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Unigwe I, Goodin A, Lo-Ciganic WH, Cook RL, Park H. Trajectories of Pre-exposure Prophylaxis Adherence Among Commercially Insured Individuals. Clin Infect Dis 2024; 78:1272-1275. [PMID: 38066587 DOI: 10.1093/cid/ciad756] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 12/06/2023] [Indexed: 05/16/2024] Open
Abstract
We used group-based trajectory models to identify 4 distinct trajectory patterns of adherence to preexposure prophylaxis (PrEP) among 20 696 users. Only 44.5% were consistently PrEP adherent, with younger age, being female, or having substance use disorder or depression associated with early discontinuation. Public health efforts are needed to improve PrEP adherence.
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Affiliation(s)
- Ikenna Unigwe
- Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Amie Goodin
- Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Wei-Hsuan Lo-Ciganic
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Center for Pharmaceutical Policy and Prescribing, Health Policy Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- North Florida/South Georgia Veterans Health System, Geriatric Research Education and Clinical Center, Gainesville, Florida, USA
| | - Robert L Cook
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Haesuk Park
- Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, Florida, USA
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2
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Dearolf MH, D’Angelo AB, Grov C. 'You have to trust their word': transmasculine experiences with sex partners and safety during the early COVID-19 outbreak. CULTURE, HEALTH & SEXUALITY 2024; 26:77-92. [PMID: 36929822 PMCID: PMC10505243 DOI: 10.1080/13691058.2023.2187093] [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: 09/22/2022] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The early months of the SARS-CoV2 pandemic exacerbated health disparities for vulnerable populations, including transgender (trans) communities, creating unique challenges for navigating sex and dating. This paper aims to expand upon the current literature regarding transmasculine populations by capturing their lived experiences during this critical time. We interviewed 20 assigned female sex at birth (AFAB) adults of the transmasculine spectrum - men, nonbinary, and transmasculine individuals - about their social and sexual experiences in the USA in May and June 2020. Transcripts were analysed using an inductive thematic approach. We found that sex drive decreased and uncertainty about health risks increased. Some participants found alternate ways to date and hook-up that reduced their COVID-19 risk, such as engaging in online sex (e.g. sexting, dating apps). Others expressed discomfort using virtual platforms for both personal/work and sexual lives, along with nuanced feelings around being objectified, compared to pornography, and fetishised as trans bodies. COVID-related shutdowns of queer spaces also amplified pre-existing concerns about interpersonal safety and rejection. When seeking new partners, participants sought behavioural characteristics that instilled trust. Future public health communications can take advantage of safety and sexual health strategies already present in trans communities to bolster wellbeing in trans lives.
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Affiliation(s)
- Michelle H. Dearolf
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| | - Alexis B. D’Angelo
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
| | - Christian Grov
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health (ISPH), New York, NY, USA
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3
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Assaf RD, Javanbakht M, Gorbach PM, Cooper ZD. Cannabis Use and Sharing Practices Among Sexual Minority and Heterosexual Individuals During the COVID-19 Pandemic. LGBT Health 2023; 10:514-525. [PMID: 37252794 PMCID: PMC10552144 DOI: 10.1089/lgbt.2022.0236] [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: 06/01/2023] Open
Abstract
Purpose: Cannabis behaviors during the COVID-19 pandemic among sexual minority (SM) individuals in the United States remain understudied. This study assessed the prevalence and correlates of cannabis use and cannabis sharing, a potential risk for COVID-19 transmission, among SM and heterosexual-identified individuals in the United States during the COVID-19 pandemic. Methods: This cross-sectional study used data from an anonymous, US-based web survey on cannabis-related behaviors from August to September 2020. Included participants reported past-year nonmedical cannabis use. Associations between frequency of cannabis use and sharing behaviors by sexual orientation were evaluated using logistic regression analysis. Results: Overall, 1112 respondents reported past-year cannabis use; mean age 33 years (standard deviation = 9.4), 66% male identified (n = 723), and 31% SM identified adults (n = 340). Increased cannabis use during the pandemic was similar among SM (24.7%; n = 84) and heterosexual (24.9%; n = 187) respondents. Any sharing during the pandemic was 81% for SM adults (n = 237) and 73% for heterosexual adults (n = 486). In the fully adjusted models, the odds of daily/weekly cannabis use and the odds of any cannabis sharing among SM respondents were 0.56 (95% confidence interval [CI] = 0.42-0.74) and 1.60 (95% CI = 1.13-2.26), respectively, compared with heterosexual respondents. Conclusions: SM respondents were less likely to use cannabis with high frequency during the pandemic but more likely to share cannabis compared with heterosexual respondents. Sharing cannabis was high overall, which may increase COVID-19 risk. Public health messaging around sharing may be important during COVID-19 surges and respiratory pandemics especially as cannabis becomes more widely available in the United States.
