21205 Baltimore, MD USA
| | - Oluwabunmi Ogungbe
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 511, 21205 Baltimore, MD USA
| | - Brenice Duroseau
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 511, 21205 Baltimore, MD USA
| | - Jason E. Farley
- Center for Infectious Disease and Nursing Innovation, Johns Hopkins University School of Nursing, 525 North Wolfe Street, Suite 511, 21205 Baltimore, MD USA
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Use of COVID-19 testing in the first year of the COVID-19 pandemic among cohorts of people at the intersection of drug use and HIV. Drug Alcohol Depend 2022; 241:109622. [PMID: 36123252 PMCID: PMC9444299 DOI: 10.1016/j.drugalcdep.2022.109622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 01/13/2023]
Abstract
People living with (PLWH) and at risk for HIV and people who use drugs (PWUD) are at heightened risk for health consequences of COVID-19 because of compromised immunity and high comorbidities. We studied their use of COVID-19 testing during the first year of the COVID-19 pandemic. Eight NIDA funded cohorts across North America in the Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO) administered multiple waves of a COVID-19 survey. Respondents were at least 18 years of age, half PLWH, and many active substance users. Wave one of the COVID-19 survey was May-November, 2020 and wave two October 2020-April 2021. Associations of COVID-19 testing with demographics, socio-demographics, substance use, and HIV-status were assessed. Of the 3762 responses from 2331 individuals, half reported ever COVID-19 testing (49.1 %), with 4.3 % reporting a positive test (163/3762 surveys=4.3 %) and 41.5 % of people reporting current symptoms reported having been tested. In multivariable analysis adjusting for age, sex, and cohort type associations with COVID-19 testing included African American/Black identification compared to Caucasian/white (adjusted odds ratio (AOR)= 0.68; 95 % confidence interval (CI) 0.53, 0.88); being unemployed (AOR=0.61; 95 % CI 0.51, 0.73), and living with HIV (AOR=0.76; 95 % CI0.65, 0.90). Findings from these C3PNO COVID-19 modules suggests that in the first year of the pandemic COVID-19 testing was not broadly accessed by these marginalized populations including PLWH and those unemployed. Factors associated with not testing may also parallel those for vaccination and identify populations needing better access to COVID-19 prevention.
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35
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Ornos EDB, Tantengco OAG, Abad CLR. Global Online Interest in HIV/AIDS care Services in the time of COVID-19: A Google Trends Analysis. AIDS Behav 2022; 27:1998-2004. [PMID: 36441409 PMCID: PMC9707175 DOI: 10.1007/s10461-022-03933-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2022] [Indexed: 11/30/2022]
Abstract
The Covid-19 pandemic has compounded the challenge of HIV/AIDS elimination, creating difficulties in accessing HIV care services such as early testing and treatment. This paper characterized the global online interest in HIV care services-related search terms before and during the pandemic. Global online search interest for HIV was measured using the Google Trends™ database. Spearman's rank-order correlation correlated country-specific characteristics and HIV prevalence data with the search volume index (SVI). We found a significant decrease in the global online search interest for HIV/AIDS care services-related search terms during the Covid-19 pandemic. The top countries with the highest online interest for "HIV/AIDS" search terms were Zambia, Eswatini, Malawi, Lesotho, and Zimbabwe. In addition, search volume indices for HIV correlated positively with HIV prevalence and negatively with GDP, GDP per capita, and the number of physicians. This result highlights that resource-poor countries with a high prevalence of HIV have a high online interest in HIV/AIDS. Therefore, there is a need to improve internet access, the quality of HIV-related health information, and online health literacy to improve health-seeking behavior, especially in areas with a high disease burden. Overall, our study shows that the infodemiologic approach through Google Trends™ can be used to assess the online interest of the public toward HIV infection and related healthcare services.
