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Shi F, Zhang J, Hung P, Sun X, Yang X, Olatosi B, Weissman S, Li X. Travel Burden and Timely Linkage to Care Among People Newly Diagnosed with HIV Infection in South Carolina from 2005 to 2020. AIDS Behav 2024; 28:2590-2597. [PMID: 38884666 PMCID: PMC11286654 DOI: 10.1007/s10461-024-04411-1] [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: 06/05/2024] [Indexed: 06/18/2024]
Abstract
This retrospective study explored the association between travel burden and timely linkage to care (LTC) among people with HIV (PWH) in South Carolina. HIV care data were derived from statewide all-payer electronic health records, and timely LTC was defined as having at least one viral load or CD4 count record within 90 days after HIV diagnosis before the year 2015 and 30 days after 2015. Travel burden was measured by average driving time (in minutes) to any healthcare facility visited within six months before and one month after the initial HIV diagnosis. Multivariable logistic regression models with the least absolute shrinkage and selection operator were employed. From 2005 to 2020, 81.2% (3,547 out of 4,366) of PWH had timely LTC. Persons who had longer driving time (adjusted Odds Ratio (aOR): 0.37, 95% CI: 0.14-0.99), were male versus female (aOR: 0.73, 95% CI: 0.58-0.91), had more comorbidities (aOR: 0.73, 95% CI: 0.57-0.94), and lived in counties with a higher percentage of unemployed labor force (aOR: 0.21, 95% CI: 0.06-0.71) were less likely to have timely LTC. However, compared to those aged between 18 and 24 years old, those aged between 45 and 59 (aOR:1.47, 95% CI: 1.14-1.90) or older than 60 (aOR:1.71, 95% CI: 1.14-2.56) were more likely to have timely LTC. Concentrated and sustained interventions targeting underserved communities and the associated travel burden among newly diagnosed PWH who are younger, male, and have more comorbidities are needed to improve LTC and reduce health disparities.
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Affiliation(s)
- Fanghui Shi
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Jiajia Zhang
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Peiyin Hung
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Xiaowen Sun
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Xueying Yang
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Bankole Olatosi
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Sharon Weissman
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC, 29208, USA
| | - Xiaoming Li
- Arnold School of Public Health, South Carolina SmartState Center for Healthcare Quality, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Rahmani A, Janatolmakan M, Rezaei E, Tabarrai M. The managers' perspectives on service providing in women's harm reduction centers during the COVID-19 pandemic: mixed method study. Harm Reduct J 2024; 21:133. [PMID: 38997734 PMCID: PMC11241914 DOI: 10.1186/s12954-024-01049-z] [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: 04/30/2024] [Accepted: 06/30/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic posed significant challenges for managers overseeing women's harm reduction centers. This study seeks to capture managers' perspectives on the service providing in women's harm reduction centers during the COVID-19 pandemic. METHODS This convergent mixed-method study conducted in three provinces of Iran: Tehran, Khuzestan, and Kermanshah. The study was carried out between January and May 2023. In the quantitative part, the researchers utilized reports from 10 center managers. A researcher-designed questionnaire was employed to collect data on a wide range of services and referrals provided by the centers. The qualitative part of the research involved conventional content analysis and included 12 individual interviews. Two directors from the Ministry of Health and ten managers of women's harm reduction centers participated in the interviews. During the interpretation phase, the researchers compared the quantitative and qualitative findings to obtain a comprehensive understanding of the topic. RESULTS During the quantitative stage of the study, it was observed that all the managers were women, with an average age of 40.7 ± 7 years. More than half of the managers had obtained a postgraduate education (n = 6, 60%), and a majority of them were married (n = 7, 70%). Additionally, 40% of the managers (n = 4) were working as contractors. During the non-COVID-19 period, there were higher coverage by centers and residents, more referrals of non-injecting drug users and sex workers, and a higher number of group counseling sessions in all three provinces compared to the COVID-19 period. The qualitative analysis revealed two primary themes: "challenges" and "capabilities." CONCLUSIONS During the COVID-19 pandemic, providing some services and client referrals decreased in the centers, and center managers faced increased challenges. Many of these challenges were in the communication, executive, management, structure, education, financial, civilization, facilities, and socio-cultural sectors. Managers used their skills to manage and control these challenges. It is important to focus on these challenges and managerial capabilities to effectively handle future crises.
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Affiliation(s)
- Azam Rahmani
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Janatolmakan
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Nursing and Midwifery Care Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Elham Rezaei
- Midwifery Department, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Malihe Tabarrai
- Department of Persian Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Yelverton V, Ostermann J, Natafgi N, Olatosi B, Weissman S, Albrecht H. Disparities in Telehealth Use in HIV Care During the COVID-19 Pandemic: Study Findings from South Carolina. Telemed J E Health 2024; 30:1594-1599. [PMID: 38350120 PMCID: PMC11296154 DOI: 10.1089/tmj.2023.0383] [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] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 02/15/2024] Open
Abstract
Background: Telehealth was adopted to maintain HIV care continuity during the COVID-19 pandemic; however, its use was unequally distributed. This study examined variation in HIV care visit patterns and whether telehealth use was associated with viral suppression. Methods: Electronic health record (EHR) data from a large HIV clinic in South Carolina was analyzed using multivariable logistic regression to characterize variation in telehealth use, having a viral load (VL) test, and viral suppression in 2022. Results: EHR data from 2,375 people living with HIV (PWH) between March 2021 and March 2023 showed telehealth use among 4.8% of PWH. PWH who are 50+ years and non-Hispanic Black had lower odds of telehealth use (odds ratio [OR] 0.59, 95% confidence interval [CI 0.40-0.86]; OR 0.58, 95% CI [0.37-0.92] respectively). Telehealth use was not associated with viral suppression and VL testing. Conclusion: Telehealth disparities in HIV care affected older and non-Hispanic Black PWH, requiring tailored strategies to promote telehealth among them.