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Affiliation(s)
- Ryan D. Assaf
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Marjan Javanbakht
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
| | - Pamina M. Gorbach
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, USA
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Ziva D. Cooper
- UCLA Center for Cannabis and Cannabinoids, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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4
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Pyra M, Kline J, Taylor O, Rusie L, Schafer T, Motley D, Johnson AK. Changes in HIV Prevention and Sexual Experiences During the COVID-19 Pandemic: A Mixed-Methods Study. J Acquir Immune Defic Syndr 2023; 94:143-150. [PMID: 37256682 PMCID: PMC10524977 DOI: 10.1097/qai.0000000000003229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/08/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND STI and HIV services and infection rates were affected during the COVID-19 pandemic, because of changes in access to health care and individual behavior. Understanding how individuals made decisions around prevention and sexual activities during different phases of the pandemic is useful to addressing the rising rates of STIs and HIV. SETTING Federally-qualified health center focused on sexual and gender minority health, Chicago IL, 2021. METHODS Patients with a history of PrEP use who were contacted by the PrEP retention team as part of standard care were invited to complete an online survey. A subset of survey participants were then contacted to complete one-on-one interviews. Participants were asked about two distinct periods: November 2020 to January 2021 and February to June 2021. RESULTS From the 356 survey participants (mostly young, insured, and experienced with PrEP), more than half maintained their number of sex partners during the early pandemic and most also maintained PrEP use; during the later pandemic; most reported more or the same number of sex partners and almost all maintained PrEP use. From interviews, we identified diverse and changing experiences regarding sexual practices throughout the pandemic; whereas many participants changed PrEP use in accordance with sexual practices, many others maintained PrEP use as a habit. COVID-19 prevention was also a factor in sexual activities, particularly prevaccination. CONCLUSION Many PrEP users try to align their HIV prevention with their sexual exposures and establish PrEP as a long-term habit. Removing financial and access barriers is important to improve PrEP use and STI testing.
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Affiliation(s)
- Maria Pyra
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
- Institute for Sexual and Gender Minority Health & Well Being, Northwestern University, Chicago, IL
| | - J Kline
- Howard Brown Health, Chicago, IL
| | - O Taylor
- Howard Brown Health, Chicago, IL
| | - L Rusie
- Howard Brown Health, Chicago, IL
| | | | - D Motley
- Department of Medicine, University of Chicago, Chicago, IL
| | - A K Johnson
- The Potocsnak Family Division of Adolescent and Young Adult Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; and
- Feinberg School of Medicine, Northwestern University, Chicago, IL
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5
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Poteat TC, Wirtz AL, Adams D, Linton SL, Gutierrez C, Brown C, Miller M, Rich AJ, Williams J, Nguyen TQ, Reisner SL. Brief Report: Interruptions in HIV Prevention and Treatment During the COVID-19 Pandemic: A Cross-Sectional Study of Transgender and Gender Nonbinary Adults in the United States. J Acquir Immune Defic Syndr 2023; 93:181-186. [PMID: 36881811 PMCID: PMC10272025 DOI: 10.1097/qai.0000000000003185] [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: 12/14/2022] [Accepted: 02/22/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND Transgender and gender nonbinary (TNB) people have been disproportionately affected by HIV and the COVID-19 pandemic. This study explored the prevalence of HIV prevention and treatment (HPT) interruptions during the pandemic and identified factors associated with these interruptions. SETTING Data were drawn from LITE Connect, a US-based, nationwide, online, self-administered survey designed to examine the experiences of TNB adults during the COVID-19 pandemic. A convenience sample of 2134 participants were recruited between June 14, 2021, and May 1, 2022. METHODS The analytic sample was restricted to participants taking antiretroviral medications to prevent or treat HIV before the onset of the pandemic (n = 153). We calculated descriptive statistics as well as Pearson χ 2 bivariate tests and multivariable models to identify factors associated with HPT interruptions during the pandemic. RESULTS Thirty-nine percent of participants experienced an HPT interruption. We found a lower odds of HPT interruptions among participants living with HIV [adjusted odds ratios (aOR) 0.45; 95% Confidence Intervals (CI): 0.22, 0.92; P = 0.02] and essential workers [aOR 0.49; 95% CI: 0.23, 1.0; P = 0.06] and higher odds among people with chronic mental health conditions [aOR 2.6; 95% CI: 1.1, 6.2; P = 0.03]. When sex and education were included, we found a lower odds of interruptions among people with higher education. CI widened, but the magnitude and direction of effects did not change for the other variables. CONCLUSIONS Focused strategies to address longstanding psychosocial and structural inequities are needed to mitigate HPT treatment interruptions in TNB people and prevent similar challenges during future pandemics.
