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Tieosapjaroen W, Mao L, Wong H, Prankumar SK, Chow EP, Fairley CK, Phillips TR, Zhang L, Ong JJ. Factors associated with HIV pre-exposure prophylaxis use among Asian men who have sex with men in Sydney and Melbourne, Australia: a cross-sectional study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101071. [PMID: 38682107 PMCID: PMC11047000 DOI: 10.1016/j.lanwpc.2024.101071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/11/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024]
Abstract
Background Asian-born MSM are a priority population as Australia aims to end HIV transmission, but they reported additional barriers to access PrEP and other HIV prevention methods. This study investigates factors associated with PrEP use among Asian MSM in Sydney and Melbourne, Australia, to inform strategies to improve PrEP uptake in this population. Methods This was a sub-analysis of a community-based cross-sectional survey conducted from March to June 2021. We recruited participants online in Sydney and Melbourne, Australia. Univariable and multivariable logistic regression analyses were performed to identify the factors associated with PrEP use in the last six months and lifetime. Latent class analyses were used to identify subgroups of Asian MSM sharing similar characteristics related to their risk practices for HIV. Findings Overall, 870 Asian MSM were included: 288 Oceanian-born Asian MSM and 582 Asian-born MSM. Three latent classes were identified: 1) Asian-born MSM who recently arrived in Australia with limited English, were less likely to use PrEP and at higher risk of HIV infection (e.g., had condomless anal sex with a casual sex partner in the last six months) (4.6%); 2) Asian MSM who were at lower risk of HIV infection and less likely to use PrEP (69.3%) and; 3) Asian MSM who were at substantial risk of HIV infection and more likely to use PrEP (26.1%). Compared to Oceanian-born Asian MSM, those who were born in Southeast Asia (adjusted odds ratio (aOR) = 0.5, 95% confidence interval (CI) 0.3-0.7) and South Asia (aOR = 0.4, 95% CI 0.2-0.8) were less likely to ever use PrEP. Compared to Oceanian-born Asian MSM, those who were born in Southeast Asia (aOR = 0.4, 95% CI 0.3-0.7), Northeast Asia (aOR = 0.5, 95% CI 0.3-0.8) and South Asia (aOR = 0.4, 95% CI 0.2-0.7) were less likely to use PrEP in the last six months. Interpretation To end HIV transmission in Australia, it will be necessary to develop strategies to improve PrEP access for the significant minority of Asian-born MSM who are at substantial risk of HIV infection. Funding EPFC and JJO are supported by an Australian National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (EPFC: GNT1172873 and JJO: GNT1193955). CKF is supported by an Australian National Health and Medical Research Council (NHMRC) Leadership Investigator Grant (GNT1172900).
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Affiliation(s)
- Warittha Tieosapjaroen
- Central Clinical School, Monash University, Carlton, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Limin Mao
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Horas Wong
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
- Susan Wakil School of Nursing and Midwifery, University of Sydney, Sydney, Australia
| | | | - Eric P.F. Chow
- Central Clinical School, Monash University, Carlton, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Christopher K. Fairley
- Central Clinical School, Monash University, Carlton, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Tiffany R. Phillips
- Central Clinical School, Monash University, Carlton, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Lei Zhang
- Central Clinical School, Monash University, Carlton, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
| | - Jason J. Ong
- Central Clinical School, Monash University, Carlton, Australia
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Australia
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Harfouch O, Comstock E, Kaplan R, Benator D, Rivasplata H, Wilson E. Impact of the COVID-19 Pandemic on the PrEP Cascade at Two Veterans Affairs Healthcare Systems. AIDS Behav 2024; 28:1227-1234. [PMID: 37542627 DOI: 10.1007/s10461-023-04146-5] [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] [Accepted: 07/19/2023] [Indexed: 08/07/2023]
Abstract
Overall, fewer Veterans were eligible for PrEP in 2020, compared to 2019, and 2018 (Maryland Veterans Affairs Health Care System- MVAHCS-: n = 890 (2020), n = 1533 (2019); Washington DC Veterans Affairs Medical Center -DC VAMC- n = 1119 (2020), n = 1716 (2019)). While the proportion of Veterans engaged in PrEP out of those eligible for PrEP increased in 2020 compared to 2019 at both sites (MVAHCS: 5.73% (2020) vs. 3.39% (2019) p-value = 0.006; F = 7.58, and DC VAMC: 15.91% (2020) vs. 9.38% (2019) p-value < 0.001; F = 27.64), the absolute number of Veterans engaged in PrEP remained unchanged (MVAHCS n = 51 (2020) and n = 52 (2019); DC VAMC n = 178 (2020) and n = 161 (2019)). Engagement in PrEP was significantly lower among Black Veterans compared to White Veterans at the DC VAMC across all FY with a widening gap in 2020. Cisgender women were less likely to be engaged in PrEP compared to cisgender men at both sites and throughout all FY with a wider gender gap in 2020. There were no significant differences in retention in PrEP between FY.Anticipated improvements in linkage, engagement, and retention in PrEP in 2020 at the MVAHCS and DC VAMC may not have been seen due to the COVID-19 pandemic. Furthermore, engagement rates in PrEP remained low overall, particularly among Black Veterans and cisgender women. Novel PrEP delivery models are needed to engage these populations in PrEP following the COVID-19 pandemic. Interactive dashboards and tele-PrEP may have played a big role in sustained retention in PrEP at the VHA.
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Affiliation(s)
- Omar Harfouch
- School of Medicine, University of Maryland, Institute of Human Virology, Baltimore, MD, USA.
| | - Emily Comstock
- Department of Infectious Diseases, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
| | - Roman Kaplan
- Department of Infectious Diseases, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
| | - Debra Benator
- Washington DC Veterans Affairs Medical Center, Washington DC, USA
| | | | - Eleanor Wilson
- School of Medicine, University of Maryland, Institute of Human Virology, Baltimore, MD, USA
- Department of Infectious Diseases, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
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Kamadjou A, Decock A, Huleux T, Depreux A, Aissi E, Landre L, Baclet V, Viget N, Valette M, Robineau O, Meybeck A. Impact of the COVID-19 pandemic on sexual behaviour and welfare of HIV preexposure prophylaxis users: a mixed-method study. AIDS Care 2024; 36:343-350. [PMID: 37128640 DOI: 10.1080/09540121.2023.2206100] [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: 11/13/2022] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
COVID-19 pandemic can affect people using HIV preexposure prophylaxis (PrEP). To assess its consequences on PrEP users' sexual behaviour and welfare, we conducted a mixed-method study. A self-administered questionnaire was given to PrEP users during scheduled consultation in Tourcoing Hospital from February to May 2021. In addition, a qualitative study included 14 participants who took part in semi-structured in-depth interviews (IDIs). Ninety-four PrEP users completed the questionnaire. During lockdown, 62% of participants continued PrEP. After lockdown release, the average number of sexual intercourses and partners increased from 6 ± 12 to 13 ± 17 intercourses/month (p < 0.001) and from 3 ± 11 to 11 ± 34 partners/month (p < 0.001). Similarly, the proportion of PrEP users who engaged in group sex, sex with alcohol or chemsex increased respectively from 28% to 55% (p < 0.001), 28% to 45% (p < 0.001) and 28% to 38% (p < 0.001). Analysis of IDIs revealed emotional deprivation and sexual frustration during the lockdown. After its release, frequent clandestine chemsex parties and curfew forcing overnight stay increased fears of intimate violence and overdoses. In conclusion, PrEP users reduced their sexual activity during the lockdown. Its release led to an increase in sexual risk-taking. Social distancing measures could favour medical and social harm of sexual risk-taking.
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Affiliation(s)
- Audrey Kamadjou
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
| | - Anna Decock
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Thomas Huleux
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Alma Depreux
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Emmanuelle Aissi
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Laura Landre
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Véronique Baclet
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Nathalie Viget
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Michel Valette
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
- Sexual Health Clinic, Tourcoing Hospital, Tourcoing, France
| | - Olivier Robineau
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
| | - Agnès Meybeck
- Infectious Diseases Department, Tourcoing Hospital, Tourcoing, France
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O'Cleirigh C, Foley JD, Stanton AM, McKetchnie SM, Gulbicki LR, Muten J, Chai P, Fitch C, Onofrey S, Klevens RM, Psaros C. Sexual Networking and HIV/STI Prevention Among Men who have Sex with Men and Identify as Persons of Color in the Era of COVID-19 in Boston, MA: Qualitative Findings from the National HIV Behavioral Surveillance Project. AIDS Behav 2024; 28:473-487. [PMID: 38165597 DOI: 10.1007/s10461-023-04238-2] [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: 11/28/2023] [Indexed: 01/04/2024]
Abstract
Men who have sex with men and identify as persons of color (MSM of color) are significantly impacted by HIV in the United States. The COVID-19 pandemic may have disproportionately exacerbated HIV-related disparities among MSM of color by affecting sexual networking behaviors and disrupting access to sexual health care. The current study explored the impact of COVID-19 on sexual networking and HIV/sexually transmitted infection (STI) prevention behaviors among MSM of color in Boston, MA. Eighteen semi-structured interviews were conducted via the 2020-2021 Boston sample of the National HIV Behavioral Surveillance (NHBS) project. Eligible participants were at least 18 years old, identified as a man or non-binary person assigned male at birth and as a person of color, and endorsed ever having sex with men. Interviews were coded using inductive and deductive approaches, and themes were extracted using thematic analysis. When participants were asked about the impact of COVID-19 on sexual networking and HIV/STI prevention, the following themes emerged: (1) differing interpretations of COVID-19 public health guidance, (2) behavior change to meet social and sexual needs, (3) limited or changed access to HIV/STI prevention services; and (4) avoidance of healthcare appointments. Overall, the pandemic affected sexual networking and HIV/STI prevention behaviors among MSM of color. Though changes in sexual networking varied, most participants decreased in-person networking, increased dating app use, and prioritized longer-term relationships. Despite loosening of restrictions, these impacts may persist and should inform the adaptation of sexual networking guidance and interventions to mitigate HIV-related disparities in communities of color.
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Affiliation(s)
- Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
- The Fenway Institute, Fenway Health, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Jacklyn D Foley
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Amelia M Stanton
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Samantha M McKetchnie
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Lauren R Gulbicki
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Jennifer Muten
- Massachusetts Department of Public Health, Boston, MA, USA
| | - Peter Chai
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, MA, USA
- The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Boston, MA, USA
| | - Calvin Fitch
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Shauna Onofrey
- Massachusetts Department of Public Health, Boston, MA, USA
| | | | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Jaafari Z, Mirzaei H, Moradi Y, Nasiri N, Mehmandoost S, Khezri M, Tavakoli F, Abbaszadeh S, Sharifi H. The impact of the COVID-19 pandemic on the provision of HIV/AIDS-related services in Iran: a qualitative study. BMC Health Serv Res 2023; 23:430. [PMID: 37138294 PMCID: PMC10155158 DOI: 10.1186/s12913-023-09407-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/15/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Providing services to people living with HIV (PLWH) faced many challenges during the COVID-19 pandemic. This study aimed to examine the impact of the COVID-19 pandemic on providing HIV/AIDS-related services in Iran. METHODS In this qualitative study, the participants were included by purposive sampling between November 2021 and February 2022. Virtually focused group discussion (FGD) meetings were conducted with the first group including policymakers, service providers, and researchers (n = 17), and the interviews were conducted telephonic and face-to-face using a semi-structured guide with the second group including people who received services (n = 38). Data were analyzed by content analysis using the inductive method in MAXQDA 10 software. RESULTS Six categories were obtained, including mostly affected services, ways of the effect of COVID-19, healthcare systems reaction, effects on social inequality, opportunities created by the pandemic, and suggestions for the future. In addition, people who received services believed the COVID-19 pandemic has affected their life in several ways, including getting COVID-19, mental and emotional problems during the pandemic, financial problems, changes in the care plan, and changes in high-risk behaviors. CONCLUSION Considering the level of community involvement with the issue of COVID-19 and the shock caused by the pandemic, as mentioned by the world health organization, it is necessary to improve health systems' resilience for better preparedness for similar conditions.
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Affiliation(s)
- Zahra Jaafari
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Mirzaei
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Naser Nasiri
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheil Mehmandoost
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Khezri
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA
| | - Fatemeh Tavakoli
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Samaneh Abbaszadeh
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Lowenthal ED, DeLong SM, Zanoni B, Njuguna I, Beima-Sofie K, Dow D, Shayo A, Schreibman A, Ahmed CV, Chapman J, Chen L, Mehta S, Mbizvo MT. Impact of COVID-19 on Adolescent HIV Prevention and Treatment Research in the AHISA Network. AIDS Behav 2023; 27:73-83. [PMID: 36094636 PMCID: PMC9466311 DOI: 10.1007/s10461-022-03811-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2022] [Indexed: 11/09/2022]
Abstract
Members of the Adolescent HIV Prevention and Treatment Implementation Science Alliance (AHISA) network conduct research aiming to close gaps between what is known to be impactful across the HIV prevention and treatment cascade, and services delivered to optimize outcomes for adolescents/young adults (AYA) in high HIV-prevalence settings. The COVID-19 pandemic introduced new challenges which threaten to exacerbate care and access disparities. We report results of a survey among AHISA teams with active AYA HIV research programs in African countries to determine how the pandemic has impacted their efforts. Results highlighted the detrimental impact of the pandemic on research efforts and the expanded need for implementation research to help provide evidence-based, context-specific pandemic recovery support. Key lessons learned included the viability of remote service delivery strategies and other innovations, the need for adaptive systems that respond to evolving contextual needs, and the need for organized documentation plans, within empathic and flexible environments.