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Affiliation(s)
- Valerie Yelverton
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Jan Ostermann
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Nabil Natafgi
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Bankole Olatosi
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, USA
| | - Sharon Weissman
- South Carolina SmartState Center for Healthcare Quality, University of South Carolina, Arnold School of Public Health, Columbia, South Carolina, USA
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
- Division of Infectious Diseases, Prisma Health Columbia, South Carolina, USA
| | - Helmut Albrecht
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
- Division of Infectious Diseases, Prisma Health Columbia, South Carolina, USA
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Dahiya P, Riano NS, Dilley JW, Olfson M, Cournos F, Mangurian C, Arnold EA. Care challenges and silver linings in HIV and behavioral health service delivery for individuals living with HIV and severe mental illness during the COVID-19 pandemic: a qualitative study. BMC Health Serv Res 2024; 24:690. [PMID: 38822307 PMCID: PMC11143645 DOI: 10.1186/s12913-024-11146-1] [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: 07/31/2023] [Accepted: 05/24/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND There has been a longstanding effort to integrate behavioral health and HIV care for people with comorbid HIV and behavioral health needs, including those with severe mental illness (SMI). As this population frequents both behavioral health and HIV care settings, they were likely to experience new obstacles to the quality and availability of care during the COVID-19 pandemic. This study aims to describe how clinics for HIV services or behavioral healthcare-as well as co-located sites providing both-sought to rapidly shift protocols to maintain a standard of patient care for people with comorbid HIV and SMI while adapting to the unprecedented circumstances of the pandemic. METHODS We interviewed HIV and behavioral healthcare providers, clinic leaders, and support service agencies that served clients impacted by both HIV and SMI. Seventeen key informants across three settings (HIV care settings, behavioral health care settings, and integrated or co-located care settings) were interviewed in 2022. Interviews focused on changes in clinical services, protocols, and care provision strategies during and at the onset of the COVID-19 pandemic. Interviews were transcribed and coded using thematic analysis. RESULTS Commonly endorsed themes included both positive and negative changes in care and care provision during the pandemic. Negative impacts of the pandemic included the loss of physical space, exacerbated mental health needs and disengagement in HIV care, patient barriers to telehealth and the digital divide, and increased healthcare workforce burnout. Positive changes included improved healthcare delivery and care engagement through telehealth, new opportunities to provide a wide range of social services, paradoxical increases in engagement in HIV care for certain patients, and broad institution of workforce wellness practices. CONCLUSIONS Though COVID-19 presented several complex barriers to care for providers serving patients with comorbid HIV and SMI, the increased flexibility afforded by telehealth and a greater focus on collaborative approaches to patient care may benefit this patient population in the future. Additionally, the focus on workforce wellness may serve to increase retention and avoid burnout among providers. The strategies and lessons learned through adapting to COVID-19 may be invaluable moving forward as healthcare systems respond to future pandemics.
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Affiliation(s)
- Priya Dahiya
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
| | - Nicholas S Riano
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
- Department of Psychological Science, School of Social Ecology, University of California Irvine. 4220 Social and Behavioral Sciences Gateway, Irvine, CA, 92697, USA
| | - James W Dilley
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
| | - Mark Olfson
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th St, New York, NY, 10032, USA
| | - Francine Cournos
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 630 West 168th St, New York, NY, 10032, USA
| | - Christina Mangurian
- Department of Psychiatry & Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, School of Medicine, 675 18th St, San Francisco, CA, 94143, USA
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine, 550 16th Street, Second Floor, San Francisco, CA, 94158, USA
- Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94110, USA
| | - Emily A Arnold
- Center for AIDS Prevention Studies, University of California San Francisco, 550 16th Street, 3rd Floor, Box 0886, San Francisco, CA, 94143, USA.
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Gamarel KE, Rodriguez-Bañuelos A, Ubong IA, Best JN, Jadwin-Cakmak L, Mitchell JW. Understanding the potential implementation determinants of Our Plan: a couples-based digital human immunodeficiency virus prevention intervention for same-gender male couples. Mhealth 2024; 10:16. [PMID: 38689615 PMCID: PMC11058597 DOI: 10.21037/mhealth-23-57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/31/2023] [Indexed: 05/02/2024] Open
Abstract
Background There has been a proliferation of digital health interventions (DHIs) focused on addressing human immunodeficiency virus (HIV) prevention and treatment outcomes, including couples-based interventions with same-gender male couples. However, the barriers and facilitators of implementing couples-based HIV and sexually transmitted infection (STI) prevention interventions using digital platforms in community-based organizations remains largely unknown. The goal of this study was to explore the implementation determinants of Our Plan, a couples-based DHI designed for new relationships of same-gender male couples and dyadic, sexual partnerships. Methods Qualitative interviews were conducted with 40 organization leaders, healthcare providers, and staff at acquired immunodeficiency syndrome (AIDS)-service and community-based organizations in 13 states serving populations in Ending the HIV Epidemic jurisdictions. Interview items and follow-up questions were guided by the Consolidated Framework for Implementation Research (CFIR) to inquire about implementation determinants of Our Plan. Results Most participants highlighted several relative advantages of Our Plan: increasing capacity to support couples, potential synergy with existing programs, and opportunities to increase patient engagement. Participants also discussed relative disadvantages: misalignment with organizational values in the provision of patient-centered models of care and low interest from some priority populations. Participants emphasized the need for adaptability of Our Plan to fit within their local contexts, which encompassed support for both implementers and end-users, cultural tailoring, and privacy and security features. The desired evidence needed to implement Our Plan focused on data on impact, acceptability, and usability and functionality from communities most heavily impacted by the HIV epidemic. The majority of participants described how Our Plan could be integrated within service delivery and aligned with their organization's aspirational values; however, some noted that their organizational culture valued in-person interactions, particularly among patients experiencing structural vulnerabilities. Finally, participants discussed how the implementation of Our Plan would require additional training and funding for staff to support end-users and a relationship with the developers so that they could demonstrate their investment in the communities that their organizations served. Conclusions Our Plan was deemed a promising tool among potential implementers. To ensure optimal implementation and organizational fit, Our Plan refinement and evaluation must include implementers and end-users most impacted by the HIV epidemic throughout the entire process.
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Affiliation(s)
- Kristi E. Gamarel
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Adrian Rodriguez-Bañuelos
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Ini-Abasi Ubong
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Janae N. Best
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Laura Jadwin-Cakmak
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jason W. Mitchell
- Department of Health Promotion and Disease Prevention, Florida International University Robert Stempel College of Public Health & Social Work, Miami, FL, USA
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Moitra E, Jiménez Muñoz PC, Sanchez MC, Pinkston MM. Viewpoint on Human Immunodeficiency Virus Medical Care Retention Guidelines in the Coronavirus 2019 Pandemic Era and Beyond: Lessons Learned From Electronic Health Record Screening and Outreach. Open Forum Infect Dis 2024; 11:ofae031. [PMID: 38312216 PMCID: PMC10836192 DOI: 10.1093/ofid/ofae031] [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: 01/03/2024] [Accepted: 01/11/2024] [Indexed: 02/06/2024] Open
Abstract
In this viewpoint, we discuss retention in care for people with human immunodeficiency virus (HIV) and call into question the methodology used to characterize retention, as well as the definitions themselves. Optimal retention for people with HIV (PWH) is defined in multiple ways by major healthcare leaders in the United States, typically focusing on appointment attendance or laboratory work. Yet, these definitions rely on in-person encounters, an approach to care that is becoming less common due to the rise of telehealth visits, particularly in light of the coronavirus disease 2019 pandemic. Our recent work showed that relying on electronic health records to identify PWH who were not retained in care not only failed to capture the nuances of modern HIV medical treatment engagement, but also led to misidentification of patients' retention status due to limitations in the record system. As such, we recommend a reevaluation of how HIV medical care retention is defined and reported.