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Affiliation(s)
- Tonia C Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | | | | | - Sabriya L Linton
- Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Carmen Gutierrez
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carter Brown
- Black Transgender Advocacy Coalition, Dallas, TX
| | - Marissa Miller
- Trans Solutions Research and Resource Center, Indianapolis, IN
| | - Ashleigh J Rich
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Jennifer Williams
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Trang Q Nguyen
- Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Sari L Reisner
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA; and
- Department of Medicine, Harvard Medical School, Boston, MA
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6
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Schmidt MA, Salas SB, Donald JL, Gift TL, Tao G. Impact of the Early COVID-19 Pandemic on the Number of HIV Preexposure Prophylaxis Uses and the Proportion of Preexposure Prophylaxis Users Receiving Sexually Transmitted Infection Testing Services. Sex Transm Dis 2023; 50:304-309. [PMID: 36730891 PMCID: PMC10097470 DOI: 10.1097/olq.0000000000001726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/26/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND With the potential impact of the COVID-19 pandemic on HIV preexposure prophylaxis (PrEP) care management, we assessed the number of PrEP users and sexually transmitted infection (STI) testing-eligible PrEP users, STI testing rates, and prevalence between prepandemic (January 1, 2018-March 31, 2020) and early-pandemic (April 1, 2020-September 30, 2020) periods. METHODS In this retrospective cohort study, a PrEP user for a given quarter is defined as either a previous PrEP user or a PrEP initiator who has at least 1-day coverage of tenofovir/emtricitabine in the given quarter. The STI testing-eligible PrEP users for a given quarter were defined as those persons whose runout date (previous dispense date + days of tenofovir/emtricitabine supply) was in the given quarter. RESULTS The quarterly number of PrEP users increased from the first quarter of 2018 to the first quarter of 2020 and then decreased in the second and third quarter of 2020. Among STI testing-eligible PrEP users who had ≤14 days between runout and next refill date, gonorrhea and chlamydia screening testing rates were 95.1% for prepandemic and 93.4% for early pandemic ( P = 0.1011). Among all STI testing-eligible PrEP users who were tested for gonorrhea and chlamydia, gonorrhea prevalence was 6.7% for prepandemic and 5.7% for early pandemic ( P = 0.3096), and chlamydia prevalence was 7.0% for prepandemic and 5.8% for early pandemic ( P = 0.2158). CONCLUSIONS Although the early COVID-19 pandemic resulted in lower numbers of PrEP users and PrEP initiators, individuals who remained continuous users of PrEP maintained extremely high rates of bacterial STI screening. With high STI prevalence among PrEP users, assessments of PrEP care management are continuously needed.