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Affiliation(s)
- Elizabeth D Lowenthal
- Departments of Pediatrics and Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
- Children's Hospital of Philadelphia Global Health Center, Philadelphia, USA.
- CHOP Roberts Center for Pediatric Research, Room 11241, 734 Schuylkill Ave, Philadelphia, PA, 19146, USA.
| | - Stephanie M DeLong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brian Zanoni
- Departments of Medicine and Pediatric Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Irene Njuguna
- Kenyatta National Hospital, Research and Programs, Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Dorothy Dow
- Department of Pediatrics, Duke University Medical Center, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
| | - Aisa Shayo
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | - Charisse V Ahmed
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jennifer Chapman
- Children's Hospital of Philadelphia Global Health Center, Philadelphia, USA
| | - Lydia Chen
- University of Pennsylvania, Philadelphia, PA, USA
| | - Shreya Mehta
- University of Pennsylvania, Philadelphia, PA, USA
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Kessel B, Heinsohn T, Ott JJ, Wolff J, Hassenstein MJ, Lange B. Impact of COVID-19 pandemic and anti-pandemic measures on tuberculosis, viral hepatitis, HIV/AIDS and malaria-A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001018. [PMID: 37126484 PMCID: PMC10150989 DOI: 10.1371/journal.pgph.0001018] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/27/2023] [Indexed: 05/02/2023]
Abstract
COVID-19 pandemic puts an enormous strain on health care systems worldwide and may have a detrimental effect on prevention, treatment and outcomes of tuberculosis (TB), viral hepatitis, HIV/AIDS and malaria, whose ending is part of the United Nations 2030 Agenda for Sustainable Development. We conducted a systematic review of scientific and grey literature in order to collect wide-ranging evidence with emphasis on quantification of the projected and actual indirect impacts of COVID-19 on the four infectious diseases with a global focus. We followed PRISMA guidelines and the protocol registered for malaria (CRD42021234974). We searched PubMed, Scopus, preView (last search: January 13, 2021) and websites of main (medical) societies and leading NGOs related to each of the four considered infectious diseases. From modelling studies, we identified the most impactful disruptions; from surveys and other quantitative studies (based e.g. on surveillance or program data), we assessed the actual size of the disruptions. The identified modelling studies warned about under-diagnosis (TB), anti-retroviral therapy interruption/decrease in viral load suppression (HIV), disruptions of insecticide-treated nets (ITN) distribution and access to effective treatment (malaria), and treatment delays and vaccination interruptions (viral hepatitis). The reported disruptions were very heterogeneous both between and within countries. If observed at several points in time, the initial drops (partly dramatic, e.g. TB notifications/cases, or HIV testing volumes decreased up to -80%) were followed by a gradual recovery. However, the often-missing assessment of the changes against the usual pre-pandemic fluctuations hampered the interpretation of less severe ones. Given the recurring waves of the pandemic and the unknown mid- to long-term effects of adaptation and normalisation, the real consequences for the fight against leading infectious diseases will only manifest over the coming years.
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Affiliation(s)
- Barbora Kessel
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
| | - Torben Heinsohn
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
| | - Jördis J. Ott
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
- Hannover Medical School (MHH), Hannover, Germany
| | - Jutta Wolff
- Hannover Medical School (MHH), Hannover, Germany
| | - Max J. Hassenstein
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
- PhD Programme “Epidemiology”, Braunschweig, Hannover, Germany
| | - Berit Lange
- Department of Epidemiology, Helmholtz Center for Infection Research, Braunschweig, Germany
- German Center for Infection research (DZIF), Partner Site Hannover-Braunschweig, Braunschweig, Germany
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Is There a Reduction in Chemsex Practice in Men Who Have Sex With Men During COVID-19 Lockdown? Results of the CheRRLock Study. J Acquir Immune Defic Syndr 2023; 92:378-384. [PMID: 36562613 DOI: 10.1097/qai.0000000000003153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Chemsex is a growing concern among men who have sex with men (MSM). COVID-19 lockdowns have had consequences on social and sexual interactions. We aimed to assess changes in chemsex practices during COVID-19 lockdown in France among MSM and factors associated with maintaining or increasing chemsex practice. METHODS Repeated face-to-face questionnaires were conducted at "Le 190" Sexual Health Center, Paris, France, exploring lifestyle, sexual, and chemsex practices, COVID-19 concerns and mental health before and during second lockdown in France (30/10/2020-15/12/2020). Inclusion criteria were chemsex practices at least 3 times throughout lifetime and at least once in the 3 months before second lockdown. The primary end point was the proportion of participants who declared having stopped, decreased, maintained, or increased their chemsex practice during lockdown. Univariable and multivariable logistic regressions were used to analyze factors associated with evolutions of chemsex practice. RESULTS Ninety-three MSM were included: 66% HIV-positive and 30% taking PrEP. Drugs most used were cathinones (91%) and GHB/GBL (52%). Participants reported stopping, decreasing, maintaining, and increasing chemsex drugs use in 14%, 22%, 22%, and 42% of cases, respectively. Despite this overall increase in chemsex practice, MSM decreased their number of sexual partners. Factors significantly associated with maintaining or increasing chemsex drugs use were feeling lonely (OR = 3.24), craving (OR = 4.51), and working during lockdown (OR = 3.27), contrasting with fear of COVID-19 (OR = 0.31). CONCLUSION Restriction measures lead to changes in sexual behavior and seem to increase chemsex practice. Maintaining care for most isolated patients should be a priority in COVID-19 context.
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Zhao T, Liu H, Bulloch G, Jiang Z, Cao Z, Wu Z. The influence of the COVID-19 pandemic on identifying HIV/AIDS cases in China: an interrupted time series study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100755. [PMID: 37360868 PMCID: PMC10072954 DOI: 10.1016/j.lanwpc.2023.100755] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/23/2023] [Accepted: 03/16/2023] [Indexed: 04/08/2023]
Abstract
Background The COVID-19 pandemic has caused significant global public health challenges, and impacted HIV testing and reporting worldwide. We aimed to estimate the impact of COVID-19 polices on identifying HIV/AIDS cases in China from 2020 to 2022. Methods We used an interrupted time series (ITS) design and seasonal autoregressive integrated moving average intervention (SARIMA Intervention) model. Monthly reported data on HIV/AIDS cases were extracted from the National Bureau of Disease Control and Prevention of China from January 2004 to August 2022. Data on Stringency Index (SI) and Economic Support Index (ESI) from January 22, 2020 to August 31, 2022 were extracted from the Oxford COVID-19 Government Response Tracker (OxCGRT). Using these, a SARIMA-Intervention model was constructed to evaluate the association between COVID-19 polices and monthly reported HIV/AIDS case numbers from January 2004 to August 2022 using auto.arima () function from R. The absolute percentage errors (APEs) compared the expected numbers generated by the SARIMA-Intervention model with actual numbers of HIV/AIDS, and was the primary outcome of this study. A second counterfactual model estimated HIV/AIDS case numbers if COVID-19 hadn't occurred in December 2019, and the mean difference between actual and predicted numbers were calculated. All statistical analyses were performed in R software (version 4.2.1) and EmpowerStats 2.0 and a P < 0.05 was considered statistically significant. Findings The SARIMA-Intervention model indicated HIV/AIDS monthly reported cases were inversely and significantly correlated with stricter lockdown and COVID-19 related polices (Coefficient for SI = -231.24, 95% CI: -383.17, -79.32) but not with economic support polices (Coefficient for ESI = 124.27, 95% CI: -309.84, 558.38). APEs of the SARIMA-Intervention model for prediction of HIV/AIDS cases from January 2022 through August 2022, were -2.99, 5.08, -13.64, -34.04, -2.76, -1.52, -1.37 and -2.47 respectively, indicating good accuracy and underreporting of cases during COVID-19. The counterfactual model estimates between January 2020 and August 2022 an additional 1314 HIV/AIDS cases should have been established monthly if COVID-19 hadn't occurred. Interpretation The COVID-19 pandemic influenced the allocation and acquisition of medical resources which impacted accurate monthly reporting of HIV in China. Interventions that promote continuous HIV testing and ensure the adequate provision of HIV services including remote delivery of HIV testing services (HIV self-testing) and online sexual counseling services are necessary during pandemics in future. Funding Ministry of Science and Technology of the People's Republic of China (The grant number: 2020YFC0846300) and Fogarty International Center, National Institutes of Health, USA (The grant number: G11TW010941).
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Affiliation(s)
- Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Gabriella Bulloch
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Zhen Jiang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaobing Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zunyou Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, China
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
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10
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Hammoud MA, Wells N, Holt M, Bavinton B, Jin F, Maher L, Philpot S, Haire B, Degenhardt L, Bourne A, Saxton P, Keen P, Storer D, Prestage G. COVID-19 Testing in a Weekly Cohort Study of Gay and Bisexual Men: The Impact of Health-Seeking Behaviors and Social Connection. AIDS Behav 2023; 27:948-956. [PMID: 36048292 PMCID: PMC9434557 DOI: 10.1007/s10461-022-03831-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 12/01/2022]
Abstract
Gay, bisexual, and other men who have sex with men (GBM) have developed community norms for regular HIV/STI testing. We investigated factors associated with self-reported COVID-19 testing in response to reported COVID-19 cases and public health restrictions. Participants responded to weekly cohort surveys between 10th May 2021 and 27th September 2021. We used the Andersen-Gill extensions to the Cox proportional hazards model for multivariable survival data to predict factors influencing COVID-19 testing. Mean age of the 942 study participants was 45.6 years (SD: 13.9). In multivariable analysis, GBM were more likely to report testing during periods of high COVID-19 caseload in their state of residence; if they were younger; university educated; close contact of someone with COVID-19; or reported coping with COVID-19 poorly. COVID-19 testing was higher among men who: were more socially engaged with other GBM; had a higher proportion of friends willing to vaccinate against COVID-19; and were willing to contact sexual partners for contact tracing. Social connection with other gay men was associated with COVID-19 testing, similar to what has been observed throughout the HIV epidemic, making community networks a potential focus for the promotion of COVID-19 safe practices.
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Affiliation(s)
- Mohamed A Hammoud
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia.
| | - Nathanael Wells
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Benjamin Bavinton
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Fengyi Jin
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Lisa Maher
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Steven Philpot
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Bridget Haire
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Peter Saxton
- Department of Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Phillip Keen
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Daniel Storer
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
| | - Garrett Prestage
- Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building UNSW, 2052, Sydney, Australia
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11
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Nadarzynski T, Nutland W, Samba P, Bayley J, Witzel TC. The Impact of First UK-Wide Lockdown (March-June 2020) on Sexual Behaviors in Men and Gender Diverse People Who Have Sex with Men During the COVID-19 Pandemic: A Cross-Sectional Survey. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:617-627. [PMID: 36344786 PMCID: PMC9640839 DOI: 10.1007/s10508-022-02458-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/30/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
The global COVID-19 pandemic resulted in strict social distancing measures restricting close physical contact. Men (cis and trans) and other gender diverse people who have sex with men (MGDSM) are at higher risk of sexually transmitted infections (STIs) and may have experienced changes in sexual behavior during government restrictions on social and sexual contact. We aimed to examine self-reported sexual behavior of MGDSM during the first UK-wide lockdown to identify the characteristics of the individuals who might most require sexual health promotion and clinical support. In April-May 2020, we conducted an online survey of MGDSM, promoted on social media and Grindr. Our exploratory approach used descriptive analysis to identify self-reported changes in sexual behavior and performed regression analyses to identify correlates of casual sex during the lockdown. A total of 1429 respondents completed the survey: mean age 36 years, 84% White, 97% male or trans male, 98% assigned male sex at birth, 2% female or non-binary, 65% degree educated or higher. During the lockdown, 76% reported not having any casual sex partners. While the majority reported reduced casual sex, 3% reported an increase in casual sex with one person and 2% with three or more people (group sex). About 12% of the sample engaged in casual sex with only one person and 5% with four or more sexual partners during the lockdown. Reporting casual sex during lockdown was associated with: lower level of education OR = 2.37 [95% CI 1.40-4.01]; identifying as a member of an ethnic minority OR = 2.27[1.40-3.53]; daily usage of sexual networking apps OR = 2.24[1.54-3.25]; being less anxious about contracting SARS-CoV-2 through sex OR = 1.66[1.12-2.44]; using PrEP before lockdown OR = 1.75[1.20-2.56]; continuing to use PrEP OR = 2.79[1.76-4.57]; and testing for STIs during lockdown OR = 2.65[1.76-3.99]. A quarter of respondents remained sexually active with casual partners, indicating a need to provide STI screening services and health promotion targeted to groups most likely to have need over this period. Future research is required to better understand how to support sexual and gender minorities to manage sexual risk in the context of pandemic public health initiatives.