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Affiliation(s)
- Ethan Moitra
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Martha C Sanchez
- Infectious Diseases and Immunology, The Miriam Hospital, Providence, Rhode Island, USA
- Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Megan M Pinkston
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Lifespan Physicians Group, Rhode Island Hospital, Providence, Rhode Island, USA
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Mude W, Mwenyango H, Preston R, O'Mullan C, Vaughan G, Jones G. HIV Testing Disruptions and Service Adaptations During the COVID-19 Pandemic: A Systematic Literature Review. AIDS Behav 2024; 28:186-200. [PMID: 37548796 PMCID: PMC10803448 DOI: 10.1007/s10461-023-04139-4] [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: 07/12/2023] [Indexed: 08/08/2023]
Abstract
Access to treatment and care in safe clinical settings improves people's lives with HIV. The COVID-19 pandemic disrupted vital HIV programs and services, increasing the risk of adverse health outcomes for people with HIV and HIV transmission rates in the community. This systematic literature review provides a meta-analysis of HIV testing disruptions and a synthesis of HIV/AIDS services adapted during COVID-19. We searched scholarly databases from 01 January 2020 to 30 June 2022 using key terms on HIV testing rates and services during the COVID-19 pandemic. The process of how the included articles were identified, selected, appraised, and synthesised was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included 17 articles that reported changes in HIV testing during the COVID-19 pandemic and 22 that reported adaptations in HIV/AIDS services. We found that HIV testing decreased by 37% during the search period because of the COVID-19 pandemic. Service providers adopted novel strategies to support remote service delivery by expanding community antiretroviral therapy dispensing, setting up primary care outreach points, and instituting multi-month dispensing services to sustain client care. Therefore, service providers and policymakers should explore alternative strategies to increase HIV testing rates impacted by COVID-19 and leverage funding to continue providing the identified adapted services.
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Affiliation(s)
- William Mude
- School of Health Medical and Applied Sciences, Central Queensland University, Cairns Campus, 42-52 Abbott Street & Shields Street, Cairns, QLD, 4870, Australia.
| | - Hadijah Mwenyango
- School of Health & Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4BN, UK
| | - Robyn Preston
- School of Health Medical and Applied Sciences, Central Queensland University, Townsville Campus, Townsville, Australia
| | - Catherine O'Mullan
- School of Health Medical and Applied Sciences, Central Queensland University, Bundaberg Campus, Bundaberg, Australia
| | - Geraldine Vaughan
- School of Health Medical and Applied Sciences, Central Queensland University, Sydney Campus, Sydney, Australia
| | - Gary Jones
- Cohort Doctoral Studies Program, James Cook University, Cairns, Australia
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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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Wang Y, Daar ES, Huang Y, Xiong D, Shen J, Zhou L, Siqueiros L, Guerrero M, Rosen MI, Liu H. Adherence to Antiretrovirals and HIV Viral Suppression Under COVID-19 Pandemic Interruption - Findings from a Randomized Clinical Trial Using Ingestible Sensors to Monitor Adherence. AIDS Behav 2023; 27:4041-4051. [PMID: 37401993 PMCID: PMC10598162 DOI: 10.1007/s10461-023-04118-9] [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] [Accepted: 06/18/2023] [Indexed: 07/05/2023]
Abstract
The COVID-19 pandemic had a significant impact on vulnerable populations, including people living with HIV. California implemented a coronavirus lockdown (stay-at-home order) in March 2020, which ended in January 2021. We evaluated the pandemic's impact on both clinical outcomes of HIV RNA viral load (VL) and retention rate in a randomized clinical trial conducted from May 2018 to October 2020. The intervention group took co-encapsulated antiretrovirals (ARVs) with ingestible sensor (IS) pills from baseline through week 16. The IS system has the capacity to monitor adherence in real-time using a sensor patch, a mobile device, and supporting software. Both the IS and usual care (UC) groups were followed monthly for 28 weeks. Longitudinal mixed-effects models with random intercept and slope (RIAS) were used to fit log VL and self-reported adherence. The sample size of the study was 112 (54 in IS). Overall, the retention rate at week 28 was 86%, with 90% before the lockdown and 83% after the lockdown. The lockdown strengthened the associations between adherence and VL. Before the lockdown, a 10% increase in adherence was associated with a 0.2 unit decrease in log VL (β = -1.88, p = 0.004), while during the lockdown, the association was a 0.41-unit decrease (β = -2.27, p = 0.03). The pandemic did not have a significant impact on our adherence-focused intervention. Our findings regarding the intervention effect remain valid. TRIAL REGISTRATION NUMBER: NCT02797262. Date registration: September 2015.
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Affiliation(s)
- Yan Wang
- Section of Public and Population Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
- Division of Infectious Diseases, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
| | - Eric S Daar
- Department of Medicine, Division of HIV Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Yilan Huang
- Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Di Xiong
- Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Jie Shen
- Section of Public and Population Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Linyu Zhou
- Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | - Lisa Siqueiros
- Department of Medicine, Division of HIV Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Mario Guerrero
- Department of Medicine, Division of HIV Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Marc I Rosen
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Honghu Liu
- Section of Public and Population Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA
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Li Z, Qiao S, Ning H, Sun X, Zhang J, Olatosi B, Li X. Place Visitation Data Reveals the Geographic and Racial Disparities of COVID-19 Impact on HIV Service Utilization in the Deep South. AIDS Behav 2023:10.1007/s10461-023-04163-4. [PMID: 37792234 DOI: 10.1007/s10461-023-04163-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND The COVID-19 pandemic has posed unprecedented pressure to health care systems, and interrupted health care delivery and access including HIV care in the United States' Deep South, which endures a double epidemic of HIV and COVID-19. Ryan White programs cover HIV care services for over half of PLWH in the Deep South. Given the important role of Ryan White programs, examining the visitation changes to Ryan White facilities during the pandemic offers insights into the impact of the pandemic on HIV healthcare utilization. OBJECTIVES Analyze the geographic distribution of HIV facility visitors at the county level before and during the pandemic in the nine US states of Deep South (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Texas) to reveal the geographic and racial disparity in visitation disruption caused by the pandemic. METHODS We first extracted mobile device-based visitation data for Ryan White HIV facilities in the Deep South during 2019 and 2020. To quantify the disruption in visitations during 2020, we calculated the visitation reduction rate (VRR) for each county, using 2019 data as the baseline. Next, we conducted a spatial analysis of the VRR values to uncover geographical disparities in visitation interruptions. To investigate racial disparities, we performed spatial regression analyses with VRR as the dependent variable, and the percentages of Black, Hispanic, and Asian populations as the independent variables. In this analysis, we controlled for potential confounders. RESULTS Geographic disparities in visitation reduction were observed, with all nine Deep South states experiencing significant drops. Georgia experienced the highest visitation loss (VRR = -0.58), followed by Texas (-0.47), Alabama (0.47), and Tennessee (-0.46), while South Carolina had the smallest reductions (-0.11). All the regression models consistently revealed racial disparities in visitation interruption. That is, counties with a higher proportion of Black population tended to have higher RW facility visitation reductions. CONCLUSIONS Our analysis revealed distinct geographic disparities in visitation interruptions at Ryan White HIV facilities in the Deep South during the COVID-19 pandemic in 2020. Furthermore, we found that the Black/African American population experienced a greater disruption at the county level in the Deep South during this period.