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Affiliation(s)
- Eric David B. Ornos
- College of Medicine, University of the Philippines Manila, Manila, Philippines
| | | | - Cybele Lara R. Abad
- Section of Infectious Diseases, Department of Medicine, Philippine General Hospital, University of the Philippines, Manila, Philippines
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González-Roz A, Haik AK, Rahman L, Todi AA, Kane C, Walji A, Dickerman SR, Scarfe M, Levitt EE, Belisario K, Kelly JF, MacKillop J. Impacts of the COVID-19 public health restrictions on substance use, mental health, and psychosocial functioning among individuals with alcohol use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:712-723. [PMID: 36417589 DOI: 10.1080/00952990.2022.2134021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: The COVID-19 pandemic has been associated with major psychosocial disruptions and there is particular concern for individuals with substance use disorders.Objectives: This study characterized the psychosocial and experiential impacts of the pandemic on individuals seeking alcohol use disorder (AUD) recovery, including pandemic impacts on self-reported drinking, heavy drinking, tobacco, cannabis, and stimulant use.Methods: Participants were 125 AUD+ individuals (% males: 57.60; Mage = 49.11, SD = 12.13) reporting on substance use from January 1st-24th March, 2020 (pre-pandemic) and since the stay-at-home orders commenced, 24th March-June 28th 2020 (intra-pandemic). Within-subjects changes were examined and a latent profile analysis was performed to identify subgroups differentially impacted by the pandemic.Results: Large proportions reported psychosocial impacts of COVID-19, but drinking and other substance use did not reveal significant changes. Latent profile analyses revealed two subgroups: Profile 1 (n = 41/125), "Moderately Impacted") and Profile 2 (n = 84/125), "Severely Impacted"). Compared to the pre-pandemic period, the group that was moderately impacted by the pandemic exhibited significantly fewer heavy drinking days (p = .02) during the intra-pandemic period, but no other substance use changes. The group showing severe pandemic impacts did not exhibit changes in alcohol or other drug use but evidenced more severe anxiety and depression (ps < .001).Conclusions: We found heterogeneous subtypes of pandemic-related impacts in AUD recovery patients. There is need to provide psychosocial support to this particular population and further monitoring substance use and mental health.
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Affiliation(s)
- Alba González-Roz
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,Addictive Behaviors Research Group, Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Amanda K Haik
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Liah Rahman
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Akshiti A Todi
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Claire Kane
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Alyna Walji
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Sarah R Dickerman
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Molly Scarfe
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Emily E Levitt
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Kyla Belisario
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - John F Kelly
- Recovery Research Institute, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - James MacKillop
- Peter Boris Centre for Addictions Research, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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Joseph OL, Hall A, Devlin SA, Kerman J, Schmitt J, McNulty MC, Ridgway JP. "When you have an immune disease like HIV and there is a pandemic, you still have to pay your bills": COVID-19-related challenges among people living with HIV and lessons for care delivery. AIDS Care 2022; 34:1405-1412. [PMID: 35473487 PMCID: PMC9596614 DOI: 10.1080/09540121.2022.2067314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 04/13/2022] [Indexed: 01/08/2023]
Abstract
COVID-19 has disrupted routine medical care and increased psychosocial and economic stressors on a global scale, yet the full impact on people living with HIV (PLWH) and the HIV continuum of care remains unknown. As the pandemic continues to pose a significant threat to PLWH and their care, this research qualitatively aimed to elicit COVID-19-related challenges and perspectives of PLWH during the early phase of the pandemic and to identify lessons learned and impactful strategies for facilitating HIV care. We recruited 32 PLWH who receive care at a large academic medical center for semi-structured remote interviews to assess psychological/structural stressors experienced during the pandemic and to discern strategies for improving care. Most participants identified as Black (91%) and heterosexual (56%). Overall, PLWH reported exacerbated mental health stressors (e.g., anxiety, depression, substance use). Most participants cited no issues with antiretroviral therapy (ART) adherence or retention in care, yet five participants reported appointment cancellations or physician inaccessibility. Participants provided specific feedback for facilitating continued engagement in care during the pandemic, including telemedicine and education/patient empowerment. By seeking participant-provided solutions, this study centered on PLWH's experiences and emphasized proactive HIV care strategies for prioritizing patient empowerment and healthcare adaptability during a rapidly evolving pandemic.
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Affiliation(s)
- Olivier L Joseph
- Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - André Hall
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | | | - Jared Kerman
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Jessica Schmitt
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Moira C McNulty
- Department of Medicine, University of Chicago, Chicago, IL, USA
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Intersecting epidemics: the impact of coronavirus disease 2019 on the HIV prevention and care continua in the United States. AIDS 2022; 36:1749-1759. [PMID: 35730392 DOI: 10.1097/qad.0000000000003305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To summarize the broad impact of the coronavirus disease 2019 (COVID-19) pandemic on HIV prevention and care in the United States with a focus on the status-neutral HIV care continuum. DESIGN We conducted an editorial review of peer-reviewed literature on the topics of HIV-risk behaviors, sexually transmitted illness (STI) and HIV prevalence, HIV prevention and treatment trends, and evolving practices during the COVID-19 pandemic. METHODS For relevant literature, we reviewed, summarized, and categorized into themes that span the HIV prevention and care continua, including sexual risk behaviors, mental health, and substance use. RESULTS We identified important changes within each component of the HIV care continuum across the United States during the COVID-19 pandemic. Shifts in prevention practices, engagement with care, care provision, medication adherence, testing, and prevalence rates were observed during the pandemic. CONCLUSION Although heightened disparities for people at risk for, and living with, HIV were seen during the COVID-19 pandemic, many health systems and clinics have achieved and maintained engagement in HIV prevention and care. This review highlights barriers and innovative solutions that can support durable and accessible health systems through future public health crises.