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Affiliation(s)
- Tom Nadarzynski
- School of Social Sciences, University of Westminster, Room 6.101, 115 New Cavendish Street, London, W1W 6UW, UK.
| | - Will Nutland
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- The Love Tank CIC, London, UK
| | - Phil Samba
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
- The Love Tank CIC, London, UK
| | - Jake Bayley
- Sexual Health and HIV Department, Barts NHS Trust, London, UK
| | - T Charles Witzel
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
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12
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Ferraz D, Rossi TA, Zucchi EM, de Deus LFA, Mabire X, Ferguson L, Magno L, Grangeiro A, Préau M, Botelho FC, Rodrigues A, Steele S, Dourado I. "I Can't Take This Shitty Quarantine Anymore": Sexual Behavior and PrEP Use Among Young Men Who Have Sex with Men and Transgender Women in Brazil During the COVID-19 Pandemic. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:689-702. [PMID: 35881251 PMCID: PMC9321283 DOI: 10.1007/s10508-022-02364-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 06/15/2023]
Abstract
This study analyzes how the COVID-19 pandemic affected sexual behavior and use of HIV prevention methods among young transgender women (YTGW) and young gay, bisexual and other men who have sex with men (YGBMSM) participating in an HIV pre-exposure prophylaxis (PrEP) demonstration study in Brazil. Online interviews with 39 participants aged 15-22 years old were conducted between September and November 2020 and analyzed based on social constructionism and human rights-based approaches to health. The pandemic disrupted interviewees' routines, negatively affecting their life conditions. Among those who did not have a steady partner, social distance measures led to temporary interruption of sexual encounters and increased sexting and solo sex. Conversely, for those who had a steady relationship such measures contributed to increasing sexual practices and intimacy. Participants who had sexual encounters during the pandemic reported having continued to use PrEP. However, home confinement with family, lack of privacy, loss of daily routines and changes in housing impaired PrEP adherence and attendance at follow-up consultations. These results highlight the importance of maintaining HIV-service delivery for these groups during a public health crisis, as well as to address the structural drivers of the epidemic with comprehensive HIV prevention policies and by ensuring access of YGBMSM and YTGW to social protection policies.
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Affiliation(s)
- Dulce Ferraz
- UMR 1296 "Radiations: Défense, Santé, Environnement", Université Lyon 2, Lyon, France.
- Institut de Psychologie, Université de Lausanne, Lausanne, Switzerland.
- Escola FIOCRUZ de Governo, Fundação Oswaldo Cruz (FIOCRUZ), Brasília, Brazil.
| | - Thais Aranha Rossi
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Brazil
| | - Eliana Miura Zucchi
- Programa de Pós-Graduação em Saúde Coletiva, Mestrado Profissional em Psicologia e Políticas Públicas, Universidade Católica de Santos (UniSantos), Santos, Brazil
| | - Luiz Fabio Alves de Deus
- Programa de Pós-Graduação em Psicologia Social e Institucional, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Xavier Mabire
- UMR 1296 "Radiations: Défense, Santé, Environnement", Université Lyon 2, Lyon, France
- Institut de Psychologie, Université de Lausanne, Lausanne, Switzerland
| | - Laura Ferguson
- Institute on Inequalities in Global Health, University of Southern California, Los Angeles, CA, USA
| | - Laio Magno
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Brazil
| | - Alexandre Grangeiro
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marie Préau
- UMR 1296 "Radiations: Défense, Santé, Environnement", Université Lyon 2, Lyon, France
| | - Fernanda Cangussu Botelho
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Ayra Rodrigues
- Programa de Pós-Graduação em Saúde Coletiva, Mestrado Profissional em Psicologia e Políticas Públicas, Universidade Católica de Santos (UniSantos), Santos, Brazil
| | - Sabrina Steele
- Departamento de Ciências da Vida, Universidade do Estado da Bahia (UNEB), Salvador, Brazil
| | - Inês Dourado
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Salvador, Brazil
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13
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Holt M, Chan C, Broady TR, Mao L, MacGibbon J, Rule J, Wilcock B, Prestage G, Bavinton BR. Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men's HIV-Related Behaviour in Australia. AIDS Behav 2023; 27:518-534. [PMID: 35895148 PMCID: PMC9326145 DOI: 10.1007/s10461-022-03788-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
COVID-19 has disrupted sexual behaviour and access to health systems. We adapted regular HIV behavioural surveillance of gay and bisexual men (GBM) in Australia in response to COVID-19, assessed the impact on the profile of the sample, the participants' HIV-related behaviour, and whether COVID-19 may have accentuated existing disparities in the Australian HIV epidemic. Data collected from five states during July 2017-June 2021 were included (N = 31,460). The emphasis on online recruitment after COVID-19 led to smaller sample sizes, greater geographic reach, and a higher proportion of bisexual-identifying participants. Most participants (88.1%) reported physical distancing and 52.1% had fewer sex partners due to COVID-19. In the COVID-19-affected rounds (July 2020-June 2021), the number of male partners, recent HIV testing and pre-exposure prophylaxis (PrEP) use all fell, and HIV risk among the smaller group of participants who reported casual sex increased. COVID-related changes were generally more pronounced among GBM aged under 25 years, participants from suburbs with fewer gay residents, and bisexual men. These groups should be prioritised when encouraging GBM to reengage with HIV testing services and effective prevention methods, like condoms and PrEP.
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Affiliation(s)
- Martin Holt
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | - Curtis Chan
- The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Timothy R Broady
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Limin Mao
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - James MacGibbon
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - John Rule
- National Association of People with HIV Australia, Sydney, Australia
| | - Ben Wilcock
- Australian Federation of AIDS Organisations, Sydney, Australia
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14
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Thongsak N, Manojai N, Apiputhipan R, Rongram N, Mattawanon N, Bunyatisai W, Plubin B, Nakharutai N, Thumronglaohapun S, Srikummoon P, Wongsawat K, Traisathit P, Homkham N. Risk Factors Associated with Loss to Follow-up Among Transgender Women Receiving HIV Pre-exposure Prophylaxis in Chiang Mai province, Thailand. AIDS Behav 2023; 27:473-483. [PMID: 35930202 PMCID: PMC9362098 DOI: 10.1007/s10461-022-03782-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/25/2022]
Abstract
Although HIV pre-exposure prophylaxis (PrEP) is free in Thailand, many transgender women discontinue taking it after initiation. We determined the loss to follow-up (LTFU) rate of transgender women who initiated PrEP at the Mplus Foundation, Chiang Mai, Thailand, and identified associated risk factors using Cox proportional hazard models. Of 235 participants who initiated PrEP, 59 (55%) out of 108 remaining participants had reactive syphilis. The LTFU rate at 6 months was 38% (95% confidence interval [CI]: 29-48%). Multivariable analysis indicates that LTFU is independently associated with age ≥ 26 years old (adjusted hazard ratio [aHR] = 2.09; 95% CI: 1.06-4.14) and reactive syphilis (aHR = 1.98; 95% CI:1.01-3.88). Delayed appointment scheduling by the PrEP providers and the syphilis clinic was associated with transgender women having reactive syphilis, and the lockdown policy during the COVID-19 pandemic might have influenced them to discontinue PrEP and their subsequent LTFU.
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Affiliation(s)
- Natthapat Thongsak
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | | | | | | | - Natnita Mattawanon
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Walaithip Bunyatisai
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Bandhita Plubin
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Nawapon Nakharutai
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Salinee Thumronglaohapun
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Pimwarat Srikummoon
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Kanokkan Wongsawat
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Patrinee Traisathit
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,Data Science Research Center, Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand ,Research Center in Bioresources for Agriculture, Industry and Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nontiya Homkham
- Faculty of Public Health, Thammasat University, Pathumthani, Thailand.
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15
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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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16
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Miller RL, McLaughlin A, Montoya V, Toy J, Stone S, Harding J, Liang RH, Wong J, Barrios R, Montaner JS, Joy JB. Impact of SARS-CoV-2 lockdown on expansion of HIV transmission clusters among key populations: A retrospective phylogenetic analysis. LANCET REGIONAL HEALTH. AMERICAS 2022; 16:100369. [PMID: 36168656 PMCID: PMC9500205 DOI: 10.1016/j.lana.2022.100369] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Public health measures designed to reduce SARS-CoV-2 transmission led to reduced access to care and prevention services for people living with or at risk of acquiring HIV, particularly during the initial introduction of extensive restrictions. This reduction in access may have contributed to increases in HIV transmission not outweighed by decreases in transmission occurring as a result of reduced contact rates promoted by the same public health measures. Methods We synthesize available province-wide HIV data in British Columbia, Canada, together with public mobility data to phylogenetically investigate the early impacts of SARS-CoV-2 on HIV transmission. Cluster growth, coalescent branching events and lineage-level diversification rates were assessed in "pre-lockdown" (January 22-March 21, 2020), "lockdown" (March 22-May 20, 2020) and "post-lockdown" (May 21-July 19, 2020) to facilitate comparison of transmission trends across key populations. Findings Results reveal increased HIV transmission in a limited number of clusters in association with reduced access to health services during the initial introduction of SARS-CoV-2-related restrictions. In particular, clusters associated with people who inject drugs (PWID) show rapid growth, extensive branching events in phylogenetic trees during and following the lockdown period, and elevated median change in individuals' viral diversification rates during lockdown compared to clusters associated with men who have sex with men (MSM), consistent with increased transmission rates between PWID. Interpretation Increased vigilance and innovative targeted solutions are critical to offset potential negative impacts of SARS-CoV-2 or future pandemic-related restrictions on HIV epidemic dynamics. Funding Funding sources include Genome Canada and Genome BC, the Public Health Agency of Canada, the BC Centre for Excellence in HIV/AIDS, and the Canadian Institutes of Health Research Coronavirus Rapid Response Programme. Student funding includes a NSERC CREATE scholarship and a Canadian Institutes of Health Research graduate fellowship.
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Affiliation(s)
- Rachel L. Miller
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Bioinformatics Program, University of British Columbia, Vancouver, BC, Canada
| | - Angela McLaughlin
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Bioinformatics Program, University of British Columbia, Vancouver, BC, Canada
| | - Vincent Montoya
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Junine Toy
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Sarah Stone
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Vancouver Coastal Health, Vancouver, BC, Canada
| | | | - Richard H. Liang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Jason Wong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Julio S.G. Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey B. Joy
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Bioinformatics Program, University of British Columbia, Vancouver, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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17
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Caba AE, Rathus T, Burson E, Chan PA, Eaton LA, Watson RJ. Who is using PrEP on-demand? Factors associated with PrEP use modality among Black and Hispanic/Latino emerging adults. AIDS Behav 2022; 26:3411-3421. [PMID: 35438349 PMCID: PMC9912752 DOI: 10.1007/s10461-022-03684-8] [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: 04/04/2022] [Indexed: 01/16/2023]
Abstract
Pre-exposure prophylaxis (PrEP) is a highly efficacious HIV prevention medication, yet Black and Hispanic/Latino sexual minority men's and gender diverse individuals' (SMMGD) PrEP use is limited due to factors such as PrEP barriers and anticipated PrEP stigma. Although most individuals who use PrEP take it as a daily regimen, there is evidence that many SMMGD are interested in using "on-demand" (also known as event-driven or intermittent or 2-1-1) PrEP. We used stepwise multinomial logistic regression to explore factors associated with on-demand, daily, and no PrEP use among 820 Black and Hispanic/Latino SMMGD ages 18-29 in the United States. We found that greater reported PrEP barriers were associated with higher odds of using PrEP on-demand or not using PrEP compared to daily PrEP use. More past 3-month sex partners and greater comfort telling others about PrEP use were associated with lower odds of on-demand compared to daily PrEP use. In addition, compared to daily PrEP use, more past 3-month sex partners, greater comfort telling others about PrEP use, and higher anticipated PrEP stigma were associated with lower odds of no current PrEP use compared to daily PrEP use. Findings may inform clinical practices and interventions to promote PrEP uptake and adherence.
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Affiliation(s)
- Antonia E Caba
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US.
| | - Taylor Rathus
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
| | - Esther Burson
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, US
| | - Philip A Chan
- Department of Medicine, Brown University, Providence, RI, US
| | - Lisa A Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
| | - Ryan J Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, US
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18
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Tran J, Ong JJ, Bradshaw CS, Chen MY, Kong FY, Hocking JS, Aung ET, Maddaford K, Fairley CK, Chow EP. Kissing, fellatio, and analingus as risk factors for oropharyngeal gonorrhoea in men who have sex with men: A cross-sectional study. EClinicalMedicine 2022; 51:101557. [PMID: 35865738 PMCID: PMC9294476 DOI: 10.1016/j.eclinm.2022.101557] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Our aim was to determine whether exposure to the anatomical sites (oropharynx, penis, or anus) of male partners of men who have sex with men (MSM) were independent risk factors for oropharyngeal gonorrhoea after adjusting for exposures to these sites. METHODS In this cross-sectional study, we invited MSM who attended the Melbourne Sexual Health Centre (MSHC) in Victoria, Australia between 26-November 2018 and 31-December 2020 to complete a survey of their sexual practices in the past three months. We collected data on the number of male partners with whom men engaged in sexual activities that exposed their oropharynx to their partners' oropharynx (kissing), penis (fellatio), and anus (rimming or analingus). Only men who were aged ≥16 years, tested for oropharyngeal gonorrhoea and did not have indeterminate or invalid results were included in the final analysis. We conducted univariable and multivariable logistic regression analyses to investigate associations between oropharyngeal gonorrhoea and the three exposures to the oropharynx. FINDINGS The median age of the 2,322 men who completed the survey was 31 years (IQR: 26-40), and 5·2% (n = 120) were diagnosed with oropharyngeal gonorrhoea. Our univariate analysis showed that oropharyngeal gonorrhoea was significantly associated with increasing number of kissing (p trend<0·0001), rimming (p trend<0·0001) and fellatio (p trend<0·0001) partners. After adjusting for all three exposures, oropharyngeal gonorrhoea was associated with increasing number of kissing (p trend =0·014) and rimming partners (p trend = 0·037) but not fellatio (p trend = 0·61). INTERPRETATION Our data suggest kissing and rimming are important practices in oropharyngeal gonorrhoea transmission in MSM Novel interventions which target the oropharynx are required for gonorrohoea prevention. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Julien Tran
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
- Corresponding authors at: Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, VIC 3053, Australia.
| | - Jason J. Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Catriona S. Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Marcus Y. Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Fabian Y.S. Kong
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane S. Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ei T. Aung
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Kate Maddaford
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Eric P.F. Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Corresponding authors at: Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, VIC 3053, Australia.