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Affiliation(s)
- Zhenlong Li
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, 29208, USA.
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA.
| | - Shan Qiao
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Huan Ning
- Geoinformation and Big Data Research Lab, Department of Geography, University of South Carolina, Columbia, SC, 29208, USA
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Geography, The Pennsylvania State University, University Park, PA, 16801, USA
| | - Xiaowen Sun
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Jiajia Zhang
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Bankole Olatosi
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Xiaoming Li
- Big Data Health Science Center, University of South Carolina, Columbia, SC, 29208, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Yelverton V, Gass SJ, Amoatika D, Cooke C, Ostermann J, Natafgi N, Hair NL, Olatosi B, Owens OL, Qiao S, Li X, Derrick C, Weissman S, Albrecht H. The Future of Telehealth in Human Immunodeficiency Virus Care: A Qualitative Study of Patient and Provider Perspectives in South Carolina. AIDS Patient Care STDS 2023; 37:459-468. [PMID: 37862076 PMCID: PMC10616939 DOI: 10.1089/apc.2023.0176] [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: 10/21/2023] Open
Abstract
To ensure care continuity during the COVID-19 pandemic, telehealth has been widely implemented in human immunodeficiency virus (HIV) care. However, participation in and benefits from telehealth were unequal. This study aims to assess the willingness of people living with HIV (PWH) and HIV care providers to use telehealth and perceptions of the future role of telehealth. In-depth interviews with 18 PWH and 10 HIV care providers from South Carolina assessed their willingness to use telehealth, their perspectives on the future of telehealth in HIV care, and recommendations to improve telehealth. Interviews were analyzed using thematic analysis. Most PWH were female (61%), Black/African American (67%), and non-Hispanic (78%). Most PWH (61%) and all providers had used telehealth for HIV care. Most PWH and all providers reported being willing to use or (re-)consider telehealth HIV care services in the future. Providers suggested that telehealth is most suitable for routine HIV care encounters and for established, clinically stable, generally healthy PWH. Attitudes toward telehealth were heterogeneous, with most interviewees valuing telehealth similarly or superior to in-person care, yet >20% perceiving it less valuable. Recommendations to improve telehealth included multilevel strategies to address challenges across four domains: technology, the virtual nature of telehealth, administrative processes, and the sociodemographic profile of PWH. Telehealth in HIV care is here to stay; however, it may not yet be suitable for all PWH and all care encounters. Decision processes related to telehealth versus in-person care need to involve providers and PWH. Existing telehealth options require multilevel adjustments addressing persistent challenges.
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Affiliation(s)
- Valerie Yelverton
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Salome-Joelle Gass
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Daniel Amoatika
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Christopher Cooke
- Department of Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
| | - Jan Ostermann
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Nabil Natafgi
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Nicole L. Hair
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Bankole Olatosi
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Otis L. Owens
- College of Social Work, University of South Carolina, Columbia, South Carolina, USA
| | - Shan Qiao
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Xiaoming Li
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Caroline Derrick
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
- Prisma Health Midlands, Columbia, South Carolina, USA
| | - Sharon Weissman
- South Carolina SmartState Center for Healthcare Quality (CHQ), Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
- Prisma Health Midlands, Columbia, South Carolina, USA
| | - Helmut Albrecht
- Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
- Prisma Health Midlands, Columbia, South Carolina, USA
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Pearson WS, Chan PA, Habel MA, Haderxhanaj LT, Hogben M, Aral SO. A Description of Telehealth Use Among Sexually Transmitted Infection Providers in the United States, 2021. Sex Transm Dis 2023; 50:518-522. [PMID: 37155609 PMCID: PMC10524588 DOI: 10.1097/olq.0000000000001826] [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: 05/10/2023]
Abstract
BACKGROUND Telehealth offers one approach to improving access to sexually transmitted infection (STI) prevention and care services. Therefore, we described recent telehealth use among those providing STI-related care and identified opportunities for improving STI service delivery. MATERIALS AND METHODS Using the DocStyles Web-based, panel survey conducted by Porter Novelli from September 14 to November 10, 2021, 1500 healthcare providers were asked about their current telehealth usage, demographics, and practice characteristics, and compared STI providers (≥10% of time spent on STI care and prevention) to non-STI providers. RESULTS Among those whose practice consisted of at least 10% STI visits (n = 597), 81.7% used telehealth compared with 75.7% for those whose practice consisted of less than 10% STI visits (n = 903). Among the providers with at least 10% STI visits in their practice, telehealth use was highest among obstetrics and gynecology specialists, those practicing in suburban areas, and those practicing in the South. Among providers whose practice consisted of at least 10% STI visits and who used telehealth (n = 488), the majority were female and obstetrics and gynecology specialists practicing in suburban areas of the South. After controlling for age, gender, provider specialty, and geographic location of their practice, providers whose practice consisted of at least 10% STI visits had increased odds (odds ratio, 1.51; 95% confidence interval, 1.16-1.97) of using telehealth compared with providers whose visits consisted of less than 10% STI visits. CONCLUSIONS Given the widespread use of telehealth, efforts to optimize delivery of STI care and prevention via telehealth are important to improve access to services and address STIs in the United States.
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Affiliation(s)
- William S. Pearson
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Philip A. Chan
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
- Department of Medicine, The Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Melissa A. Habel
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Laura T. Haderxhanaj
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Matthew Hogben
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
| | - Sevgi O. Aral
- Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Qiao S, Shirley C, Garrett C, Weissman S, Olatosi B, Li X. Facilitators of Organizational Resilience Within South Carolina AIDS Service Organizations: Lessons Learned from the COVID-19 Pandemic. AIDS Behav 2023:10.1007/s10461-023-04089-x. [PMID: 37247043 DOI: 10.1007/s10461-023-04089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 05/30/2023]
Abstract
HIV care services have been interrupted by the COVID-19 pandemic in many states in the U.S. including South Carolina (SC). However, many HIV care facilities demonstrated organizational resilience (i.e., the ability to maintain needed health services amid rapidly changing circumstances) by addressing challenges to maintaining care during the pandemic. This study, therefore, aims to identify key facilitators for organizational resilience among AIDS Services Organizations (ASOs) in SC. In-depth interviews were conducted among 11 leaders, from 8 ASOs, across SC during the summer of 2020. The interviews were recorded after receiving proper consent and then transcribed. Utilizing a codebook based upon the interview guide, a thematic analysis approach was utilized to analyze the data. All data management and analysis were conducted in NVivo 11.0. Our findings demonstrate several facilitators of organizational resilience, including (1) accurate and timely crisis information dissemination; (2) clear and preemptive protocols; (3) effective healthcare system policies, management, and leadership; (4) prioritization of staff psychological wellbeing; (5) stable access to personal protective equipment (PPE); (6) adequate and flexible funding; and (7) infrastructure that supports telehealth. Given the facilitators of organizational resilience among ASOs in SC during the COVID-19 pandemic, it is recommended that organizations implement and maintain coordinated and informed responses based upon preemptive protocols and emerging needs. ASO funders are encouraged to allow a flexibility in spending. The lessons learned from the participating leaders enable ASOs to develop and strengthen their organizational resilience and experience fewer disruptions in the future.