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Affiliation(s)
- Mark A. Schmidt
- From the Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Suzanne B. Salas
- From the Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Judy L. Donald
- From the Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | | | - Guoyu Tao
- Centers for Disease Control and Prevention, Atlanta, GA
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7
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Characterizing the Impact of the COVID-19 Pandemic on HIV PrEP care: A Review and Synthesis of the Literature. AIDS Behav 2022; 27:2089-2102. [DOI: 10.1007/s10461-022-03941-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 12/03/2022]
Abstract
AbstractThe global COVID-19 pandemic and associated lockdown measures have caused disruptions to sexual health services and created additional barriers to the continuity of HIV pre-exposure prophylaxis (PrEP) among key populations. This review provides an examination of the influences of the pandemic on engagement in the PrEP care continuum. Using the PRISMA guideline, 46 studies were included in this review and the synthesis. Most of the studies were conducted in high-income settings through quantitative analysis. A majority of studies examining the changes in PrEP use suggested a decline or discontinuation in PrEP uptake during the pandemic. The most common reasons for stopping using PrEP were perceived barriers to PrEP-related care, having reduced sexual behaviors and fewer sexual partners, and reduced perceived risk of HIV infection. Limited studies documenting an increase in PrEP uptake were all in specific PrEP optimizing programs. During the pandemic, there is also an emerging trend of switching to on-demand PrEP from daily oral PrEP. Future studies should understand the mechanism of strategies that facilitated the improvements during the pandemic. PrEP implementation programs should consider alternative PrEP modalities and provide consistent and comprehensive knowledge about correct information.
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8
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Nyitray AG, Quinn KG, John SA, Walsh JL, Schim van der Loeff MF, Wu R, Eastwood D, McAuliffe TL. Sexually Transmitted Infections Diagnosed Among Sexual and Gender Minority Communities During the First 11 Months of the COVID-19 Pandemic in Midwest and Southern Cities in the United States. Sex Transm Dis 2022; 49:687-694. [PMID: 35858473 PMCID: PMC9477706 DOI: 10.1097/olq.0000000000001681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic adversely affected sexual health services. Given the burden of sexually transmitted infections (STIs) on sexual and gender minorities (SGMs), we estimated incidence of self-reported STI diagnoses and factors associated with STI diagnoses among SGMs during the pandemic's first year. METHODS A cohort of 426 SGM persons, 25 years or older, recruited in Chicago, Milwaukee, Detroit, Minneapolis, and Houston completed 5 online surveys from April 2020 to February 2021. Persons self-reported on each survey all health care provider STI diagnoses. Kaplan-Meier was used to estimate the cumulative risk of STI diagnoses, stratified by human immunodeficiency virus (HIV) status. Factors associated with STI diagnoses were assessed with a longitudinal negative binomial regression. RESULTS Median age was 37 years, and 27.0% were persons living with HIV (PLH). Participants reported 63 STIs for a cumulative incidence for PLH and HIV-negative persons of 0.19 (95% confidence interval [CI], 0.13-0.29) and 0.12 (95% CI, 0.09-0.17), respectively. Regardless of HIV, a younger age and changes in health care use were associated with STI diagnoses. Among HIV-negative persons, the rate of STI diagnoses was higher in Houston than the Midwest cities (adjusted relative risk, 2.37; 95% CI, 1.08-5.20). Among PLH, a decrease in health care use was also associated with STI diagnoses (adjusted relative risk, 3.53; 95% CI, 1.01-12.32 vs no change in health care services), as was Hispanic ethnicity and using a dating app to meet a sex partner. CONCLUSIONS Factors associated with STI diagnoses during the COVID-19 pandemic generally reflected factors associated with STI incidence before the pandemic like geography, HIV, age, and ethnicity.