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Baral S, Rao A, Rwema JOT, Lyons C, Cevik M, Kågesten AE, Diouf D, Sohn AH, Phaswana-Mafuya RN, Kamarulzaman A, Millett G, Marcus JL, Mishra S. Competing health risks associated with the COVID-19 pandemic and early response: A scoping review. PLoS One 2022; 17:e0273389. [PMID: 36037216 PMCID: PMC9423636 DOI: 10.1371/journal.pone.0273389] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/09/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. OBJECTIVES We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. METHODS A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from November 1st, 2019 to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English. RESULTS A total of 1604 published papers and 205 preprints were retrieved in the search. Overall, 8.0% (129/1604) of published studies and 10.2% (21/205) of preprints met the inclusion criteria and were included in this review: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (19/183) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. DISCUSSION COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.
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Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Amrita Rao
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Jean Olivier Twahirwa Rwema
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, St. Andrews, Scotland
| | - Anna E. Kågesten
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | | | - Annette H. Sohn
- TREAT Asia, amfAR, The Foundation for AIDS Research, Bangkok, Thailand
| | - Refilwe Nancy Phaswana-Mafuya
- South African Medical Research Council/University of Johannesburg Pan African Centre for Epidemics Research Extramural Unit, Johannesburg, South Africa
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Adeeba Kamarulzaman
- Department of Medicine and Infectious Diseases, University of Malaya, Kuala Lumpur, Malaysia
| | - Gregorio Millett
- Public Policy Office, amfAR, Washington, District of Columbia, United States of America
| | - Julia L. Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States of America
| | - Sharmistha Mishra
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, Canada
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20
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Mirzaei H, Moradi Y, Abbaszadeh S, Nasiri N, Mehmandoost S, Khezri M, Tavakoli F, Sharifi H. The Impact of COVID-19 on Disruptions of HIV-related Services: A Rapid Review. Med J Islam Repub Iran 2022; 36:98. [PMID: 36419948 PMCID: PMC9588155 DOI: 10.47176/mjiri.36.98] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Indexed: 12/02/2022] Open
Abstract
Background: People living with HIV (PLHIV) and those at risk of HIV are marginalized worldwide and need to reach services regularly. The COVID-19 pandemic can disrupt the HIV care continuum. This study aimed to identify the extent to which HIV-related services have been affected by the COVID-19 pandemic and how we can overcome these challenges. Methods: In this rapid review, we systematically searched PubMed and Scopus databases, the references of studies, international agencies, and studies "cited by" feature in google scholar till May 28, 2021, without restrictions to language. Results: Among the total of 1,121 studies, 31 of them were included in the review. The most important HIV-related services affected by the COVID-19 pandemic were; access to anti-retroviral drugs, HIV testing, periodic HIV-related testing in people living with HIV (PLHIV), pre-exposure prophylaxis, post-exposure prophylaxis, harm reduction services, psychological and counseling services. Some factors were introduced to mitigate the effects of these challenges, including increasing the resilience of health, protecting health care workers and their clients against COVID-19 through vaccination, providing HIV-related services through telehealth, and multi-month dispensing (MMD) of medicines. Conclusion: The results of this review study showed that PLHIV had difficulty in accessing follow-up, care and treatment services during the COVID-19 pandemic. Programs such as the MMD or telemedicine can be useful in providing services to PLHIV during the pandemic.
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Affiliation(s)
- Hossein Mirzaei
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran , Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran, Corresponding author:Yousef Moradi,
| | - Samaneh Abbaszadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Naser Nasiri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheil Mehmandoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Khezri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Tavakoli
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran, Corresponding author:Hamid Sharifi,
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21
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Uhrmacher M, Skaletz-Rorowski A, Nambiar S, Schmidt AJ, Ahaus P, Serova K, Mordhorst I, Kayser A, Wach J, Tiemann C, Münstermann D, Brockmeyer NH, Potthoff A. HIV pre-exposure prophylaxis during the SARS-CoV-2 pandemic: Results from a prospective observational study in Germany. Front Public Health 2022; 10:930208. [PMID: 36091531 PMCID: PMC9449641 DOI: 10.3389/fpubh.2022.930208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/02/2022] [Indexed: 01/24/2023] Open
Abstract
Aims Since 2017, HIV pre-exposure prophylaxis (PrEP) care has been provided through an intersectoral collaboration at WIR (Walk-in-Ruhr, Center for Sexual Health and Medicine, Bochum, Germany). The aim of this study was to establish possible impact of COVID-restrictions on the sexual behavior of PrEP users in North Rhine-Westphalia. Methods The current PrEP study collected data of individuals using PrEP, their sexual behavior and sexually transmitted infections (STIs) before (each quarter of year 2018) and during the COVID-19 pandemic (each quarter of year 2020). Results During the first lockdown in Germany from mid-March until May 2020, PrEP-care appointments at WIR were postponed or canceled. Almost a third of PrEP users had discontinued their PrEP intake in the 2nd quarter of 2020 due to alteration of their sexual behavior. The number of sexual partners decreased from a median of 14 partners in the previous 6 months in 1st quarter of 2020, to 7 partners in 4th quarter of 2020. Despite such a significant reduction in partner number during the pandemic in comparison to the pre-pandemic period, a steady rate of STIs was observed among PrEP users in 2020. Conclusion The SARS-CoV-2-pandemic has impacted PrEP-using MSM in North Rhine-Westphalia with respect to their PrEP intake regimen and sexual behavior in 2020. Our study revealed a steady rate of STI among PrEP users even during the pandemic, thus highlighting the importance of ensuring appropriate HIV/STI prevention services in times of crisis.
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Affiliation(s)
- M. Uhrmacher
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany
| | - A. Skaletz-Rorowski
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany
| | - S. Nambiar
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany
| | - A. J. Schmidt
- Sigma Research, Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom,Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - P. Ahaus
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany
| | - K. Serova
- Institute of Educational Research, Ruhr Universität Bochum, Bochum, Germany
| | - I. Mordhorst
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany
| | - A. Kayser
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Aidshilfe Bochum e.V. (Aids-Service Organization Bochum), Bochum, Germany
| | - J. Wach
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Local Health Department Bochum, Bochum, Germany
| | - C. Tiemann
- Laboratory Krone, Bad Salzuflen, Germany
| | | | - N. H. Brockmeyer
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany
| | - A. Potthoff
- WIR – Walk in Ruhr, Center for Sexual Health and Medicine, Bochum, Germany,Interdisciplinary Immunological Outpatient Clinic, Center for Sexual Health and Medicine, Department of Dermatology, Venereology and Allergology, Ruhr Universität Bochum, Bochum, Germany,*Correspondence: A. Potthoff
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22
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Evidence supports use of on-demand PrEP for HIV prevention. THE LANCET HIV 2022; 9:e524-e526. [DOI: 10.1016/s2352-3018(22)00158-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/16/2022] [Indexed: 11/20/2022]
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23
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Aung ET, Fairley CK, Ong JJ, Phillips TP, Tran J, Chen MY, Maddaford K, Chow EPF. Adherence to weekly anal self-examination among men who have sex with men for detection of anal syphilis. Front Med (Lausanne) 2022; 9:941041. [PMID: 35979212 PMCID: PMC9376231 DOI: 10.3389/fmed.2022.941041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Background Men who have sex with men (MSM) practicing exclusively receptive anal sex are more likely to present with secondary than primary syphilis, implying primary anorectal lesions may be missed. If men could detect anorectal lesions by regular anal self-examination, the duration of infectiousness could be reduced. This study aimed to examine adherence to weekly anal self-examination. Method We conducted a longitudinal feasibility study examining the adherence to weekly anal self-examinations among MSM attending a sexual health clinic in Melbourne, Australia between December 2020 and June 2021. Adherence to weekly anal self-examinations over 12 weeks was assessed from a logbook and 4-weekly surveys. Participants who identified abnormalities in their anus were recommended to seek medical review. Results Of the 30 men who completed the study, anal self-examination was performed at least weekly for 308 of 360 person-weeks (86% of the weeks, 95% CI: 82–89). The mean adherence was 3.6 (95% CI: 3.3–3.9) examinations per 4-weeks per person in Weeks 1–4, 3.5 (95% CI: 3.1–3.8) in Weeks 5–8 and 3.3 (95% CI: 2.9–3.7) in Weeks 9–12 (Ptrend = 0.06). Six men (20%, 6/30) were seen for medical review after they identified abnormalities, whilst eight men (27%, 8/30) reported abnormalities, but did not seek medical review. No participants were diagnosed with syphilis during the study period. Conclusion We conclude that men adhered well to weekly anal self-examination. Therefore, it is feasible to trial this as a routine practice among MSM. Future studies should investigate possible reductions in adherence over time and ways to increase medical review for abnormalities that men find.
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Affiliation(s)
- Ei T. Aung
- 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: Ei T. Aung
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jason J. Ong
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Tiffany P. Phillips
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Julien Tran
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Marcus Y. Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Kate Maddaford
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
| | - Eric P. F. Chow
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Eric P. F. Chow
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24
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Storer D, Prestage G, McManus H, Maher L, Bavinton BR, Ellard J, Jin F, Philpot S, Holt M, Saxton P, Haire B, Murphy D, Hammoud MA. Relationship Between Sexual Behaviors with Non-committed Relationship Partners and COVID-19 Restrictions and Notification Rates: Results from a Longitudinal Study of Gay and Bisexual Men in Australia. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 20:825-836. [PMID: 35669626 PMCID: PMC9142826 DOI: 10.1007/s13178-022-00733-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/06/2022] [Indexed: 05/28/2023]
Abstract
Introduction COVID-19 related lockdowns have impacted the sexual activity of gay and bisexual men (GBM). We investigated trends in sexual behaviors and the COVID-19 context in which they occurred (COVID-notification rates and jurisdictional restrictions) to understand changes in the duration and severity of periods of lockdown on the sexual behavior of Australian GBM. Methods In an online, prospective observational study of 831 GBM from May 2020 to May 2021, we investigated associations between changes in sexual behavior among Australian GBM, lockdowns, and COVID-19 notification rates through weekly surveys from May 2020 to May 2021. Results The mean age was 45.71 years (SD: 13.93). Most identified as gay (89.0%) and 10.2% were living with HIV. There was an overall increase in the mean weekly number of non-committed relationship partners (0.53-0.90, p < 0.001). The state of Victoria experienced a significant extended COVID-19 outbreak, accompanied by severe lockdown restrictions. In response, Victorian men's partner numbers shifted three times, while elsewhere there was an overall gradually increasing trend. Conclusions Less severe outbreaks with shorter lockdown periods, involving fewer and geographically contained, COVID-19 notifications were accompanied by non-significant changes in sex with non-relationship partners than more severe outbreaks over extended periods and larger geographical areas. Supplementary Information The online version contains supplementary material available at 10.1007/s13178-022-00733-8.
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Affiliation(s)
- Daniel Storer
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | - Garrett Prestage
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | - Hamish McManus
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | - Lisa Maher
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | | | - Jeanne Ellard
- Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, Australia
| | - Fengyi Jin
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | - Steven Philpot
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | - Martin Holt
- Centre for Social Research in Health, UNSW, Sydney, Australia
| | - Peter Saxton
- Department of Social and Community Health, University of Auckland, Auckland, New Zealand
| | - Bridget Haire
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | - Dean Murphy
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
| | - Mohamed A. Hammoud
- The Kirby Institute, UNSW, Wallace Wurth Building, Sydney, NSW 2052 Australia
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25
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Krist LC, Zimmermann HML, van Dijk M, Stutterheim SE, Jonas KJ. PrEP Use in Times of COVID-19 in the Netherlands: Men Who Have Sex With Men (MSM) on PrEP Test Less for HIV and Renal Functioning During a COVID-19 Related Lockdown. AIDS Behav 2022; 26:3656-3666. [PMID: 35578141 PMCID: PMC9109746 DOI: 10.1007/s10461-022-03693-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2022] [Indexed: 11/24/2022]
Abstract
As a result of the COVID-19 pandemic, HIV care and prevention efforts have been disrupted. We investigated pre-exposure prophylaxis (PrEP) use and testing behaviors among MSM in the Netherlands, and the factors that influenced testing behaviors during the COVID-19 pandemic. A cohort of 766 MSM, established in 2017, was asked in August 2020 to report on their experiences during the COVID-19 pandemic via an online survey. Participants (n = 319) reported increased PrEP use and, among PrEP users (n = 211), significantly lower rates of having tested in the last 3 months for HIV and renal functioning compared to before the pandemic. Daily PrEP use and a higher number of sexual partners during the pandemic was significantly associated with continued HIV testing. Continued renal functioning testing was associated with older age. Correcting for pandemic-related disruptions in PrEP use and care will require sustained effort to understand and address missed opportunities.