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Sharma BB, Small E, Okumu M, Mwima S, Patel M. Addressing the Syndemics of HIV, Mental Health, and COVID-19 Using the Health and Human Rights Framework among Youth Living with HIV, in Uganda: an Interpretive Phenomenological Study. JOURNAL OF HUMAN RIGHTS AND SOCIAL WORK 2022; 7:285-298. [PMID: 36090014 PMCID: PMC9446591 DOI: 10.1007/s41134-022-00221-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 06/08/2023]
Abstract
Stigma and discrimination negatively impact the prevention, treatment, and care of HIV. The COVID-19 pandemic increased this complexity and created a cluster of synergistic health contexts, wherein the physiological aspects of HIV and the social and environmental conditions increased the vulnerability in health outcomes for youth living with HIV (YPLHIV) in Kampala, Uganda. We used interpretive phenomenological analysis (IPA) and the syndemics framework to understand the lived experiences of YPLHIV. From December 2020 to May 2021, six qualitative focus groups were held with 31 youth living with HIV to understand the lived experiences of YPLHIV. The guided questions used were audio-recorded, transcribed verbatim, and coded for thematic analysis. Findings highlight the complexity of intersecting stigma of HIV and COVID-19 that have worsened antiretroviral treatment adherence and mental health issues due to lack of access to critical needs such as fears of food insecurity, health-related worries, the fear of perishing due to COVID-19, and human rights concerns related to gender and sexual identity. The study recommends addressing human rights-related concerns in addition to health-related concerns to comprehensively mitigate the syndemics of HIV and COVID-19 for YPLHIV in Uganda.
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Affiliation(s)
- Bonita B. Sharma
- Department of Social Work, University of Texas at San Antonio, College for Health, Community, and Policy, 501 W. Cesar Chavez Blvd, San Antonio, TX 78207 USA
| | - Eusebius Small
- School of Social Work, University of Texas, 211 S. Cooper St., Bldg. A, ArlingtonArlington, TX 76019 USA
| | - Moses Okumu
- School of Social Work, University of Illinois Urbana-Champaign, 1010 W. Nevada Street, Urbana, IL 61801 USA
- School of Science, Uganda Christian University, Mukuno, Uganda
| | - Simon Mwima
- School of Social Work, University of Illinois Urbana-Champaign, 1010 W. Nevada Street, Urbana, IL 61801 USA
| | - Mansi Patel
- School of Social Work, University of Texas, 211 S. Cooper St., Bldg. A, ArlingtonArlington, TX 76019 USA
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Rosen JG, Zhang L, Pelaez D, Coleman JS, To C, Cooper L, Olatunde PF, Toomre T, Glick JL, Park JN. Provider Perspectives on HIV Pre-Exposure Prophylaxis Service Disruptions and Adaptations During the COVID-19 Pandemic in Baltimore, Maryland: A Qualitative Study. AIDS Patient Care STDS 2022; 36:313-320. [PMID: 35951445 PMCID: PMC9419971 DOI: 10.1089/apc.2022.0058] [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] [Indexed: 11/12/2022] Open
Abstract
The COVID-19 pandemic continues driving unprecedented disruptions to health care provision, including HIV pre-exposure prophylaxis (PrEP) services. We explored service provider experiences promoting and prescribing PrEP to marginalized populations during the COVID-19 pandemic in Baltimore, Maryland. In February to April 2021, we facilitated four virtual focus group discussions with 20 PrEP providers, representing various professional cadres and practice settings. Employing an iterative, team-based thematic analysis, we identified salient enablers and constraints to PrEP promotion, initiation, and maintenance in the COVID-19 era, along with innovative adaptations to PrEP service delivery. Discussants described attenuated demands for PrEP early in the pandemic, exemplified by high PrEP discontinuation rates. This was attributed to changes in clients' sexual behaviors and shifting priorities, including caregiving responsibilities, during the pandemic. Substantial systems-level disruptions impacting PrEP provision were identified, including outreach service suspension, personnel shortages, and facility restrictions on face-to-face visits. Providers emphasized that these disruptions, though occurring early in the pandemic, had protracted impacts on PrEP accessibility. The transition to telemedicine rendered health care services, including PrEP, more accessible/convenient to some clients and expeditious to providers. However, structural barriers to telehealth engagement (telephone/internet access), coupled with limitations of the virtual care environment (difficulty establishing rapport), impeded efforts to equitably promote and prescribe PrEP. Expanding the PrEP outreach workforce and availing alternatives to telemedicine (e.g., community-based PrEP provision, specimen self-collection) could facilitate PrEP care continuity, especially as COVID-19 transitions from an acute to a protracted health crisis.