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Affiliation(s)
- Alan G. Nyitray
- From the Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine
- Clinical Cancer Center, Medical College of Wisconsin, Milwaukee, WI
| | - Katherine G. Quinn
- From the Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine
| | - Steven A. John
- From the Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine
| | - Jennifer L. Walsh
- From the Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine
| | - Maarten F. Schim van der Loeff
- Department of Infectious Diseases, Public Health Service of Amsterdam
- Amsterdam UMC, University of Amsterdam, Internal Medicine, Amsterdam Institute for Infection and Immunity
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Ruizhe Wu
- Institute for Health and Equity, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI
| | - Daniel Eastwood
- Institute for Health and Equity, Division of Biostatistics, Medical College of Wisconsin, Milwaukee, WI
| | - Timothy L. McAuliffe
- From the Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine
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9
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Goedel WC, Rogers BG, Li Y, Nunn AS, Patel RR, Marshall BD, Mena LA, Ward LM, Brock JB, Napoleon S, Zanowicki-Marr A, Curoe K, Underwood A, Johnson CJ, Lockwood KR, Chan PA. Pre-exposure Prophylaxis Discontinuation During the COVID-19 Pandemic Among Men Who Have Sex With Men in a Multisite Clinical Cohort in the United States. J Acquir Immune Defic Syndr 2022; 91:151-156. [PMID: 36094480 PMCID: PMC9472808 DOI: 10.1097/qai.0000000000003042] [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: 01/31/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic continues to put strain on health systems in the United States, leading to significant shifts in the delivery of routine clinical services, including those offering HIV pre-exposure prophylaxis (PrEP). We aimed to assess whether individuals discontinued PrEP use at higher rates during the COVID-19 pandemic and the extent to which disruptions to usual clinical care were mitigated through telehealth. METHODS Using data from an ongoing prospective cohort of men who have sex with men (MSM) newly initiating PrEP in 3 mid-sized cities (n = 195), we calculated the rate of first-time discontinuation of PrEP use in the period before the COVID-19 pandemic and during the COVID-19 pandemic and compared these rates using incidence rate ratios (IRRs). Furthermore, we compared the characteristics of patients who discontinued PrEP use during these periods with those who continued to use PrEP during both periods. RESULTS Rates of PrEP discontinuation before the COVID pandemic and during the COVID-19 pandemic were comparable [4.29 vs. 5.20 discontinuations per 100 person-months; IRR: 1.95; 95% confidence interval (CI): 0.83 to 1.77]. Although no significant differences in the PrEP discontinuation rate were observed in the overall population, the rate of PrEP discontinuation increased by almost 3-fold among participants aged 18-24 year old (IRR: 2.78; 95% CI: 1.48 to 5.23) and by 29% among participants covered by public insurance plans at enrollment (IRR: 1.29; 95% CI: 1.03 to 5.09). Those who continued to use PrEP were more likely to have had a follow-up clinical visit by telehealth in the early months of the pandemic (45% vs. 17%). CONCLUSIONS In this study, rates of PrEP discontinuation were largely unchanged with the onset of the COVID-19 pandemic. The use of telehealth likely helped retain patients in PrEP care and should continue to be offered in the future.
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Affiliation(s)
- William C. Goedel
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Brooke G. Rogers
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI
| | - Yu Li
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Amy S. Nunn
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
| | - Rupa R. Patel
- Department of Internal Medicine, School of Medicine, Washington University in Saint Louis, Saint Louis, MO
| | - Brandon D.L. Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI
| | - Leandro A. Mena
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS
| | - Lori M. Ward
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS
| | - J. Benjamin Brock
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS
| | - Siena Napoleon
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI
| | | | - Kate Curoe
- Department of Internal Medicine, School of Medicine, Washington University in Saint Louis, Saint Louis, MO
| | - Ashley Underwood
- Department of Internal Medicine, School of Medicine, Washington University in Saint Louis, Saint Louis, MO
| | - Catrell J. Johnson
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS
| | - Khadijra R. Lockwood
- Department of Population Health Sciences, University of Mississippi Medical Center, Jackson, MS
| | - Philip A. Chan
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI
- Department of Medicine, Warren Alpert Medical School, Brown University, Providence, RI
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10
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Dorrell P, Pillay Y, Maithufi R, Pinini Z, Chidarikire T, Stamper N, Frank D, Peters RPH. Impact of the first COVID-19 lockdown on male urethritis syndrome services in South Africa. Sex Transm Infect 2022; 99:200-202. [PMID: 35790390 DOI: 10.1136/sextrans-2022-055483] [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: 03/16/2022] [Accepted: 06/09/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Globally, there have been significant changes in utilisation of STI testing and treatment services during the period of the COVID-19 pandemic. The impact of COVID-19 in countries that use syndromic STI management is not documented. This study used routine STI surveillance data to evaluate the impact of COVID-19 on utilisation of STI syndromic management services during the first wave of the COVID-19 epidemic in South Africa. METHODS We conducted a time-trend analysis of male urethritis syndrome (MUS) cases reported through routine national STI surveillance in South Africa and COVID-19 data available through the national dashboard. We defined three time periods (prelockdown, lockdown and postlockdown) based on COVID-19 response levels. Trends in MUS reporting was compared between these time periods at national and provincial level and with the number of positive COVID-19 tests in a district. RESULTS An overall reduction of 27% in the national number of MUS cases reported (monthly average from 27 117 to 20 107) occurred between the pre-COVID-19 and COVID-19 lockdown periods (p<0.001), with a range of 18%-39% between the nine provinces. Postlockdown, case numbers returned almost to the prelockdown level (26 304; -3.0%). No significant difference was found in number of MUS cases between the prelockdown and postlockdown periods. A weak correlation (R2=0,21) was identified between the change in number of MUS reported and COVID-19 positive tests in a district. CONCLUSIONS A strong reduction in reported MUS cases for syndromic management was observed during the first wave of the COVID-19 epidemic and lockdown across all provinces in South Africa. This is likely the result of various healthcare system and service delivery factors associated with lockdown measures. The observed return of MUS cases reported to prelockdown measures is reassuring.