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Affiliation(s)
- Lizette C Krist
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.
| | - Hanne M L Zimmermann
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Mart van Dijk
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Sarah E Stutterheim
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
| | - Kai J Jonas
- Faculty of Psychology and Neuroscience, Department of Work and Social Psychology, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
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26
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Gao Y, Hu Q, Leuba SI, Jia L, Wang H, Huang X, Chen Y, Wang H, Zhang J, Chu Z, Zhang L, Wang Z, Shang H, Xu J. Medication Non-adherence and Condomless Anal Intercourse Increased Substantially During the COVID-19 Pandemic Among MSM PrEP Users: A Retrospective Cohort Study in Four Chinese Metropolises. Front Med (Lausanne) 2022; 9:738541. [PMID: 35573017 PMCID: PMC9100828 DOI: 10.3389/fmed.2022.738541] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic has impacted HIV prevention strategies globally. However, changes in pre-exposure prophylaxis (PrEP) adherence and HIV-related behaviors, and their associations with medication adherence among men who have sex with men (MSM) PrEP users remain unclear since the onset of the COVID-19 pandemic. Methods A Retrospective Cohort Study of HIV-negative MSM PrEP users was conducted in four Chinese metropolises from December 2018 to March 2020, assessing the changes in PrEP adherence and HIV-related behaviors before and during the COVID-19. The primary outcome was poor PrEP adherence determined from self-reported missing at least one PrEP dose in the previous month. We used multivariable logistic regression to determine factors correlated with poor adherence during COVID-19. Results We enrolled 791 eligible participants (418 [52.8%] in daily PrEP and 373 [47.2%] in event-driven PrEP). Compared with the data conducted before the COVID-19, the proportion of PrEP users decreased from 97.9 to 64.3%, and the proportion of poor PrEP adherence increased from 23.6 to 50.1% during the COVID-19 [odds ratio (OR) 3.24, 95% confidence interval (CI) 2.62-4.02]. While the percentage of condomless anal intercourse (CAI) with regular partners (11.8 vs. 25.7%) and with casual partners (4.4 vs. 9.0%) both significantly increased. The proportion of those who were tested for HIV decreased from 50.1 to 25.9%. Factors correlated with poor PrEP adherence during the COVID-19 included not being tested for HIV (adjusted odds ratio [aOR] = 1.38 [95% CI: 1.00, 1.91]), using condoms consistently with regular partners (vs. never, aOR = 2.19 [95% CI: 1.16, 4.13]), and being married or cohabitating with a woman (vs. not married, aOR = 3.08 [95% CI: 1.60, 5.95]). Conclusions Increased poor PrEP adherence and CAI along with the decrease in HIV testing can lead to an increase in HIV acquisition and drug resistance to PrEP. Targeted interventions are needed to improve PrEP adherence and HIV prevention strategies.
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Affiliation(s)
- Yangyang Gao
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Qinghai Hu
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Sequoia I. Leuba
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Le Jia
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Hongyi Wang
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Xiaojie Huang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yaokai Chen
- Chongqing Public Health Medical Center, Chongqing, China
| | - Hui Wang
- Department of Infectious Diseases, National Clinical Center for Infectious Diseases, Third People's Hospital of Shenzhen, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Jing Zhang
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Zhenxing Chu
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China
| | - Lukun Zhang
- Department of Infectious Diseases, National Clinical Center for Infectious Diseases, Third People's Hospital of Shenzhen, Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Zixin Wang
- Faculty of Medicine, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hong Shang
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China,*Correspondence: Hong Shang
| | - Junjie Xu
- National Health Commission Key Laboratory of Acquired Immunodeficiency Syndrome (AIDS) Immunology (China Medical University), National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China,Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, China,Key Laboratory of AIDS Immunology of Liaoning Province, Shenyang, China,Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China,Junjie Xu
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The impact of COVID-19 restrictions on online sales of HIV self-test kits and implications for HIV prevention: analysis of transaction data from a leading e-commerce platform in China. J Acquir Immune Defic Syndr 2022; 90:408-417. [PMID: 35394989 DOI: 10.1097/qai.0000000000002997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/31/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The effect of the COVID-19 epidemic on HIV self-testing (HIVST) remains unclear. We aimed to quantify the impact of COVID-restrictions on HIVST kit purchasing behaviors in mainland China. METHODS De-identified transaction data were retrieved from a large online shopping platform. An interrupted time series model was constructed to examine the impact of COVID-restrictions on the weekly number of anonymous customers purchasing HIVST kits, online orders, and purchased kits. RESULTS A total of 2.32 million individuals submitted 4.46 million orders for 4.84 million HIVST kits between 7 January 2016 and 22 April 2020. Compared to expected levels assuming COVID-19 epidemic and related restrictions had not happened, the number of purchasers, orders, and kits decreased by an estimated 10,500 (51.7%), 18,000 (55.3%) and 18,500 (54.9%) in the first week (23 January 2020 to 29 January 2020) after COVID-restrictions were implemented, respectively. As restrictions eased, the number of purchasers, orders, and kits increased by an average of 7.4%, 4.8%, and 4.9% per week, respectively. In the first week after COVID-restrictions were lifted (9 April 2020 to 15 April 2020), the number of purchasers returned to expected levels, whereas the number of orders and kits were still lower than expected levels. The impact of COVID-restrictions on outcomes at the beginning of COVID-restrictions and the increasing trends of outcomes were larger among those living in regions with higher COVID-19 incidence (e.g., Wuhan city and Hubei province). CONCLUSIONS Online sales of HIVST kits were significantly impacted by COVID-restrictions, and HIVST kit purchasing patterns returned to expected levels after restrictions were lifted.
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Corneli A, Perry B, Taylor J, Beckford J, Molokwu N, Reif S, Wilson J, Gulden C, Bickham J, Siren J, Thompson W, Clement ME. HIV Prevention During the COVID-19 Pandemic: Sexual Activity and PrEP Use Among Black Same-Gender-Loving Men and Black Cisgender Women. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2022; 34:142-157. [PMID: 35438538 PMCID: PMC9534043 DOI: 10.1521/aeap.2022.34.2.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Black populations in the U.S. South are disproportionally affected by HIV and COVID-19 due to longstanding inequalities. We conducted 20 in-depth interviews-12 with Black same-gender-loving men and 8 with Black cisgender women-to explore the impact of the initial phase of the COVID-19 pandemic on sexual activities and PrEP use. Almost all participants reduced the frequency of sex and number of partners. Women described little interest in sex, whereas men began to connect with some sexual partners after stay-at-home orders were lifted. Both populations were concerned about contracting COVID-19 through sexual partners, and men described selecting partners based on perceived COVID-19 risk. Participants valued PrEP and could access it, although several men who were not having sex stopped taking it. Risk of acquiring HIV during this time was likely limited. Future qualitative research is needed to understand how sexual behaviors and PrEP use changed as the pandemic continued.
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Affiliation(s)
- Amy Corneli
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
- Duke Clinical Research Institute, Durham, NC
| | - Brian Perry
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Jamilah Taylor
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Jeremy Beckford
- Louisiana State University Health Sciences Center, Section of Infectious Diseases, New Orleans, LA
| | - Nneka Molokwu
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Susan Reif
- Center for Health Policy and Inequities Research, Duke University, Durham, NC
| | | | | | - Jacquelyn Bickham
- Louisiana Department of Health STD/HIV/Hepatitis Program, New Orleans, LA
| | - Julia Siren
- CrescentCare Federally Qualified Health Center, New Orleans, LA
| | | | - Meredith E. Clement
- Louisiana State University Health Sciences Center, Section of Infectious Diseases, New Orleans, LA
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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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Karaosmanoglu HK, Mete B, Gunduz A, Sevgi DY, Aydin OA, Dokmetas I, Tabak F. Changing Characteristics of Patients Living with HIV/AIDS after COVID-19 Pandemics in Turkey. Curr HIV Res 2022; 20:236-241. [PMID: 35240974 DOI: 10.2174/1570162x20666220303103805] [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: 08/25/2021] [Revised: 01/04/2022] [Accepted: 01/27/2022] [Indexed: 11/22/2022]
Abstract
AIMS COVID-19 pandemic has substantially changed the life and presented several barriers to health services. HIV care continuum needs a high rate of diagnosis, an effective treatment and a sustained suppression of viral replication. COVID-19 pandemic has affected these three steps of HIV care. In this study, we investigated the characteristics of newly diagnosed patients living with HIV/AIDS (PLWH) during the COVID pandemic and compared them with those before the pandemic. METHODS All newly diagnosed patients in three HIV healthcare center, in Istanbul, Turkey were included into the study. Pandemic period included April 1, 2020 to April 1, 2021 and pre-pandemic period included March 1, 2019 to March 1, 2020. RESULTS During pre-pandemic period, 756 patients were diagnosed HIV/AIDS. In pandemic period, this figure was 58% less: 315. Patients in pre-pandemic and pandemic period had comparable age and gender distributions. PLWH diagnosed in pandemic period had higher rates of low CD4 cells: low CD4 (<350 cells /mm3) was measured in 243 (36.4%) patients in pre-pandemic, while it was done in 126 (47.9%) in pandemic period (p<0.01). Also the distribution of CD4 cells was significantly different between periods: In pandemic period, CD4 cell distribution skewed to lower CD4 categories significantly. Symptomatic patient rate and AIDS-defining disorder rate among symptomatic patients were comparable. Viral loads were not significantly different in two periods. CONCLUSION Less number of newly diagnosed PLWH can be explained by less HIV testing, less admission to the health care or actual decrease of HIV prevalence during pandemic. Sexual behaviors may have changed during COVID-19 pandemic which could lead to HIV transmission restriction. Lower CD4 counts among the newly diagnosed PLWH suggest that admittance to health care is late and a significant portion of PLWH remain undiagnosed.
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Affiliation(s)
- Hayat Kumbasar Karaosmanoglu
- Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Birgul Mete
- Cerrahpasa University Medical Faculty, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Alper Gunduz
- Sisli Hamidiye Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Dilek Yildiz Sevgi
- Sisli Hamidiye Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Ozlem Altuntas Aydin
- Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Ilyas Dokmetas
- Sisli Hamidiye Training and Research Hospital, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
| | - Fehmi Tabak
- Cerrahpasa University Medical Faculty, Infectious Diseases and Clinical Microbiology, Istanbul, Turkey
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Hong C, Horvath KJ, Stephenson R, Nelson KM, Petroll AE, Walsh JL, John SA. PrEP Use and Persistence Among Young Sexual Minority Men 17-24 Years Old During the COVID-19 Pandemic. AIDS Behav 2022; 26:631-638. [PMID: 34387777 PMCID: PMC8361406 DOI: 10.1007/s10461-021-03423-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/15/2022]
Abstract
The COVID-19 pandemic has caused disruptions to health care access for sexual and gender minorities in the U.S. We sought to explore the impact of COVID-19 on HIV pre-exposure prophylaxis (PrEP) use and sexual health services by assessing PrEP eligibility and use, changes in sexual behaviors, and HIV/STI testing during the COVID-19 pandemic. We surveyed 239 young sexual minority men (YSMM) 17-24 years old between April and September 2020 in the U.S. One-in-seven YSMM PrEP users discontinued use during the pandemic, and all those who discontinued PrEP reported a decrease in sexual activity. Twenty percent reported difficulty getting prescriptions and medications from their doctors or pharmacies, and more than 10% reported challenges accessing HIV/STI testing. Among those who met Centers for Disease Control and Prevention criteria for PrEP (n = 104), 86.5% were not currently using PrEP. Among those surveyed 3 months or later after the start of major COVID-19 stay-at-home measures (n = 165), 35.8% reported CAS with a causal partner within the past 3 months during the COVID-19 pandemic. Seeking HIV testing was associated with reporting condomless anal sex in the previous 3 months, indicating the necessity for ensuring continuity of basic sexual health services for YSMM. Failure to adequately adjust HIV prevention services and intervention in the face of pandemic-related adversity undermines efforts to end the HIV epidemic in the U.S.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA
| | - Keith J Horvath
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Rob Stephenson
- Department of Systems, Population and Leadership, School of Nursing & The Center for Sexuality and Health Disparities, University of Michigan, Ann Arbor, MI, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences & Department of Psychiatry, Boston University, Boston, MA, USA
| | - Andrew E Petroll
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 N. Summit Avenue, Milwaukee, WI, 53202, USA
| | - Jennifer L Walsh
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 N. Summit Avenue, Milwaukee, WI, 53202, USA
| | - Steven A John
- Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 N. Summit Avenue, Milwaukee, WI, 53202, USA.