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Affiliation(s)
- Joseph G Rosen
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Leanne Zhang
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Danielle Pelaez
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jenell S Coleman
- Department of Gynecology and Obstetrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - C To
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lyra Cooper
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Praise F Olatunde
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Teagan Toomre
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer L Glick
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ju Nyeong Park
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Division of General Internal Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Center for Biomedical Research Excellence on Opioids and Overdose, Rhode Island Hospital, Providence, Rhode Island, USA
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Varshney K, Ghosh P, Stiles H, Iriowen R. Risk Factors for COVID-19 Mortality Among People Living with HIV: A Scoping Review. AIDS Behav 2022; 26:2256-2265. [PMID: 35024992 PMCID: PMC8756751 DOI: 10.1007/s10461-022-03578-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 11/01/2022]
Abstract
People living with HIV (PLWH) are particularly vulnerable to worsened outcomes of COVID-19. Therefore, the purpose of this work was to provide a scoping review of the literature to assess the risk factors for COVID-19 mortality among PLWH. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), searches were conducted in PubMed, Scopus, Global Health, and WHO Coronavirus Database. Articles were eligible for inclusion if they were in English, included PLWH who died after COVID-19 infection, and described risk factors for mortality. Results were descriptively synthesized and pooled thereafter. Study quality was assessed using the Joanna Brigg Institute's critical appraisal tools. 20 studies were eligible for inclusion, with the pooled death rate being 11.7%. Age was a major risk factor, especially after 50 (23.2%) and after 70 (41.8%), and males had a death rate nearly double that of females. As total comorbidities increased, the death rate also greatly increased; among those with comorbidities, the highest fatality rates were those with cardiovascular disease (30.2%), chronic kidney disease (23.5%), obesity (22.4%), and diabetes (18.4%). Other risk factors for mortality among PLWH included having a Black racial background, being an injection drug user, being a smoker, and having a CD4 cell count below 200. There is a need to better study confounding factors, and to understand how vaccination influences mortality risk. Overall, the findings highlight a need to ensure that focus is placed on the varying demographics of PLWH amidst COVID-19 control efforts.
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Affiliation(s)
- Karan Varshney
- College of Population Health, Thomas Jefferson University, Philadelphia, PA USA
- School of Medicine, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - Prerana Ghosh
- School of Medicine, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - Helena Stiles
- School of Medicine, Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3216 Australia
| | - Rosemary Iriowen
- College of Population Health, Thomas Jefferson University, Philadelphia, PA USA
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Devlin SA, Johnson AK, McNulty MC, Joseph OL, Hall A, Ridgway JP. "Even if I'm undetectable, I just feel like I would die": a qualitative study to understand the psychological and socioeconomic impacts of the COVID-19 pandemic on women living with HIV (WLWH) in Chicago, IL. BMC Womens Health 2022; 22:218. [PMID: 35689277 PMCID: PMC9185710 DOI: 10.1186/s12905-022-01812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
Background The COVID-19 pandemic has affected the health and well-being of people worldwide, yet few studies have qualitatively examined its cumulative effects on ciswomen living with HIV (WLWH). We aimed to explore how the pandemic has impacted WLWH, including challenges related to HIV care, employment, finances, and childcare. We also investigated how HIV status and different psychosocial stressors affected their mental health. Methods We performed 25 semi-structured qualitative interviews with WLWH regarding the ways in which COVID-19 impacted their social determinants of health and physical well-being during the pandemic. 19 WLWH who received care at the University of Chicago Medicine (UCM) and 6 women who received care at Howard Brown Health, a federally qualified health center (FQHC) in Chicago, were interviewed remotely from June 2020 to April 2021. All interviews were audio recorded and transcribed. Interviews were thematically analyzed for commonalities regarding HIV-specific and general experiences of WLWH during the pandemic. Results The majority of participants reported COVID-19 impacted their HIV care, such as appointment cancellations and difficulties adhering to antiretroviral therapy. In addition to HIV care obstacles, almost all participants described perceived heightened vulnerability to or fear of COVID-19. The pandemic also affected the socioeconomic well-being of participants, with reported financial strains and employment disruptions. Some mothers took on additional childcare responsibilities, such as homeschooling. Increased mental health concerns and negative psychological effects from the social isolation associated with the pandemic were also experienced by most participants. Conclusions We gained invaluable insight into how WLWH were challenged by and adapted to the COVID-19 pandemic, including its destabilizing effects on their HIV care and mental health. Women described how they undertook additional childcare responsibilities during the pandemic and how their HIV status compounded their concerns (e.g., perceived heightened vulnerability to COVID-19). Strategies to better support WLWH in maintaining their overall health throughout the pandemic include childcare assistance, access to affordable mental health services, support groups, and education from HIV care providers. These findings have significant implications for examining future health crises through the perspective of potential gender inequalities.