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Affiliation(s)
- Shan Qiao
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, The University of South Carolina, Columbia, SC, USA.
| | - Callie Shirley
- Department of Biological Sciences, College of Arts and Sciences, The University of South Carolina, Columbia, SC, USA
| | - Camryn Garrett
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, The University of South Carolina, Columbia, SC, USA
| | - Sharon Weissman
- Department of Internal Medicine, School of Medicine Columbia, The University of South Carolina, Columbia, SC, USA
| | - Bankole Olatosi
- Department of Health Services Policy and Management, Arnold School of Public Health, The University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, The University of South Carolina, Columbia, SC, USA
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14
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Bell S, Ranuschio B, Waldron JM, Barnes L, Sheik-Yosef N, Villalobos E, Wackens J, Liboro RM. Pandemic upon Pandemic: Middle-Aged and Older Men Who Have Sex with Men Living with HIV Coping and Thriving during the Peak of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5979. [PMID: 37297583 PMCID: PMC10252860 DOI: 10.3390/ijerph20115979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
When the COVID-19 pandemic emerged in early 2020, not only did it abruptly impede the progress that was being made toward achieving global targets to end the HIV pandemic, but it also created significant impacts on the physical and mental health of middle-aged and older men who have sex with men living with HIV. Utilizing a qualitative, community-based participatory research approach, we conducted semi-structured, one-on-one interviews with 16 ethnoracially diverse, middle-aged and older men who have sex with men living with HIV residing in Southern Nevada, to examine the different ways the COVID-19 pandemic directly impacted their physical and mental health, and explore how they eventually coped and thrived during the peak of the crisis. Using thematic analysis to analyze our interview data, we identified three prominent themes: (1) challenges to obtaining credible health information, (2) the physical and mental health impacts of the COVID-19-pandemic-imposed social isolation, and (3) digital technologies and online connections for medical and social purposes. In this article, we extensively discuss these themes, the current discourse on these themes in academic literature, and how the perspectives, input, and lived experiences of our participants during the peak of the COVID-19 pandemic could be critical to addressing issues they had already been experiencing prior to the emergence of the pandemic in 2020, and just as importantly, helping us best prepare in stark anticipation of the next potentially devastating pandemic.
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Affiliation(s)
- Sherry Bell
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Brandon Ranuschio
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - John M. Waldron
- LGBTQIA+ Community Center of Southern Nevada (The Center), Las Vegas, NV 89101, USA;
| | - Lianne Barnes
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Nadia Sheik-Yosef
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Esmeralda Villalobos
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Janelle Wackens
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
| | - Renato M. Liboro
- Department of Psychology, University of Nevada, Las Vegas, NV 89154, USA; (S.B.); (B.R.); (L.B.); (N.S.-Y.); (E.V.); (J.W.)
- Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
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15
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COVID-19, Retention in HIV Care, and Access to Ancillary Services for Young Black Men Living with HIV in Chicago. AIDS Behav 2023; 27:535-544. [PMID: 36048289 PMCID: PMC9434087 DOI: 10.1007/s10461-022-03789-0] [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: 07/05/2022] [Indexed: 02/04/2023]
Abstract
This study conducted 28 semi-structured, in-depth interviews with Young Black Men who have Sex with Men in Chicago to investigate the impact of COVID-19 on their HIV care and ancillary service access. The qualitative analysis identified both negative and positive effects. The negative effects included: (l) mixed disruptions in linkage to and receipt of HIV care and ancillary services, and (2) heightened concerns about police and racial tensions in Chicago following the murder of George Floyd, contributing to possible disruption of retention in care. The positive effects included: (1) the ability to reflect and socially connect, contributing to heightened self-care and retention in care, and (2) some improvements in receipt of medical care. These findings suggest that while COVID-19 disruptions in care reduced in-person use of HIV care, the expansion of telemedicine allowed more administrative tasks to be handled online and focused in-person interactions on more substantive interactions.
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16
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Kruse CS, Pacheco GJ, Rosenthal N, Kopp CJ, Omorotionmwan O, Cruz JE. Leveraging mHealth for the Treatment and Management of PLHIV. Risk Manag Healthc Policy 2023; 16:677-697. [PMID: 37077534 PMCID: PMC10106311 DOI: 10.2147/rmhp.s403946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/25/2023] [Indexed: 04/21/2023] Open
Abstract
Objective The objective of this systematic review was to analyze published literature from the last five years to assess facilitators and barriers to the adoption of mHealth as interventions to treat and manage HIV for PLHIV (people living with HIV). The primary outcomes were physical and mental conditions. The secondary outcomes were behavior based (substance use, care engagement, and healthy habits). Methods Four databases (PubMed, CINAHL, Web of Science, and ScienceDirect) were queried on 9/2/2022 for peer-reviewed studies on the treatment and management of PLHIV with mHealth as the intervention. The review was conducted in accordance with the Kruse Protocol and reported in accordance with PRISMA 2020. Results Five mHealth interventions were identified across 32 studies that resulted in improvements in physical health, mental health, care engagement, and behavior change. mHealth interventions offer both convenience and privacy, meet a digital preference, increase health knowledge, decrease healthcare utilization, and increase quality of life. Barriers are cost of technology and incentives, training of staff, security concerns, digital literacy gap, distribution of technology, technical issues, usability, and visual cues are not available over the phone. Conclusion mHealth offers interventions to improve physical health, mental health, care engagement, and behavior for PLHIV. There are many advantages to this intervention and very few barriers to its adoption. The barriers are strong, however, and should be addressed through policy. Further research should focus on specific apps for younger versus older PLHIV, based on preferences and the digital literacy gap.