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Di Ciaccio M, Villes V, Michels D, Morel S, Delabre RM, Rojas Castro D, Velter A. Impact of the early 2020 COVID-19 crisis and lockdown on PrEP use among men who have sex with men (MSM) in France. Sex Transm Infect 2022; 98:510-517. [PMID: 35149580 DOI: 10.1136/sextrans-2021-055189] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 12/23/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To describe changes in pre-exposure prophylaxis (PrEP) use during and following the COVID-19 lockdown in France (March-May 2020) and identify the factors associated with PrEP discontinuation among men who have sex with men (MSM) after the lockdown. METHODS Data from the, an anonymous, cross-sectional internet survey among MSM in July 2020, were analysed. Among respondents who were using PrEP prior to the lockdown, a binary logistic regression model was used to compare participants who were still taking PrEP (current PrEP users) with those who were not taking PrEP at the time of the survey (former PrEP users). RESULTS Among 8345 respondents, 946 were PrEP users before the lockdown, of whom 58.8% (n=556) reported stopping PrEP during the lockdown and 15.4% (n=146) were not using PrEP at the time of the survey. Among the 556 who stopped PrEP during lockdown, 86.5% (n=481) reported no sexual activity; 76.8% (n=427) restarted PrEP after lockdown. Former PrEP users were more likely to be younger, not living with a stable male sexual partner, report moderate anxiety, report increased psychoactive drug use during the lockdown, and report not having tested for HIV or STI since the end of the lockdown because they did not know where to go, preferred to wait or for another reason. Reporting fewer male sexual partners in the last 6 months was also significantly associated with being a former PrEP user. CONCLUSIONS MSM adapted PrEP use to their sexual activity during and after the French lockdown. After the lockdown, discontinued PrEP occurred more often among MSM who had fewer sexual partners and had mental health vulnerabilities. These factors could also be predictive of PrEP discontinuation in a more general context. PrEP users should be informed on how to safely stop/start PrEP and on the use of other prevention tools to reduce potential risk exposure during PrEP discontinuation.
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Affiliation(s)
- Marion Di Ciaccio
- Community-based Research Laboratory, Coalition PLUS, Pantin, France .,Groupe de Recherche en Psychologie Sociale (GRePS), Université Lyon 2, Lyon, France
| | - Virginie Villes
- Community-based Research Laboratory, Coalition PLUS, Pantin, France
| | - David Michels
- Community-based Research Laboratory, Coalition PLUS, Pantin, France.,AIDES, Pantin, France
| | - Stéphane Morel
- Community-based Research Laboratory, Coalition PLUS, Pantin, France.,AIDES, Pantin, France
| | | | - Daniela Rojas Castro
- Community-based Research Laboratory, Coalition PLUS, Pantin, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale, ISSPAM, Marseille, France
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Abstract
PURPOSE OF REVIEW The COVID-19 pandemic materialized in 2020, the year the international community had expected to meet the interim targets to end AIDS by 2030. Forty years into the HIV pandemic, the COVID-19 pandemic challenges the achievements made in HIV and may even reverse some of them. RECENT FINDINGS This article provides an overview of the impact of COVID-19 on people with, and at risk of, HIV infection. It addresses where the global response to HIV was expected to be by 2020, analyzes the impact of COVID-19 on HIV-related outcomes and reviews the impact of HIV on COVID-19 related outcomes. SUMMARY The COVID-19 pandemic has had a profound impact on the response to HIV infection through disruption of prevention, testing, and access to antiretroviral treatment, as well as on the management of long-term HIV and mental health. This negative impact has been unequal throughout the world and across populations and deepens inequities in health. HIV does not increase Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) susceptibility once confounders are taken into account and inconsistencies are reported regarding its direct role on clinical severity. In post-COVID-19 scenarios, new models for HIV testing and care are likely to be consolidated. Monitoring responses needs high-quality epidemiological data and collaborative research.
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Affiliation(s)
- Julia Del Amo
- División de control de VIH, ITS, Hepatitis virales y Tuberculosis. Ministry of Health, Madrid, Spain
- AIDS Research Network. Ciber de Enfermedades Infecciosas. Institute of Health Carlos III Madrid, Spain
| | - Asuncion Diaz
- División de control de VIH, ITS, Hepatitis virales y Tuberculosis. Ministry of Health, Madrid, Spain
- AIDS Research Network. Ciber de Enfermedades Infecciosas. Institute of Health Carlos III Madrid, Spain
- National Center for Epidemiology, Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Rosa Polo
- División de control de VIH, ITS, Hepatitis virales y Tuberculosis. Ministry of Health, Madrid, Spain
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Shi L, Liu G, Fu G, Zaller N, Wei C, Yang C, Yan H. Psychosocial and behavioral correlates with HIV testing among men who have sex with men during the COVID‐19 pandemic in China. PLoS One 2022; 17:e0262472. [PMID: 35073356 PMCID: PMC8786173 DOI: 10.1371/journal.pone.0262472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 12/23/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives Some of community mitigation efforts on COVID-19 created challenges to ongoing public health programs, including HIV care and prevention services among men who have sex with men (MSM). The goal of the current study was to explore sociodemographic factors and the impact of COVID-19 on HIV testing among Chinese MSM during state-enforced quarantine. Methods We conducted a community based survey between May 1st to June 30th, 2020 on COVID-19 related impacts on HIV testing among 436 China MSM during the COVID-19 state-enforced quarantine. Results One-third (33.7%) of MSM received HIV testing during the quarantine period. Few participants reported difficulty accessing facility-based testing (n = 13, 3.0%) or obtaining HIV self-test kit online (n = 22, 5.0%). However, 12.1% of participants reported being afraid of getting facility-based HIV test due to concerns about the risk of COVID-19. In the multivariate logistic regression model, participants who were married (aOR: 1.89, 95%CI: 1.19–3.01), reported increased quality of sleep (aOR: 2.07, 95%CI: 1.11–3.86), and increased difficulty in accessing health care (aOR: 2.34, 95%CI: 1.37–3.99) were more likely to get an HIV test during the state-enforced quarantine. Conclusion The mitigation measures of COVID-19 have created various barriers to access HIV related prevention services in China, including HIV testing. To mitigate these impacts on HIV prevention and care services, future programs need to address barriers to HIV-related services, such as providing high-quality HIV self-testing. Meanwhile, psychological services or other social services are needed to those experiencing mental distress.
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Affiliation(s)
- Lingen Shi
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Guangxia Liu
- Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Gengfeng Fu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Nick Zaller
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - Chongyi Wei
- Department of Health Behavior, Society, and Policy, Rutgers University School of Public Health, New Brunswick, New Jersey, United States of America
| | - Cui Yang
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Hongjing Yan
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- * E-mail:
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Grov C, Zohra F, Westmoreland DA, Mirzayi C, D'Angelo A, Stief M, Kulkarni S, Nash D, Carrico AW. Sex in the Era of COVID-19 in a U.S. National Cohort of Cisgender Men, Transgender Women, and Transgender Men Who Have Sex with Men: April-May 2020. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:343-354. [PMID: 34845579 PMCID: PMC8628839 DOI: 10.1007/s10508-021-02121-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 05/05/2021] [Accepted: 08/01/2021] [Indexed: 05/28/2023]
Abstract
Since the emergence of the COVID-19 pandemic, there has been an increasing body of research focused on the effects that measures like stay-at-home orders and social distancing are having on other aspects of health, including mental health and sexual health. Currently, there are limited extant data on the effects of the pandemic on sexual and gender minorities. Between April 15, 2020, and May 15, 2020, we invited participants in an ongoing U.S. national cohort study (Together 5000) to complete a cross-sectional online survey about the pandemic, and its effects on mental and sexual health and well-being (n = 3991). Nearly all (97.7%) were living in an area where they were told they should only leave their homes for essentials. Most (70.1%) reported reducing their number of sex partners as a result of the pandemic. Among the 789 participants prescribed HIV pre-exposure prophylaxis (PrEP), 29.9% said they stopped taking their PrEP entirely, and 14.2% started selectively skipping doses. For those who had been taking PrEP, discontinuing PrEP was associated with having no new sex partners (β = 0.90, 95% CI 0.40-1.40). Among the 152 HIV-positive participants, 30.9% said they were unable to maintain an HIV-related medical appointment because of the pandemic and 13.8% said they had been unable to retrieve HIV medications. Additionally, 35.3% of participants were experiencing moderate to severe anxiety because of the pandemic and 36.7% reported symptoms of depression. In a multivariable logistic regression, reporting a new sex partner in the prior 30 days was significantly associated with being aged 30 or older (vs. not, AOR = 1.21), being Black (AOR = 1.79) or Latinx (AOR = 1.40, vs. white), and being unsure if they had been in close contact with someone diagnosed with COVID-19 (AOR = 1.32, vs. no contact). It was unassociated with COVID-19-induced anxiety, depression, or knowing someone hospitalized with COVID-19. The pandemic has caused disruptions in sexual behavior (partner reduction) as well as difficulties navigating PrEP and HIV care continua. Findings will guide more comprehensive public health responses to optimize HIV prevention and treatment in the era of COVID-19.
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Affiliation(s)
- Christian Grov
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA.
- CUNY Institute for Implementation Science in Population Health, New York, USA.
| | - Fatima Zohra
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Drew A Westmoreland
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Chloe Mirzayi
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Alexa D'Angelo
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Matthew Stief
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Sarah Kulkarni
- CUNY Institute for Implementation Science in Population Health, New York, USA
| | - Denis Nash
- CUNY Graduate School of Public Health and Health Policy, 7th Floor Mailroom, 55 W. 125th St., New York, NY, 10027, USA
- CUNY Institute for Implementation Science in Population Health, New York, USA
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Wu HJ, Yu YF, Ku SWW, Tseng YC, Yuan CW, Li CW, Huang PH, Ko NY, Anderson PL, Strong C. Usability and effectiveness of adherence monitoring of a mobile app designed to monitor and improve adherence to event-driven and daily HIV pre-exposure prophylaxis among men who have sex with men in Taiwan. Digit Health 2022; 8:20552076221102770. [PMID: 35646378 PMCID: PMC9131382 DOI: 10.1177/20552076221102770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/05/2022] [Indexed: 11/17/2022] Open
Abstract
Objective The UPrEPU mobile app is a self-monitoring system to enable men who have sex with men to optimize their pre-exposure prophylaxis adherence for HIV prevention. The app was designed to accommodate a rather complicated event-driven dosing schedule. We aim to evaluate the usability of the UPrEPU app and its effectiveness in improving adherence monitoring. Methods From May to October 2020, 35 participants were enrolled for the usability study and followed up for 4 months. Blood samples for the drug concentration in the dried blood spots were obtained once during the second to fourth follow-up visits. The effectiveness of adherence monitoring was analyzed using Cohen's kappa statistic to calculate the concordance between the average number of pills taken and drug concentration in the dried blood spots. Results Overall retention was 91.4% (32 participants) at the end of the study. Participants used the app for a mean of 29 days and made 2565 data entries in total, with an average of 76 data entries. The average systematic usability scale score for the app was 71.5, indicating acceptable usability. Slight agreement was reached between the dried blood spots measurement and the number of pills taken and recorded in the app (weighted kappa: 0.21). Conclusions Our user-centered UPrEPU app demonstrated that it could accommodate both daily and event-driven dosing schedules for men who have sex with men clients with acceptable usability scores. We confirmed that complex behaviors such as different drug-dosing regimens that are contingent on sexual behaviors could be incorporated into the design of a mobile app.
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Affiliation(s)
- Huei-Jiuan Wu
- UNSW Sydney, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Yi-Fang Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Stephane Wen-Wei Ku
- Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan
| | - Yuan-Chi Tseng
- Institute of Service Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Chien-Wen Yuan
- Graduate Institute of Library & Information Studies, National Taiwan Normal University, Taipei, Taiwan
| | - Chia-Wen Li
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Hsien Huang
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Nai-Ying Ko
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Peter L. Anderson
- Department of Pharmaceutical Sciences, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Yu YF, Wu HJ, Ku SWW, Huang PH, Li CW, Huang P, Strong C. Condomless Anal Sex Associated With Heterogeneous Profiles Of HIV Pre-Exposure Prophylaxis Use and Sexual Activities Among Men Who Have Sex With Men: A Latent Class Analysis Using Sex Diary Data on a Mobile App. J Med Internet Res 2021; 23:e33877. [PMID: 34941560 PMCID: PMC8738983 DOI: 10.2196/33877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/26/2021] [Accepted: 11/21/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND New innovative technologies, such as mobile apps, have been developed to increase pre-exposure prophylaxis (PrEP) adherence and the use of log sex diaries. The contiguity of mobile apps reduces the recall bias that generally affects reported condom and PrEP use. However, none of the currently used mobile apps were designed for event-driven PrEP users, and few studies have demonstrated the potential usage of sex diary data to facilitate the understanding of the different HIV risks among heterogeneous profiles of sex diaries and PrEP use. OBJECTIVE We aim to discriminate the heterogeneous profiles of sex events and PrEP use and examine the risk of condomless anal sex among different types of sex events. METHODS We recruited 35 adult men who have sex with men from two medical centers in Taiwan since May 2020 and followed up for four months. Participants were on PrEP or willing to take PrEP. They were asked to log their sex events, PrEP use, and dosing regimens on a mobile app to improve their PrEP adherence. Latent class analysis was used to distinguish profiles of sex events and PrEP use. Indicators included correct intake of PrEP for each sex event, participants' sexual positioning, partner's HIV status, and age. RESULTS A total of 551 sex events were classified into three classes by latent class analysis: PrEP nonadherent flip-flopping (234/551, 42%), PrEP imperfect-adherent power bottoming (284/551, 52%), and PrEP adherent serodiscordant topping (33/551, 6%). "PrEP nonadherent flip-flopping" sex events were more likely to involve condomless anal sex than "PrEP imperfect-adherent power bottoming" (OR 1.83, 95% CI 1.03-3.25) after considering random intercepts for individuals, and this class needed to increase their PrEP adherence and use of condoms. "PrEP imperfect-adherent power bottoming" realized their own risk and packaged PrEP with condoms to protect themselves. Up to 99% (32/33) of sex events in "PrEP adherent serodiscordant topping" were protected by PrEP, but all of the sex events in this group were condomless. CONCLUSIONS Using the sex diary data could advance the capacity to identify high-risk groups. HIV prevention strategy should be more flexible and combine PrEP with condom use for future HIV prevention.