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Affiliation(s)
- Philip Dorrell
- Clinton Health Access Initiative, Pretoria, South Africa
| | - Yogan Pillay
- Clinton Health Access Initiative, Pretoria, South Africa.,Department of Global Health, Stellenbosch University, Stellenbosch, South Africa
| | | | | | | | | | - Derusha Frank
- Clinton Health Access Initiative, Pretoria, South Africa
| | - Remco P H Peters
- Research Unit, Foundation for Professional Development, East London, South Africa .,Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.,Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
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11
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Biello KB, Valente PK, Lin WY, Lodge Ii W, Drab R, Hightow-Weidman L, da Silva DT, Mayer K, Bauermeister JA. PrEParing for NextGen: Cognitive Interviews to Improve Next Generation PrEP Modality Descriptions for Young Men Who have Sex with Men. AIDS Behav 2022; 26:1956-1965. [PMID: 34860304 PMCID: PMC9050851 DOI: 10.1007/s10461-021-03545-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
Next generation PrEP formulations may circumvent factors that impede daily oral pre-exposure prophylaxis (PrEP) use among young men who have sex with men (YMSM). We conducted video-based cognitive interviews with 20 YMSM (age 16-24) recruited in the US Northeast to assess participants' attitudes and comprehension of written descriptions of next generation PrEP modalities. Participants were predominately racial/ethnic minorities and half used daily oral PrEP. We identified four main areas for improvement of descriptions: defining scientific terms and balancing medical jargon and casual language; referencing more established products to contextualize PrEP formulations (e.g., hormonal implants); ensuring clarity and reducing redundancy; and including imagery (e.g., rectal douche applicator). The refined descriptions serve as exemplar text that may be used in future studies examining YMSM's preferences across next generation PrEP modalities. Accurate descriptions of next generation PrEP products strengthen measurement accuracy and can help roll-out products that become approved for clinical use.
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Affiliation(s)
- Katie B Biello
- School of Public Health, Brown University, 121 South Main Street, Box G-S121-8, Providence, RI, 02912, USA.
- Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Pablo K Valente
- School of Public Health, Brown University, 121 South Main Street, Box G-S121-8, Providence, RI, 02912, USA
| | - Willey Y Lin
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - William Lodge Ii
- School of Public Health, Brown University, 121 South Main Street, Box G-S121-8, Providence, RI, 02912, USA
| | - Ryan Drab
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Daniel Teixeira da Silva
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- National Clinician Scholars Program, University of Pennsylvania, Philadelphia, USA
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12
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Gaither TW, Sigalos JT, Landovitz RJ, Mills JN, Litwin MS, Eleswarapu SV. Engagement with HIV and COVID-19 prevention: a national cross-sectional analysis of users on a geosocial networking app (Preprint). J Med Internet Res 2022; 24:e38244. [PMID: 36026586 PMCID: PMC9512083 DOI: 10.2196/38244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Thomas W Gaither
- Department of Urology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States
| | - John T Sigalos
- Department of Urology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States
| | - Raphael J Landovitz
- Division of Infectious Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States
- Center for Clinical AIDS Research & Education, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jesse N Mills
- Department of Urology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mark S Litwin
- Department of Urology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Health Policy & Management, UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Sriram V Eleswarapu
- Department of Urology, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA, United States
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13
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Griffin M, Jaiswal J, Martino RJ, LoSchiavo C, Comer-Carruthers C, Krause KD, Stults CB, Halkitis PN. Sex in the Time of COVID-19: Patterns of Sexual Behavior Among LGBTQ+ Individuals in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:287-301. [PMID: 35141814 PMCID: PMC9033939 DOI: 10.1007/s10508-022-02298-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 12/21/2021] [Accepted: 01/20/2022] [Indexed: 05/16/2023]
Abstract
The SARS-CoV-2 virus, the pathogen which causes COVID-19, has left an indelible impact on the daily lives of individuals in the USA. This study sought to explore the sexual behaviors among people in the LGBTQ+ population at the onset of the pandemic. Behaviors were explored across sub-groups of the population. The study employed data from an internet survey about the impact of COVID-19 on LGBTQ+ identified individuals conducted between May and July 2020. The final sample was comprised of 1090 participants from across the USA. Overall, sexual activity and the number of sexual partners decreased after March 13, 2020 (as compared to before this date) across all sexual orientation groups; however, living situation and partnership status supported sexual activity. Gay and bisexual men living with a partner or a spouse (AOR = 2.20, p = .023) and those living with a non-romantic roommate or friend (AOR = 2.88, p = .004) reported more sexual activity. For both cisgender lesbian and bisexual women and transgender and non-binary individuals, those who were married or in a domestic partnership (AOR = 4.54, p < .001; AOR = 9.97, p < .001, respectively) and those in a committed relationship (AOR = 3.54, p = .001; AOR = 8.46, p < .001, respectively) reported more sexual activity. Additionally, cisgender lesbian and bisexual women living with their partner or spouse (AOR = 2.14, p = .044) reported more sexual activity. When examining the number of sexual partners, cisgender lesbian and bisexual women and transgender and non-binary individuals in a committed relationship (AOR = 0.31, p < 0.001; AOR = 0.26, p = .004, respectively) and those living with a partner or spouse (AOR = 0.30, p = .002; AOR = 0.25, p = .028, respectively) were less likely to report two or more sexual partners. Examining the changes in sexual activity and number of sexual partners helps us better identify the effects of COVID-19 on intimate relationships and sexual behaviors. Furthermore, this study may help develop clinical best practices to facilitate risk-reduction strategies for LGBTQ+ populations when engaging in sexual activity within a communicable disease framework. Current guidance on sexual activity within a pandemic has created a unique opportunity for sex-positive public health messaging that protects individual health while also offering a framework for conversations about risk mitigation that is applicable for both COVID-19 and STI/HIV prevention.
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Affiliation(s)
- Marybec Griffin
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ, 08854, USA.
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA.
| | - Jessica Jaiswal
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA
- Department of Health Science, University of Alabama, Tuscaloosa, AL, USA
- Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA
| | - Richard J Martino
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA
| | - Caleb LoSchiavo
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA
| | - Camilla Comer-Carruthers
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA
| | - Kristen D Krause
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA
| | - Christopher B Stults
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA
- Psychology Department, Baruch College, City University of New York, New York, NY, USA
| | - Perry N Halkitis
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, 683 Hoes Lane West, Piscataway, NJ, 08854, USA
- Center for Health, Identity, Behavior and Prevention Studies, Rutgers University, Piscataway, NJ, USA
- Department of Biostatistics and Social and Behavioral Health Sciences, Rutgers School of Public Health, Rutgers University, Piscataway, NJ, USA
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14
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Scott-Sheldon LAJ, Mark KP, Balzarini RN, Welling LLM. Guest Editors' Introduction to the Special Section on the Impact of COVID-19 on Sexual Health and Behaviors. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:101-103. [PMID: 35089460 PMCID: PMC8796739 DOI: 10.1007/s10508-022-02289-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Lori A J Scott-Sheldon
- Division of AIDS Research, National Institute of Mental Health, 5601 Fishers Lane, Bethesda, MD, 20892, USA.
| | - Kristen P Mark
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Rhonda N Balzarini
- Department of Psychology, Texas State University, San Marcos, TX, USA
- Kinsey Institute, Indiana University, Bloomington, IN, USA
| | - Lisa L M Welling
- Department of Psychology, Oakland University, Rochester, MI, USA
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