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Affiliation(s)
- Clemens Scott Kruse
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
- Correspondence: Clemens Scott Kruse, Email
| | - Gerardo J Pacheco
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Noah Rosenthal
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Caris J Kopp
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Omosigho Omorotionmwan
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - John E Cruz
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
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17
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Amhare AF, Zhao M, Seeley J, Zhang WH, Goyomsa GG, Geleta TA, Zhao R, Zhang L. Impact of COVID-19 on HIV services and anticipated benefits of vaccination in restoring HIV services in Ethiopia: A qualitative assessment. Front Public Health 2022; 10:1033351. [PMID: 36408047 PMCID: PMC9671075 DOI: 10.3389/fpubh.2022.1033351] [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: 08/31/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background HIV services were inevitably disrupted and affected due to COVID-19. There are many challenges in implementing appropriate HIV services, particularly in the provision of health care and the link between people living with HIV/AIDS and retention in care. The study investigated the impact of COVID-19 on HIV services and the anticipated benefit of the COVID-19 vaccination on HIV service restoration in North Shewa, Oromia, Ethiopia. Methods A qualitative descriptive study approach was used to explore how healthcare delivery evolved during the outbreak of COVID-19 in Ethiopia. Sixteen antiretroviral therapy (ART) clinics were selected from 13 districts and one administrative town in Ethiopia. From them, 32 ART providers were purposively selected based on their experience in ART provision. Data were collected from June to July 2021 using in-depth interviews. A thematic analysis approach was used to analyze the data, based on themes and subthemes emerging from the data. ATLAS.ti software was used for coding. Results Healthcare for people living with HIV was interrupted due to the COVID-19 pandemic. Medical appointments, HIV testing and counseling services, opportunistic infection treatment, medicine supply, and routine viral load and CD4 T-cell count tests were interrupted. Due to a shortage of healthcare staff, outreach testing services and home index testing were discontinued and HIV testing was limited only to hospitals and health centers. This has substantially affected accessibility to HIV testing and reduced the quality of HIV service delivery. Telehealth and less frequent visits to health facilities were used as alternative ways of delivering HIV services. The COVID-19 vaccination campaign is expected to restore healthcare services. Vaccination may also increase the confidence of healthcare providers by changing their attitudes toward COVID-19. Conclusions The COVID-19 pandemic has substantially impacted HIV services and reduced the quality of HIV care in Ethiopia. Health facilities could not provide routine HIV services as they prioritize the fight against COVID-19, leading to an increase in service discontinuation and poor adherence.
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Affiliation(s)
- Abebe Feyissa Amhare
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China,College of Health Science, Salale University, Fiche, Ethiopia
| | - Min Zhao
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China,Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Janet Seeley
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Wei Hong Zhang
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium,School of Public Health, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Rui Zhao
- School of Humanities and Management, Institute of Life Culture, Guangdong Medical University, Dongguan, China,Rui Zhao
| | - Lei Zhang
- China-Australia Joint Research Center for Infectious Diseases, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China,Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia,*Correspondence: Lei Zhang
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18
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Sullivan PS, Galli R, Malhomme N, York J. Laboratory Industry Perspectives on the Role of Self-Collection and Self-Testing in Remote Care for Sexually Transmitted Infections: How Do We Bring These Services to Scale? Sex Transm Dis 2022; 49:S31-S35. [PMID: 35839281 PMCID: PMC10405362 DOI: 10.1097/olq.0000000000001676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Patrick S Sullivan
- From the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Rick Galli
- MAP Centre for Urban Health Solutions, REACH Nexus, St. Michael's Hospital, Unity Health, Toronto, Canada
| | | | - James York
- Business Development, Molecular Testing Labs, Vancouver, WA
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López LLA, Solis-Soto MT. Response of Care Services for Patients with HIV/AIDS during a Pandemic: Perspectives of Health Staff in Bolivia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13515. [PMID: 36294095 PMCID: PMC9602848 DOI: 10.3390/ijerph192013515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has caused an unprecedented crisis striking health services, generating risks of setbacks in health care and affecting the most vulnerable populations such as HIV patients. This study aims to explore the impact of the COVID-19 pandemic on the operational management of health services for people living with HIV/AIDS in Cochabamba, Bolivia. We applied a qualitative approach using semi-structured in-depth interviews with ten key health professionals who care for patients with HIV/AIDS in Cochabamba, Bolivia. Interviews were transcribed verbatim and uploaded to Atlas.ti software for analysis. We used an ethnographic approach within the interpretive paradigm to carry out the thematic analysis, considering the "Determinants of health systems resilience framework" of five dimensions developed by the World Health Organization. Even though the provision of services in public care services was not interrupted during the COVID-19 pandemic, health service delivery was severely affected. Digital technology could be used to compensate in urban areas. Regarding the distribution of medications, adaptative strategies to reduce patient complications were implemented. Unfortunately, the complementary tests availability was limited. The COVID-19 pandemic had a significant impact on HIV/AIDS patient care services in Cochabamba, with repercussions for HIV treatment access and virologic suppression.
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Affiliation(s)
- Liseth Lourdes Arias López
- OH TARGET Competence Center, Universidad San Francisco Xavier de Chuquisaca, Estudiantes, 96, Sucre P.O. Box 212, Bolivia
| | - Maria Teresa Solis-Soto
- OH TARGET Competence Center, Universidad San Francisco Xavier de Chuquisaca, Estudiantes, 96, Sucre P.O. Box 212, Bolivia
- Occupational and Environmental Epidemiology & Net Teaching Unit, Institute for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Ziemssenstr. 1, 80336 Munich, Germany
- Center for International Health, University Hospital Munich (LMU), Ziemssenstr. 1, 80336 Munich, Germany
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20
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Koester KA, Fuller SM, Steward WT, Arnold EA. Impacts of COVID-19 on HIV/AIDS-Related Services in California. J Int Assoc Provid AIDS Care 2022; 21:23259582221128500. [PMID: 36214179 PMCID: PMC9551343 DOI: 10.1177/23259582221128500] [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] [Indexed: 11/05/2022] Open
Abstract
The degree to which COVID-19 has disrupted the advances in reducing new HIV
infections and preventing AIDS-related deaths is unknown. We present findings
related to the effect COVID-19 had on HIV, sexual health and harm reduction
service delivery in the state of California. We conducted a qualitative rapid
assessment with health care providers, as well as representatives from
non-medical support service agencies serving clients living with HIV in a range
of counties in California. Some organizations adapted fairly easily while others
struggled or were unable to adapt at all. Clinics were better positioned than
community-based organizations to accommodate COVID restrictions and to quickly
reestablish services. Influential forces that softened or calcified the
hardships created by COVID-19 included influx of funding, flexibility in
managing funds, networking and relationships, and workforce vulnerabilities.
These data clearly suggest that an enhanced level of flexibility within funding
streams and reporting requirements should be continued.
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Affiliation(s)
- Kimberly A. Koester
- Division of Prevention Science, University of California San
Francisco, San Francisco, CA, USA,Kimberly A. Koester, Division of Prevention
Science, University of California San Francisco, 550 16th St., Third Floor, UCSF
Mailcode 0886, San Francisco, CA, 94143, USA.