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Affiliation(s)
- Samantha A Devlin
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA.
| | - Amy K Johnson
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Moira C McNulty
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
| | - Olivier L Joseph
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
| | - André Hall
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
| | - Jessica P Ridgway
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL, 60637, USA
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McCrimmon T, Sundelson A, Darisheva M, Gilbert L, Hunt T, Terlikbayeva A, Primbetova S, El-Bassel N. HIV Care Continuum Services for People Who Inject Drugs in Kazakhstan During COVID-19: A Qualitative Study of Service Provider Perspectives. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:e2100619. [PMID: 35487549 PMCID: PMC9053153 DOI: 10.9745/ghsp-d-21-00619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/15/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION The coronavirus disease (COVID-19) pandemic and resulting lockdowns have disrupted health care service delivery globally. This includes disruptions in harm reduction and HIV service delivery for people who inject drugs (PWID), a population at high risk for not only COVID-19 but also poor HIV and drug-treatment access. However, little is known about these issues in Kazakhstan. We examined harm reduction provider experiences with delivering services and regulatory changes during the COVID-19 pandemic. METHODS We conducted in-depth interviews with 24 nurses, social workers, and doctors serving both HIV-positive and HIV-negative PWID at 13 needle and syringe programs (NSPs) and 4 AIDS Centers (HIV treatments centers) in Kazakhstan from May to August 2020. Participants were asked how the COVID-19 pandemic had impacted their PWID clients' risks, their organizational environment, and the services offered to PWID over the prior 3-6 months. Thematic content analysis was used to elicit findings. FINDINGS The COVID-19 pandemic considerably impacted NSP and AIDS Center operations. Participants perceived high risks of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection for themselves and their clients, as well as pandemic-related increases in substance use and HIV risks for clients. Organizations instituted several policy and regulatory changes to adapt to the pandemic, most notably tasking NSPs with delivering HIV medications; these changes necessitated new roles and responsibilities for many providers. Despite this stressful changing environment and increased service demands, participants still shared examples of persistence and resilience as they worked to meet client needs during these challenging times. DISCUSSION NSPs in Kazakhstan are well-positioned to reach key populations with crucial information and flexible services during the COVID-19 pandemic. However, they need recognition as essential organizations and additional equipment and staff support to protect staff and clients, maintain pandemic-related regulatory changes, and address additional challenges such as overdose prevention among clients.
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Affiliation(s)
- Tara McCrimmon
- Columbia University Mailman School of Public Health, New York, NY, USA.
| | - Anne Sundelson
- Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Louisa Gilbert
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
- Columbia University School of Social Work, New York, NY, USA
| | - Timothy Hunt
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
- Columbia University School of Social Work, New York, NY, USA
| | | | | | - Nabila El-Bassel
- Global Health Research Center of Central Asia, Almaty, Kazakhstan
- Columbia University School of Social Work, New York, NY, USA
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Reilly ED, Chamberlin ES, Duarte BA, Harris JI, Shirk SD, Kelly MM. The Impact of COVID-19 on Self-Reported Substance Use, Well-Being, and Functioning Among United States Veterans: A Cross-Sectional Study. Front Psychol 2022; 13:812247. [PMID: 35478735 PMCID: PMC9035845 DOI: 10.3389/fpsyg.2022.812247] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
Abstract
As the COVID-19 pandemic sweeps the globe, many veterans with substance use issues have faced the closure of treatment facilities, mandates to shelter in place, and social distancing measures. To better understand their pandemic experiences, substance use changes, and functioning, a survey was nationally administered to a sample of United States veterans reporting substance use issues during the pandemic. The purpose of this cross-sectional online survey for veterans (N = 409) was to report on COVID-19 experiences, safety behaviors, and infection experiences while also investigating the relationship among addictive behaviors, mental and physical health, and COVID-19 impact. Measures also assessed specific substance use concerns, pandemic-related loneliness, and functioning. Though few veterans reported personally receiving a confirmed COVID-19 medical diagnosis (10.5%), the impact of pandemic stressors was evident, with a majority reporting anxiety related to contracting COVID-19 (61.4%) or fear of a family member or close friend contracting COVID-19 (58.7%). Participants reported increased use of alcohol (45.3%), sedatives (36.6%), inhalants (35.7%), tobacco (35.0%), and cannabis (34.9%), attributed specifically to the pandemic. Regression analyses revealed that even when controlling for the contribution of problematic substance use issues, negative pandemic impacts and self-reported COVID-19 related loneliness were related to more impaired physical and mental health functioning during the pandemic. Findings from this sample of veterans with addiction issues add to the growing literature suggesting unique and adverse effects of COVID-19 stressors on functioning while also revealing specific pandemic impacts for this group.