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Affiliation(s)
- Yi-Fang Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Huei-Jiuan Wu
- The Kirby Institute, University of New South Wales, Sydney, Australia
| | - Stephane Wen-Wei Ku
- Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan
| | - Po-Hsien Huang
- Department of Psychology, National Chengchi University, Taipei, Taiwan
| | - Chia-Wen Li
- Center for Infection Control and Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Poyao Huang
- Institute of Health Behavior and Community Sciences, National Taiwan University, Taipei, Taiwan
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Baral S, Rao A, Twahirwa Rwema JO, Lyons C, Cevik M, Kågesten AE, Diouf D, Sohn AH, Phaswana-Mafuya N, Kamarulzaman A, Millett G, Marcus JL, Mishra S. Competing Health Risks Associated with the COVID-19 Pandemic and Early Response: A Scoping Review. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.01.07.21249419. [PMID: 33442703 PMCID: PMC7805463 DOI: 10.1101/2021.01.07.21249419] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats. OBJECTIVES We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. METHODS A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from January 1st to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English. RESULTS A total of 1604 published papers and 205 preprints met inclusion criteria, including 8.2% (132/1604) of published studies and 10.2% (21/205) of preprints: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (13/166) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. DISCUSSION COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.
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Affiliation(s)
- Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Amrita Rao
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | | | - Carrie Lyons
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Muge Cevik
- Division of Infection and Global Health Research, School of Medicine, University of St. Andrews, Scotland
| | - Anna E Kågesten
- Department of Global Public Health, Karolinska Institutet, Sweden
| | | | - Annette H Sohn
- TREAT Asia, amfAR, the Foundation for AIDS Research, Bangkok, Thailand
| | - Nancy Phaswana-Mafuya
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg
| | | | | | - Julia L Marcus
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Sharmistha Mishra
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Canada
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Phillips TR, Fairley CK, Donovan B, Ong JJ, McNulty A, Marshall L, Templeton DJ, Owen L, Ward A, Gunathilake M, Russell D, Langton‐Lockton J, Bourne C, Martin S, Chow EP. Sexual health service adaptations to the coronavirus disease 2019 (COVID-19) pandemic in Australia: a nationwide online survey. Aust N Z J Public Health 2021; 45:622-627. [PMID: 34473388 PMCID: PMC8652521 DOI: 10.1111/1753-6405.13158] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/01/2021] [Accepted: 08/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE Examine the changes in service delivery Australian public sexual health clinics made to remain open during lockdown. METHODS A cross-sectional survey designed and delivered on Qualtrics was emailed to 21 directors of public sexual health clinics across Australia from July-August 2020 and asked about a variety of changes to service delivery. Descriptive statistics were calculated. RESULTS Twenty clinics participated, all remained open and reported service changes, including suspension of walk-in services in eight clinics. Some clinics stopped offering asymptomatic screening for varying patient populations. Most clinics transitioned to a mix of telehealth and face-to-face consultations. Nineteen clinics reported delays in testing and 13 reported limitations in testing. Most clinics changed to phone consultations for HIV medication refills (n=15) and eleven clinics prescribed longer repeat prescriptions. Fourteen clinics had staff redeployed to assist the COVID-19 response. CONCLUSION Public sexual health clinics pivoted service delivery to reduce risk of COVID-19 transmission in clinical settings, managed staffing reductions and delays in molecular testing, and maintained a focus on urgent and symptomatic STI presentations and those at higher risk of HIV/STI acquisition. Implications for public health: Further research is warranted to understand what impact reduced asymptomatic screening may have had on community STI transmission.
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Affiliation(s)
- Tiffany R. Phillips
- Central Clinical School, Monash University, Melbourne, Victoria,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria,Correspondence to: Dr Tiffany R Phillips, Melbourne Sexual Health Centre, 580 Swanston Street, Carlton, VIC 3053
| | - Christopher K. Fairley
- Central Clinical School, Monash University, Melbourne, Victoria,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria
| | - Basil Donovan
- Kirby Institute, UNSW Sydney, Sydney, New South Wales,Sydney Sexual Health Centre, Sydney, New South Wales
| | - Jason J. Ong
- Central Clinical School, Monash University, Melbourne, Victoria,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria
| | - Anna McNulty
- Sydney Sexual Health Centre, Sydney, New South Wales
| | - Lewis Marshall
- South Terrace Clinic, Fremantle Hospital and Health Service, Western Australia
| | - David J. Templeton
- Kirby Institute, UNSW Sydney, Sydney, New South Wales,Department of Sexual Health Medicine, Sydney Local Health District, Camperdown, New South Wales
| | | | - Alison Ward
- Adelaide Sexual Health Centre, Adelaide, South Australia
| | - Manoji Gunathilake
- Sexual Health & Blood Borne Virus Unit of Centre for Disease Control, Northern Territory Department of Health, Northern Territory
| | | | | | - Christopher Bourne
- Kirby Institute, UNSW Sydney, Sydney, New South Wales,Sydney Sexual Health Centre, Sydney, New South Wales,Centre for Population Health, NSW Health, New South Wales
| | - Sarah Martin
- Canberra Hospital, Canberra, Australian Capital Territory
| | - Eric P.F. Chow
- Central Clinical School, Monash University, Melbourne, Victoria,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria,Melbourne School of Population and Global Health, The University of Melbourne, Victoria
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40
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Eisinger RW, Lerner AM, Fauci AS. Human Immunodeficiency Virus/AIDS in the Era of Coronavirus Disease 2019: A Juxtaposition of 2 Pandemics. J Infect Dis 2021; 224:1455-1461. [PMID: 33825905 PMCID: PMC8083774 DOI: 10.1093/infdis/jiab114] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/09/2021] [Indexed: 12/17/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted persons with human immunodeficiency virus (HIV), interfering with critical health services for HIV prevention, treatment, and care. While there are multiple profiles of persons living with HIV and the impact of COVID-19 may differ for each, the severity of COVID-19 in persons with HIV is related strongly to the presence of comorbidities that increase the risk of severe disease in COVID-19 patients in the absence of HIV. An effective response to the juxtaposition of the HIV and COVID-19 pandemics requires a novel coordinated and collaborative global effort of scientists, industry, and community partners to accelerate basic and clinical research, as well as implementation science to operationalize evidence-based interventions expeditiously in real-world settings. Accelerated development and clinical evaluation of prevention and treatment countermeasures are urgently needed to mitigate the juxtaposition of the HIV and COVID-19 pandemics.
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Affiliation(s)
- Robert W Eisinger
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrea M Lerner
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Anthony S Fauci
- Office of the Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
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41
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Gilbert M, Chang HJ, Ablona A, Salway T, Ogilvie GS, Wong J, Haag D, Pedersen HN, Bannar-Martin S, Campeau L, Ford G, Worthington C, Grace D, Grennan T. Accessing needed sexual health services during the COVID-19 pandemic in British Columbia, Canada: a survey of sexual health service clients. Sex Transm Infect 2021; 98:360-365. [PMID: 34740976 PMCID: PMC8577923 DOI: 10.1136/sextrans-2021-055013] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022] Open
Abstract
Objectives We assessed COVID-19 pandemic impacts on accessing needed sexual health services, and acceptability of alternative service delivery models, among sexual health service clients in British Columbia (BC), Canada. Methods We administered an online survey on 21 July–4 August 2020 to clients using a provincial STI clinic or internet-based testing service, GetCheckedOnline, in the year prior to March 2020. We used logistic regression to identify factors associated with having unmet sexual health needs (ie, not accessing needed services) during March–July 2020 and the likelihood of using various alternative service models, if available. Results Of 1198 survey respondents, 706 (59%) reported needing any sexual health service since March 2020; of these 706, 365 (52%) did not access needed services and 458 (66%) had avoided or delayed accessing services. GetCheckedOnline users (univariate OR (uOR)=0.62; 95% CI 0.43 to 0.88) or clients with more urgent needs (eg, treatment for new STI, uOR 0.40 (95% CI 0.21 to 0.7)) had lower odds of unmet sexual health needs. The most common factors reported for avoiding or delaying access were public messaging against seeking non-urgent healthcare (234/662, 35%), concern about getting COVID-19 while at (214/662, 32%) or travelling to (147/662, 22%) a clinic or lab and closure of usual place of accessing services (178/662, 27%). All factors were positively associated with having unmet sexual health needs, with public messaging showing the strongest effect (adjusted OR=4.27 (95% CI 2.88 to 6.42)). Likelihood of using alternative sexual health service models was high overall, with the most appealing options being home self-collection kits (634/706, 90%), receiving test kits or antibiotics at home (592/700, 85%) and express testing (565/706, 80%). Conclusions Of BC sexual health service clients needing services during March–July 2020, many had unmet needs. Offering alternative service delivery methods may help to improve access during and beyond the COVID-19 pandemic.
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Affiliation(s)
- Mark Gilbert
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada .,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Hsiu-Ju Chang
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Aidan Ablona
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Gina Suzanne Ogilvie
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.,Women's Health Research Institute, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Jason Wong
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.,School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Devon Haag
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Heather Nicole Pedersen
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | | | - Laurence Campeau
- Vancouver Island Health Authority, Victoria, British Columbia, Canada
| | - Geoffrey Ford
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Catherine Worthington
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Troy Grennan
- Clinical Prevention Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.,Division of Infectious Diseases, Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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42
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Amatavete S, Lujintanon S, Teeratakulpisarn N, Thitipatarakorn S, Seekaew P, Hanaree C, Sripanjakun J, Prabjuntuek C, Suwannarat L, Phattanathawornkool T, Photisan N, Suriwong S, Avery M, Mills S, Phanuphak P, Phanuphak N, Ramautarsing RA. Evaluation of the integration of telehealth into the same-day antiretroviral therapy initiation service in Bangkok, Thailand in response to COVID-19: a mixed-method analysis of real-world data. J Int AIDS Soc 2021; 24 Suppl 6:e25816. [PMID: 34713623 PMCID: PMC8554221 DOI: 10.1002/jia2.25816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 08/19/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction Same‐day antiretroviral therapy (SDART) initiation has been implemented at the Thai Red Cross Anonymous Clinic (TRCAC) in Bangkok, Thailand, since 2017. HIV‐positive, antiretroviral therapy (ART)‐naïve clients who are willing and clinically eligible start ART on the day of HIV diagnosis. In response to the first wave of the coronavirus disease 2019 (COVID‐19) outbreak in March 2020, telehealth follow‐up was established to comply with COVID‐19 preventive measures and allow service continuation. Here, we evaluate its implementation. Methods Pre‐COVID‐19 (until February 2020) clients who initiated SDART received a 2‐week ART supply and returned to the clinic for evaluation before being referred to long‐term ART maintenance facilities. If no adverse events (AEs) occurred, another 8‐week ART supply was provided while referral was arranged. During the first wave of COVID‐19 (March–May 2020), clients received a 4‐week ART supply and the option of conducting follow‐up consultation and physical examination via video call. Clients with severe AEs were required to return to TRCAC; those without received another 6‐week ART supply by courier to bridge transition to long‐term facilities. This adaptation continued post‐first wave (May–August 2020). Routine service data were analysed using data from March to August 2019 for the pre‐COVID‐19 period. Interviews and thematic analysis were conducted to understand experiences of clients and providers, and gain feedback for service improvement. Results Of 922, 183 and 321 eligible clients from the three periods, SDART reach [89.9%, 96.2% and 92.2% (p = 0.018)] and ART initiation rates [88.1%, 90.9% and 94.9% (p<0.001)] were high. ART uptake, time to ART initiation and rates of follow‐up completion improved over time. After the integration, 35.3% received the telehealth follow‐up. The rates of successful referral to a long‐term facility (91.8% vs. 95.3%, p = 0.535) and retention in care at months 3 (97.5% vs. 98.0%, p = 0.963) and 6 (94.1% vs. 98.4%, p = 0.148) were comparable for those receiving in‐person and telehealth follow‐up. Six clients and nine providers were interviewed; six themes on service experience and feedback were identified. Conclusions Telehealth follow‐up with ART delivery for SDART clients is a feasible option to differentiate ART initiation services at TRCAC, which led to its incorporation into routine service.