| | - Shannon M. Fuller
- Division of Prevention Science, University of California San
Francisco, San Francisco, CA, USA
| | - Wayne T. Steward
- Division of Prevention Science, University of California San
Francisco, San Francisco, CA, USA
| | - Emily A. Arnold
- Division of Prevention Science, University of California San
Francisco, San Francisco, CA, USA
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21
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Zhu W, Huang YLA, Wiener J, Neblett-Fanfair R, Kourtis AP, Hall HI, Hoover KW. Impact of the coronavirus disease 2019 pandemic on prescriptions for antiretroviral drugs for HIV treatment in the United States, 2019-2021. AIDS 2022; 36:1697-1705. [PMID: 35848572 PMCID: PMC10773577 DOI: 10.1097/qad.0000000000003315] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess disruption in healthcare services for HIV treatment by national emergency in response to the coronavirus disease 2019 (COVID-19) pandemic in the United States. DESIGN Time-series analysis. METHODS We analyzed the IQVIA Real World Data-Longitudinal Prescriptions Database and calculated time trends in the weekly number of persons with active antiretroviral prescriptions for HIV treatment, and of persons who obtained antiretroviral prescriptions during January 2017-March 2021. We used interrupted time-series models to estimate the impact of the COVID-19 pandemic on antiretroviral therapy (ART) use between March 2020 and March 2021. RESULTS We found that the weekly number of persons with active antiretroviral prescriptions decreased by an average 2.5% (95% confidence interval [CI]: -3.8% to -1.1%), compared to predicted use, during March 2020 through March 2021. The weekly number of persons who obtained antiretroviral prescriptions decreased 4.5% (95% CI: -6.0% to -3.0%), compared to the predicted number. Men, persons aged ≤34 years, privately insured persons, and persons in medication assistance programs had greater decreases than other groups. CONCLUSIONS We demonstrated a decrease in the number of persons with active antiretroviral prescriptions during the first year of the COVID-19 pandemic and the number did not return to levels expected in the absence of the pandemic. Disruptions in HIV care and decreased ART may lead to lower levels of viral suppression and immunologic control, and increased HIV transmission in the community.
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Affiliation(s)
- Weiming Zhu
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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22
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Cascalheira CJ, Morrison C, D’Angelo AB, Villanueva OG, Grov C. The Impact of the COVID-19 Pandemic on HIV-Positive Men Who Have Sex With Men: (Dis)connection to Social, Sexual, and Health Networks. PSYCHOLOGY & SEXUALITY 2022; 14:306-320. [PMID: 36743519 PMCID: PMC9897219 DOI: 10.1080/19419899.2022.2112745] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/08/2022] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic has disproportionately affected HIV-positive cisgender men who have sex with men (MSM). Between May and June in 2020, we conducted one-on-one semi-structured qualitative interviews with 20 HIV-positive MSM aiming to describe their (dis)connection to social, sexual, and health networks during the COVID-19 pandemic. All participants relied on social support networks to manage pandemic-based distress, using computer-mediated communication as well as physical proximity. To connect to sexual networks, this sample described adaptations to their partner selection strategies, such as enumerating harm reduction approaches. To connect to health networks, participants depended on reassuring providers, resourceful case managers, telehealth, and streamlined access to their antiretroviral therapy (ART) medications. Nonetheless, stay-at-home recommendations reduced community connection, sexual activity, and healthcare access for many participants, and perceptions of these losses were shaped by psychosocial burdens (e.g., loneliness), structural burdens (e.g., environmental barriers, financial difficulties), and health-protective factors (e.g., hopeful outlook, adherence to a regular routine). The COVID-19 pandemic appears to have exacerbated health-related issues for HIV-positive MSM. Given the ongoing COVID-19 mutations, community-based organizations, clinicians, and researchers might use these findings to modify HIV prevention and intervention efforts.
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Affiliation(s)
| | - Corey Morrison
- City University of New York (CUNY) Institute for Implementation Science in Population Health
| | - Alexa B. D’Angelo
- City University of New York (CUNY) Institute for Implementation Science in Population Health
- CUNY Graduate School of Public Health and Health Policy
| | | | - Christian Grov
- City University of New York (CUNY) Institute for Implementation Science in Population Health
- CUNY Graduate School of Public Health and Health Policy
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23
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Santos GM, Hong C, Wilson N, Nutor JJ, Harris O, Garner A, Holloway I, Ayala G, Howell S. Persistent disparities in COVID-19-associated impacts on HIV prevention and care among a global sample of sexual and gender minority individuals. Glob Public Health 2022; 17:827-842. [PMID: 35435149 PMCID: PMC10953730 DOI: 10.1080/17441692.2022.2063362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/24/2022] [Indexed: 02/06/2023]
Abstract
As COVID-19 continues to persist, there is a need to examine its impact among sexual and gender minority individuals, especially those with intersecting vulnerabilities. We conducted a cross-sectional survey with a global sample of sexual and gender minority individuals (n = 21,795) from October 25, 2020 to November 19, 2020, through a social networking app. We characterised the HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 mitigation response and examined whether subgroups of our study population are disproportionately impacted by COVID-19. Many sexual and gender minority individuals reported interruptions to HIV prevention and HIV care and treatment services. These consequences were significantly greater among people living with HIV, racial/ethnic minorities, immigrants, individuals with a history of sex work, and socio-economically disadvantaged groups. These findings highlight the urgent need to mitigate the negative impacts of COVID-19 among sexual and gender minority individuals.
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Affiliation(s)
- Glenn-Milo Santos
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
- Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA, USA
| | - Chenglin Hong
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| | - Natalie Wilson
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Jerry John Nutor
- Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | - Orlando Harris
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
| | | | - Ian Holloway
- Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA, USA
| | - George Ayala
- Alameda County Public Health Department, San Leandro, CA, USA
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24
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MacNeill JJ, Linnes JC, Hubach RD, Rodriguez NM. From crisis to crisis: impacts of the COVID-19 pandemic on people living with HIV and HIV/AIDS service organizations in Indiana. BMC Health Serv Res 2022; 22:622. [PMID: 35534824 PMCID: PMC9081957 DOI: 10.1186/s12913-022-07998-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/26/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic thrust people living with HIV (PLWH) and HIV/AIDS service organizations into an environment ripe with uncertainty. This study examined Indiana HIV/AIDS service provider perceptions of how COVID-19 affected the overall health and access to care of their clients, and how the organizations prepared for, adapted, and responded to the needs of PLWH during the pandemic. METHODS Guided by the socioecological model, fifteen semi-structured interviews were conducted with ten different HIV/AIDS service organizations across the state of Indiana. RESULTS Despite the profound disruptions experienced by HIV programs, HIV/AIDS service organizations responded quickly to the challenges posed by the COVID-19 pandemic through myriad innovative strategies, largely informed by prior experiences with the HIV epidemic. CONCLUSIONS The lessons provided by HIV/AIDS service organizations are invaluable to informing future pandemic response for PLWH. Service delivery innovations in response to the COVID-19 crisis may provide insights to improve HIV care continuity strategies for vulnerable populations far beyond the pandemic.
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Affiliation(s)
- Justin J MacNeill
- Weldon School of Biomedical Engineering, College of Engineering, Purdue University, IN, West Lafayette, USA
| | - Jacqueline C Linnes
- Weldon School of Biomedical Engineering, College of Engineering, Purdue University, IN, West Lafayette, USA
| | - Randolph D Hubach
- Department of Public Health, College of Health and Human Sciences, Purdue University, IN, West Lafayette, USA
| | - Natalia M Rodriguez
- Weldon School of Biomedical Engineering, College of Engineering, Purdue University, IN, West Lafayette, USA.
- Department of Public Health, College of Health and Human Sciences, Purdue University, IN, West Lafayette, USA.