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Affiliation(s)
- Erin D. Reilly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
- *Correspondence: Erin D. Reilly,
| | - Elizabeth S. Chamberlin
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
| | | | - J. Irene Harris
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Steven D. Shirk
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Megan M. Kelly
- Mental Illness Research, Education, and Clinical Center (MIRECC), VA Bedford Healthcare System, Bedford, MA, United States
- The Department of Psychiatry and Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
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Kumar N, Janmohamed K, Nyhan K, Martins SS, Cerda M, Hasin D, Scott J, Sarpong Frimpong A, Pates R, Ghandour LA, Wazaify M, Khoshnood K. Substance, use in relation to COVID-19: A scoping review. Addict Behav 2022; 127:107213. [PMID: 34959077 PMCID: PMC8684053 DOI: 10.1016/j.addbeh.2021.107213] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 10/24/2021] [Accepted: 12/11/2021] [Indexed: 02/06/2023]
Abstract
Background We conducted a scoping review focused on various forms of substance use amid the pandemic, looking at both the impact of substance use on COVID-19 infection, severity, and vaccine uptake, as well as the impact that COVID-19 has had on substance use treatment and rates. Methods A scoping review, compiling both peer-reviewed and grey literature, focusing on substance use and COVID-19 was conducted on September 15, 2020 and again in April 15, 2021 to capture any new studies. Three bibliographic databases (Web of Science Core Collection, Embase, PubMed) and several preprint servers (EuropePMC, bioRxiv, medRxiv, F1000, PeerJ Preprints, PsyArXiv, Research Square) were searched. We included English language original studies only. Results Of 1564 articles screened in the abstract and title screening phase, we included 111 research studies (peer-reviewed: 98, grey literature: 13) that met inclusion criteria. There was limited research on substance use other than those involving tobacco or alcohol. We noted that individuals engaging in substance use had increased risk for COVID-19 severity, and Black Americans with COVID-19 and who engaged in substance use had worse outcomes than white Americans. There were issues with treatment provision earlier in the pandemic, but increased use of telehealth as the pandemic progressed. COVID-19 anxiety was associated with increased substance use. Conclusions Our scoping review of studies to date during COVID-19 uncovered notable research gaps namely the need for research efforts on vaccines, COVID-19 concerns such as anxiety and worry, and low- to middle-income countries (LMICs) and under-researched topics within substance use, and to explore the use of qualitative techniques and interventions where appropriate. We also noted that clinicians can screen and treat individuals exhibiting substance use to mitigate effects of the pandemic. Funding Study was funded by the Institution for Social and Policy Studies, Yale University and The Horowitz Foundation for Social Policy. DH was funded by a NIDA grant (R01DA048860). The funding body had no role in the design, analysis, or interpretation of the data in the study.
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Leonhardt M, Brodahl M, Cogan N, Lien L. How did the first COVID-19 lockdown affect persons with concurrent mental health and substance use disorders in Norway? A qualitative study. BMC Psychiatry 2022; 22:179. [PMID: 35287637 PMCID: PMC8919911 DOI: 10.1186/s12888-022-03812-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/24/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The outbreak of COVID-19 with its severe social restrictions touched the daily life of most people. While everyday social life becomes difficult for citizens with economic and cultural capital, it becomes even worse for vulnerable groups such as persons with mental health and substance use disorders, who are particularly vulnerable to social exclusion. The aim of this study is to investigate how the first COVID-19 lockdown affected the everyday life and health of persons with co-occurring mental health and substance use disorders. METHODS This qualitative study reports data from 17 individual interviews and one focus group of five participants, all with a self-reported mental health and substance use disorder. Interviews were conducted based on a semi-structured interview guide in September and October 2020 in a medium-sized local authority in Norway. Data were analysed using thematic analysis. A reference group of people with varied knowledge and experiences of the phenomenon were involved in study design, recruitment, data generation and analysis. RESULTS The analysis identified four interrelated main themes, describing how the first lockdown affected the everyday life and health of persons suffering from a mental health and substance use disorder: (1) The COVID-19 outbreak as a perceived challenge, (2) A decline in mental health and well-being, (3) Increased substance use challenges, and (4) Diverse experiences with health and social services. The results show that people with a co-occurring disorder have challenges with digital tools and/or do not have the appropriate equipment. Further, participants were not concerned about becoming infected themselves, but infecting others. CONCLUSIONS Persons with a mental health and substance use disorder face major challenges during the COVID-19 pandemic. There is a need to maintain continuous low-threshold services especially directed towards persons with co-occurring disorders during the pandemic. Furthermore, it is important to improve the digital skills of every service user or offer alternatives to digital consultations and meetings.
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Affiliation(s)
- Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Post Box 104, 2381, Brumunddal, Norway. .,Faculty of Health Studies, VID Specialized University, Oslo, Norway.
| | - Morten Brodahl
- grid.412929.50000 0004 0627 386XNorwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Post Box 104, 2381 Brumunddal, Norway
| | - Nicola Cogan
- grid.11984.350000000121138138School of Psychological Sciences & Health, University of Strathclyde, 40 George Street, G1 1QE Glasgow, UK
| | - Lars Lien
- grid.412929.50000 0004 0627 386XNorwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Post Box 104, 2381 Brumunddal, Norway ,grid.477237.2Department of Health and Social Science, Inland Norway University of Applied Science, Elverum, Norway
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COVID-19 Vaccine Hesitancy and Associated Factors among People with HIV in the United States: Findings from a National Survey. Vaccines (Basel) 2022; 10:vaccines10030424. [PMID: 35335054 PMCID: PMC8949562 DOI: 10.3390/vaccines10030424] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/27/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
Introduction: Scaling up vaccination against COVID-19 is central to controlling the COVID-19 epidemic in the United States. Several vaccines are now approved for the prevention of COVID-19, but public concerns over safety and efficacy have heightened distrust and vaccine hesitancy. This is particularly concerning among people with HIV (PWH) who may be vulnerable to more severe COVID-19 disease. Here, we aimed to identify and understand COVID-19 vaccine hesitancy in a sample of PWH in the U.S. Methods: We conducted a cross-sectional online survey among PWH in the U.S. between 6 December 2020 and 8 January 2021. Measures included demographics, participants’ HIV and health-related attributes, COVID-19 history and experiences, COVID-19 vaccine-related concerns, and standardized measures of attitudes towards COVID-19 vaccines. Multivariate linear regression was used to identify factors associated with vaccine hesitancy in this sample. Results: Among the 1030 respondents, most were male (89.7%), White (66.0%), and identified as gay or lesbian (84.5%). Participants’ mean time living with HIV was 17.0 years (standard deviation (SD) = 11.1). The mean score for vaccine hesitancy was 1.5 (SD = 0.5; range: 1−5); 935 participants (90.8%) had a score greater than 1.0, indicating most participants had some degree of vaccine hesitancy. The final multivariate linear regression showed that greater vaccine hesitancy was associated with being Black (b = 0.149, p = 0.005), single (b = 0.070, p = 0.018), politically conservative (b = 0.157, p = 0.010), “anti-vaxxer” (b = 1.791, p < 0.001), concern about side effects (b = 0.226, p < 0.001), concern about safety (b = 0.260, p < 0.001), and being worried that the vaccine will not be effective (b = 0.169, p = 0.008) and they were being experimented on (b = 0.287, p < 0.001). Participants who were male White (b = −0.093, p = 0.008) and university graduates (b = −0.093, p < 0.001) and had a CD4 count of 200 cells/mm3 (b = −0.082, p = 0.048) and a liberal political orientation (b = −0.131, p < 0.001) were associated with lower vaccine hesitancy. Conclusions: Our findings provide important insights regarding COVID-19 vaccine hesitancy among PWH. Further efforts are required to understand how various social, political, and psychological factors contribute to COVID-19 vaccine hesitancy among key populations.