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25
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Baim-Lance A, Angulo M, Chiasson MA, Lekas HM, Schenkel R, Villarreal J, Cantos A, Kerr C, Nagaraja A, Yin MT, Gordon P. Challenges and opportunities of telehealth digital equity to manage HIV and comorbidities for older persons living with HIV in New York State. BMC Health Serv Res 2022; 22:609. [PMID: 35524251 PMCID: PMC9073813 DOI: 10.1186/s12913-022-08010-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/28/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Older persons living with HIV (PLWH) need routine healthcare to manage HIV and other comorbidities. This mixed methods study investigated digital equity, constituted as access, use and quality, of HIV and specialty telehealth services for PLWH > 50 years during the initial wave of the COVID-19 pandemic when services transitioned to remote care. METHODS A survey of closed and open-ended questions was administered to 80 English (N = 63) and Spanish (N = 17) speaking PLWH receiving HIV care at an Academic Medical Center (N = 50) or a Federally Qualified Health Center (N = 30) in New York State. Quantitative analyses examined characteristics predicting telehealth use and visit quality. Qualitative analyses utilized thematic coding to reveal common experiences. Results were integrated to deepen the interpretation. RESULTS Telehealth access and use were shaped by multiple related and unstable factors including devices and connectivity, technology literacy, and comfort including privacy concerns. Participants demonstrated their substantial effort to achieve the visit. The majority of patients with a telehealth visit perceived it as worse than an in-person visit by describing it as less interpersonal, and resulting in poorer outcomes, particularly participants with less formal education. Technology was not only a barrier to access, but also influenced perceptions of quality. CONCLUSIONS In the COVID-19 pandemic initial wave, barriers to using telehealth were unequally distributed to those with more significant access and use challenges. Beyond these barriers, examining the components of equity indicate further challenges replicating in-person care using telehealth formats for older PLWH. Work remains to establish telehealth as both equitable and desirable for this population.
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Affiliation(s)
- Abigail Baim-Lance
- Geriatric Research Education and Clinical Center (GRECC), James J Peters VA Medical Center, 130 W. Kingsbridge Rd, 4A-17, Bronx, VA, 10468, USA.
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Matthew Angulo
- Columbia University Mailman School of Public Health, New York, NY, USA
| | - Mary Ann Chiasson
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | - Helen-Maria Lekas
- Division of Social Solutions and Services Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
- Grossman School of Medicine, New York University, New York, NY, USA
| | - Rachel Schenkel
- Department of Family Medicine, Emory School of Medicine, Atlanta, GA, USA
| | - Jason Villarreal
- Comprehensive Health Program, New York-Presbyterian Hospital, New York, NY, USA
| | - Anyelina Cantos
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | | | | | - Michael T Yin
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
| | - Peter Gordon
- Division of Infectious Diseases, Columbia University Irving Medical Center, New York, NY, USA
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26
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MacNeill JJ, Linnes JC, Rodriguez NM. From Crisis To Crisis: Impacts Of The COVID-19 Pandemic On People Living With HIV And AIDS Service Organizations In Indiana. RESEARCH SQUARE 2022:rs.3.rs-1003567. [PMID: 35194595 PMCID: PMC8863148 DOI: 10.21203/rs.3.rs-1003567/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: The COVID-19 pandemic thrust people living with HIV (PLWH) and HIV/AIDS service organizations into an environment ripe with uncertainty. This study examined Indiana AIDS services provider perceptions of how COVID-19 affected the overall health and access to care of their clients, and how the organizations prepared for, adapted, and responded to the needs of PLWH during the pandemic. Methods: Guided by the socioecological model, fifteen semi-structured interviews were conducted with ten different HIV/AIDS service organizations across the state of Indiana. Results: Despite the profound disruptions experienced by HIV programs, HIV/AIDS service organizations responded quickly to the challenges posed by the COVID-19 pandemic through myriad innovative strategies, largely informed by prior experiences with the HIV epidemic. Conclusions: The lessons provided by HIV/AIDS service organizations are invaluable to informing future pandemic response for PLWH. Service delivery innovations in response to the COVID-19 crisis may provide insights to improve HIV care continuity strategies for vulnerable populations far beyond the pandemic.
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27
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Supporting Retention in HIV Care: Comparing In-Person and Telehealth Visits in a Chicago-Based Infectious Disease Clinic. AIDS Behav 2022; 26:2581-2587. [PMID: 35113267 PMCID: PMC8811006 DOI: 10.1007/s10461-022-03604-w] [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: 01/21/2022] [Indexed: 12/03/2022]
Abstract
The COVID-19 pandemic has created increased need for telehealth appointments. To assess differences in appointment adherence for telehealth compared to in-person HIV medical care visits, we conducted a cross-sectional study of patients receiving HIV care in a safety-net hospital-based outpatient infectious disease clinic in a large urban area (Chicago, IL). The sample (N = 347) was predominantly Black (n = 251) and male (62.5%, n = 217); with a mean age of 44.2 years. Appointment attendance was higher for telehealth (78.9%) compared to in-person (61.9%) appointments. Compared to patients without drug use, those with drug use had 19.4 percentage point lower in-person appointment attendance. Compared to those with stable housing, those in unstable housing arrangements had 15.0 percentage point lower in-person appointment attendance. Telehealth as a modality will likely have some staying power as it offers patients newfound flexibility, but barriers to telehealth need to be assessed and addressed.
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28
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Barbera LK, Kamis KF, Rowan SE, Davis AJ, Shehata S, Carlson JJ, Johnson SC, Erlandson KM. HIV and COVID-19: review of clinical course and outcomes. HIV Res Clin Pract 2021; 22:102-118. [PMID: 34514963 PMCID: PMC8442751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Background:Understanding the relationship between HIV and SARS-CoV-2 has important public health implications.Objective:To summarize current research on COVID-19 among people with HIV (PWH) as published through 15 July 2021.Methods: We conducted a search of PubMed, Scopus, preprint databases (medRxiv, bioRxiv), and the references of publications found using key terms relevant to COVID-19 ('COVID-19' OR 'SARS-CoV-2' OR 'coronavirus') AND to HIV ('HIV' OR 'Human Immunodeficiency Virus' OR 'AIDS' OR 'Acquired Immunodeficiency Syndrome'). We summarized all articles that reported data or opinions on SARS-CoV-2 and HIV coinfection.Conclusions: Although many initial case series and cohort studies found no increased risk for SARS-CoV-2 infection or severe COVID-19 outcomes among PWH, recent studies have signaled an increased risk for severe COVID-19 disease progression even in the setting of well-controlled HIV. Whether this is due to the increased prevalence of comorbidities in PWH and other social determinants of health is unknown. These conflicting findings highlight the continued need for COVID-19 related research among PWH that addresses COVID-19 disease course as well as exacerbation of existing comorbidities already disproportionately represented among PWH.
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Affiliation(s)
| | | | - Sarah E. Rowan
- Denver Public Health, Denver, CO, USA
- Denver Health, Division of Infectious Diseases, Denver, CO, USA
- University of Colorado, Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA
| | | | - Soraya Shehata
- University of Colorado, School of Medicine, Aurora, CO, USA
| | | | - Steven C. Johnson
- University of Colorado, Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA
| | - Kristine M. Erlandson
- University of Colorado, Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA
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