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Kosobuski L, Hawn A, France K, Chen N, LaPlante C, Palombi L. Using Qualitative, Community-Based Input to Steer Post-COVID-19 Pharmacy Practice in Substance Use. J Am Pharm Assoc (2003) 2022; 62:1555-1563.e2. [PMID: 35428578 PMCID: PMC8933963 DOI: 10.1016/j.japh.2022.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/02/2022] [Accepted: 03/16/2022] [Indexed: 11/24/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a disproportionately negative impact on individuals with a substance use disorder (SUD). A rapidly changing public health and treatment environment has resulted in increased needs for pharmacist engagement in SUD-focused patient care. Objectives This study used semistructured interviews of SUD professionals to evaluate where they believe pharmacy practice could better support people at risk of or having SUD in light of challenges posed by the COVID-19 pandemic. Methods Professionals dedicated to the care of individuals with SUD were recruited from a large community substance use coalition to participate in a qualitative study examining how pharmacists could take a more active role in SUD prevention, intervention, recovery, and harm reduction (HR). A consensual qualitative research approach was used in data analysis. Results Domains identified in analysis included pharmacists as educators of patients and communities, pharmacists as educators of health care providers, pharmacists as advocates for individuals with SUD, the need for increased pharmacist engagement owing to COVID-19 challenges for individuals with SUD, the need for expanded pharmacy practice interventions, and the need for pharmacist self-development. Conclusion Increased medication counseling, HR practices, addressing stigma, and community-level education focused on SUD were among the most commonly reported areas for pharmacy practice development. In addition, the urgent need to adjust pharmacy practice in response to the COVID-19 pandemic was also identified by interviewees.
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Tran NK, Vu BN, DeSilva MB. Impacts of the COVID-19 Pandemic on People Living with HIV Who Are Members of Vulnerable Groups in Vietnam. AIDS Behav 2022; 26:2855-2865. [PMID: 35199248 PMCID: PMC8865487 DOI: 10.1007/s10461-022-03630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/01/2022]
Abstract
We explored the effects of the COVID-19 pandemic on people living with HIV (PLHIV) in Vietnam. In June 2020, we interviewed 32 PLHIV who identified as men who have sex with men, persons who inject drugs, female sex workers, or transgender after Vietnam's strict quarantine period. While most participants were knowledgeable regarding COVID-19 transmission and prevention, COVID-19 was perceived more as a threat to individual rather than community health. The pandemic affected PLHIV significantly. Many lost employment with reduced income and increased family stress and conflict. Travel restrictions and unemployment affected access to antiretroviral (ARV) medication, particularly for transgender PLHIV who obtain ARVs from unofficial sources. Participants recounted substantial mental health effects, including worry, stress, and boredom. However, some respondents reported positive effects on family relationships. After quarantine, most reported feeling better, although financial worries persisted. Preparation for social emergencies should include development of supports for PLHIV in vulnerable groups.
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Currin JM, Evans AE, Miller BM, Owens C, Giano Z, Hubach RD. The impact of initial social distancing measures on individuals' anxiety and loneliness depending on living with their romantic/sexual partners. CURRENT PSYCHOLOGY 2022; 42:1-9. [PMID: 35153455 PMCID: PMC8816308 DOI: 10.1007/s12144-022-02830-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2022] [Indexed: 11/04/2022]
Abstract
In response to the COVID-19 pandemic, large swaths of the U.S. were under stay-at-home orders, thus preventing many individuals from leaving their homes. While previous studies have shown that such orders can be detrimental to mental health, specific mental health outcomes, such as loneliness and anxiety, have yet to be fully explored, particularly among various living situation contexts (e.g., living alone, with romantic/sexual partners, without romantic/sexual partners). The current study explores this using a mixed-methods approach. Data were collected via Amazon's M-Turk (N = 85). Kruskal-Wallis tests revealed significant differences between the three groups with respect to loneliness. Statistically significant greater levels of loneliness were found in individuals living alone compared to those living with romantic/sexual partners and those living with non-romantic/sexual partners. No significant differences in anxiety levels were detected. Qualitative analysis revealed similar themes among all groups regarding anxiety. When asked about loneliness, however, those living alone shared more about feeling isolated, unwanted feelings of solitude, and how technology only mitigates a portion of these feelings. Those living with others and sexual partners shared desires to see friends and co-workers, yet not to the severity described by individuals living alone. Romantic/sex life themes are also discussed.
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Affiliation(s)
- Joseph M. Currin
- Department of Behavioral Sciences and Leadership, United States Air Force Academy, USAF Academy, CO USA
| | - Amelia E. Evans
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX USA
| | - Bridget M. Miller
- Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Christopher Owens
- Department of Health and Kinesiology, Texas A&M University, College Station, TX USA
| | - Zachary Giano
- Department of Rural Health, Oklahoma State University Center for Health Sciences, Tulsa, OK USA
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