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Affiliation(s)
| | | | | | | | - Pich Seekaew
- Institute of HIV Research and Innovation, Bangkok, Thailand.,Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA
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Comparing HIV Post-Exposure Prophylaxis, Testing, and New Diagnoses in Two Australian Cities with Different Lockdown Measures during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010814. [PMID: 34682556 PMCID: PMC8535787 DOI: 10.3390/ijerph182010814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/04/2021] [Accepted: 10/10/2021] [Indexed: 12/26/2022]
Abstract
Australia introduced a national lockdown on 22 March 2020 in response to the COVID-19 pandemic. Melbourne, but not Sydney, had a second COVID-19 lockdown between July and October 2020. We compared the number of HIV post-exposure prophylaxis (PEP) prescriptions, HIV tests, and new HIV diagnoses during these lockdown periods. The three outcomes in 2020 were compared to 2019 using incidence rate ratio. There was a 37% and 46% reduction in PEP prescriptions in Melbourne and Sydney, respectively, with a larger reduction during lockdown (68% and 57% reductions in Melbourne's first and second lockdown, 60% reduction in Sydney's lockdown). There was a 41% and 32% reduction in HIV tests in Melbourne and Sydney, respectively, with a larger reduction during lockdown (57% and 61% reductions in Melbourne's first and second lockdowns, 58% reduction in Sydney's lockdown). There was a 44% and 47% reduction in new HIV diagnoses in Melbourne and Sydney, respectively, but no significant reductions during lockdown. The reduction in PEP prescriptions, HIV tests, and new HIV diagnoses during the lockdown periods could be due to the reduction in the number of sexual partners during that period. It could also result in more HIV transmission due to substantial reductions in HIV prevention measures during COVID-19 lockdowns.
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44
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Mistler CB, Curley CM, Rosen AO, El-Krab R, Wickersham JA, Copenhaver MM, Khati A, Shrestha R. The Impact of COVID-19 on Access to HIV Prevention Services Among Opioid-Dependent Individuals. J Community Health 2021; 46:960-966. [PMID: 33770334 PMCID: PMC7996112 DOI: 10.1007/s10900-021-00979-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2021] [Indexed: 01/17/2023]
Abstract
The COVID-19 pandemic has necessitated restrictive orders and programmatic changes that may be associated with disruptions in services, including those for opioid-dependent people who inject drugs (PWID). This study aims to assess the impact of COVID-19 pandemic on access to and utilization of various HIV prevention services among PWID with opioid use disorder (OUD). We interviewed 110 PWID enrolled in medication for opioid use disorder (MOUD) treatment (e.g., methadone) between May and October, 2020 to identify if this sample experienced changed in access to the following services due to the COVID-19 pandemic: (a) HIV or sexually transmitted infection (STI) testing, (b) pre-exposure prophylaxis (PrEP) services, (c) HIV counselor or doctor appointments, and (d) clean injection equipment. A majority of the sample reported that COVID-19 had not changed their access to HIV testing or access to STI testing. Almost half of the sample reported that getting an appointment with a doctor decreased due to COVID-19. Participants reported that access to a lab or blood testing, access to injection equipment, and sessions with a case manager or counselor decreased. One-fourth of the 32 participants who were taking PrEP before the onset of COVID-19 reported that they had trouble getting their PrEP prescription due to COVID-19, and some reported that they had difficulty getting the PrEP prescription filled at their pharmacy. Our results indicate that PWID did not experience reduced access to HIV or STI testing, but difficulties in obtaining appointments with HIV counselors or doctors and limited access to PrEP were presented. Innovative strategies are needed to reduce the adverse effects of COVID-19 on HIV prevention among PWID.
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Affiliation(s)
- Colleen B Mistler
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA.
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA.
| | - Christine M Curley
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Aviana O Rosen
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Renee El-Krab
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Jeffrey A Wickersham
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
- Department of Internal Medicine, Section of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA
| | - Michael M Copenhaver
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
- Institute for Collaboration on Health, Intervention, and Policy (InCHIP), University of Connecticut, Storrs, CT, USA
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Kumar N, Janmohamed K, Nyhan K, Forastiere L, Zhang WH, Kågesten A, Uhlich M, Sarpong Frimpong A, Van de Velde S, Francis JM, Erausquin JT, Larrson E, Callander D, Scott J, Minichiello V, Tucker J. Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review. Sex Transm Infect 2021; 97:402-410. [PMID: 33782145 PMCID: PMC8380886 DOI: 10.1136/sextrans-2020-054896] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/20/2021] [Accepted: 02/27/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The COVID-19 pandemic has exposed and exacerbated existing socioeconomic and health disparities, including disparities in sexual health and well-being. While there have been several reviews published on COVID-19 and population health disparities generally-including some with attention to HIV-none has focused on sexual health (ie, STI care, female sexual health, sexual behaviour). We have conducted a scoping review focused on sexual health (excluding reproductive health (RH), intimate partner violence (IPV) and gender-based violence (GBV)) in the COVID-19 era, examining sexual behaviours and sexual health outcomes. METHODS A scoping review, compiling both peer-reviewed and grey literature, focused on sexual health (excluding RH, IPV and GBV) and COVID-19 was conducted on 15 September 2020. Multiple bibliographical databases were searched. Study selection conformed to Joanna Briggs Institute (JBI) Reviewers' Manual 2015 Methodology for JBI Scoping Reviews. We only included English-language original studies. RESULTS We found that men who have sex with men may be moving back toward pre-pandemic levels of sexual activity, and that STI and HIV testing rates seem to have decreased. There was minimal focus on outcomes such as the economic impact on sexual health (excluding RH, IPV and GBV) and STI care, especially STI care of marginalised populations. In terms of population groups, there was limited focus on sex workers or on women, especially women's sexual behaviour and mental health. We noticed limited use of qualitative techniques. Very few studies were in low/middle-income countries (LMICs). CONCLUSIONS Sexual health research is critical during a global infectious disease pandemic and our review of studies suggested notable research gaps. Researchers can focus efforts on LMICs and under-researched topics within sexual health and explore the use of qualitative techniques and interventions where appropriate.
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Affiliation(s)
- Navin Kumar
- Department of Sociology, Yale University, New Haven, Connecticut, USA
| | - Kamila Janmohamed
- Department of Sociology, Yale University, New Haven, Connecticut, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University School of Medicine, New Haven, Connecticut, USA
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Laura Forastiere
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Wei-Hong Zhang
- School of Public Health, Free University of Brussels, Brussels, Belgium
- International Centre for Reproductive Health, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Anna Kågesten
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Sarah Van de Velde
- Department of Sociology, Centre for Population, Family and Health, University of Antwerp, Antwerp, Belgium
| | - Joel M Francis
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Jennifer Toller Erausquin
- Public Health Education, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Elin Larrson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Deton Callander
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - John Scott
- School of Social Justice, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Victor Minichiello
- School of Social Justice, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine and Health, University of New England, Armidale, New South Wales, Australia
| | - Joseph Tucker
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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46
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Reyniers T, Rotsaert A, Thunissen E, Buffel V, Masquillier C, Van Landeghem E, Vanhamel J, Nöstlinger C, Wouters E, Laga M, Vuylsteke B. Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey. Sex Transm Infect 2021; 97:414-419. [PMID: 33172917 PMCID: PMC7656903 DOI: 10.1136/sextrans-2020-054756] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/05/2020] [Accepted: 10/17/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To examine changes in the occurrence of physical sex with non-steady partners among men who have sex with men (MSM) in Belgium during the first weeks of the COVID-19 lockdown and associations with sociodemographic factors, sexual practices, drug, alcohol and pre-exposure prophylaxis (PrEP) use. A secondary objective was to explore changes in PrEP use and the need for PrEP follow-up. METHODS A cross-sectional online survey. The questionnaire was available in Dutch, French and English, between April 10 and 27 (2020), and disseminated via sexual health and lesbian, gay, bisexual, trans, queer or intersex organisations throughout Belgium. Eligibility criteria included being 18 years or older, not being exclusively heterosexual and living or being born in Belgium. RESULTS The sample included 694 MSM. Physical sex with non-steady partners decreased from 59.1% to 8.9% during the first weeks of the lockdown. Those who had sex with non-steady partners were significantly more likely to be HIV positive, to use PrEP or to have engaged in sexual practices such as group sex, chemsex and sex work before the lockdown, compared with their counterparts. Among those who used PrEP before the lockdown, 47.0% stopped using PrEP, 19.7% used event-driven PrEP and 33.3% used daily PrEP during the lockdown. Almost two-thirds of PrEP users had a PrEP care appointment in the weeks before the lockdown and a minority received follow-up elsewhere or online. Some PrEP users had concerns regarding their follow-up. CONCLUSIONS MSM in our survey substantially reduced sexual contact with non-steady partners during the first weeks of the COVID-19 lockdown, suggesting that the risk for HIV and STI transmission in this period was low. We recommend ensuring access to sexual health services, such as HIV testing and follow-up for PrEP for the small group having multiple sex partners and engaging in sexual practices such as chemsex, or group sex, even in times of a pandemic threat.
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Affiliation(s)
- Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Anke Rotsaert
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | | | - Veerle Buffel
- Department of Sociology, University of Antwerp, Antwerpen, Belgium
| | | | - Ella Van Landeghem
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Jef Vanhamel
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | | | - Edwin Wouters
- Department of Sociology, University of Antwerp, Antwerpen, Belgium
| | - Marie Laga
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
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47
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Tsuboi M, Evans J, Davies EP, Rowley J, Korenromp EL, Clayton T, Taylor MM, Mabey D, Chico RM. Prevalence of syphilis among men who have sex with men: a global systematic review and meta-analysis from 2000-20. LANCET GLOBAL HEALTH 2021; 9:e1110-e1118. [PMID: 34246332 PMCID: PMC9150735 DOI: 10.1016/s2214-109x(21)00221-7] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 04/11/2021] [Accepted: 04/26/2021] [Indexed: 01/20/2023]
Abstract
BACKGROUND The WHO Global Health Sector Strategy aims to reduce worldwide syphilis incidence by 90% between 2018 and 2030. If this goal is to be achieved, interventions that target high-burden groups, including men who have sex with men (MSM), will be required. However, there are no global prevalence estimates of syphilis among MSM to serve as a baseline for monitoring or modelling disease burden. We aimed to assess the global prevalence of syphilis among MSM using the available literature. METHODS In this global systematic review and meta-analysis, we searched MEDLINE, Embase, LILACS, and AIM databases, and Integrated Bio-Behavioral Surveillance (IBBS) reports between April 23, 2019, and Feb 1, 2020, to identify studies done between Jan 1, 2000, and Feb 1, 2020, with syphilis point prevalence data measured by biological assay among MSM (defined as people who were assigned as male at birth and had oral or anal sex with at least one other man in their lifetime). Studies were excluded if participants were exclusively HIV-infected MSM, injection-drug users, only seeking care for sexually transmitted infections (STIs) or genital symptoms, or routine STI clinic attendees. Data were extracted onto standardised forms and cross-checked for accuracy and validity. We used random-effects models to generate pooled prevalence estimates across the eight regions of the Sustainable Development Goals. We calculated risk of study bias based on the Appraisal tool for Cross-Sectional Studies, and stratified results based on low versus high risk of bias. This systematic review and meta-analysis was registered with PROSPERO, CRD42019144594. FINDINGS We reviewed 4339 records, 228 IBBS reports, and ten articles from other sources. Of these, 1301 duplicate records were excluded, 2467 records were excluded after title and abstract screening, and 534 articles were excluded after full-text analysis. We identified 345 prevalence data points from 275 studies across 77 countries, with a total of 606 232 participants. Global pooled prevalence from 2000-20 was 7·5% (95% CI 7·0-8·0%), ranging from 1·9% (1·0-3·1%) in Australia and New Zealand to 10·6% (8·5-12·9%) in Latin America and the Caribbean. INTERPRETATION Unacceptably high syphilis prevalence among MSM warrants urgent action. FUNDING Wellcome Trust.
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Affiliation(s)
- Motoyuki Tsuboi
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Jayne Evans
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Ella P Davies
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | - Tim Clayton
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Melanie M Taylor
- Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland; Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA, USA
| | - David Mabey
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - R Matthew Chico
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
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48
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Silhol R, Geidelberg L, Mitchell KM, Mishra S, Dimitrov D, Bowring A, Béhanzin L, Guédou F, Diabaté S, Schwartz S, Billong SC, Njindam IM, Levitt D, Mukandavire C, Maheu-Giroux M, Rönn MM, Dalal S, Vickerman P, Baral S, Alary M, Boily MC. Assessing the Potential Impact of Disruptions Due to COVID-19 on HIV Among Key and Lower-Risk Populations in the Largest Cities of Cameroon and Benin. J Acquir Immune Defic Syndr 2021; 87:899-911. [PMID: 33657058 PMCID: PMC8191475 DOI: 10.1097/qai.0000000000002663] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The COVID-19 pandemic indirectly impacts HIV epidemiology in Central/West Africa. We estimated the potential impact of COVID-19-related disruptions to HIV prevention/treatment services and sexual partnerships on HIV incidence and HIV-related deaths among key populations including female sex workers (FSW), their clients, men who have sex with men, and overall. SETTING Yaoundé (Cameroon) and Cotonou (Benin). METHODS We used mathematical models of HIV calibrated to city population-specific and risk population-specific demographic/behavioral/epidemic data. We estimated the relative change in 1-year HIV incidence and HIV-related deaths for various disruption scenarios of HIV prevention/treatment services and decreased casual/commercial partnerships, compared with a scenario without COVID-19. RESULTS A 50% reduction in condom use in all partnerships over 6 months would increase 1-year HIV incidence by 39%, 42%, 31%, and 23% among men who have sex with men, FSW, clients, and overall in Yaoundé, respectively, and 69%, 49%, and 23% among FSW, clients, and overall, respectively, in Cotonou. Combining a 6-month interruption of ART initiation and 50% reduction in HIV prevention/treatment use would increase HIV incidence by 50% and HIV-related deaths by 20%. This increase in HIV infections would be halved by a simultaneous 50% reduction in casual and commercial partnerships. CONCLUSIONS Reductions in condom use after COVID-19 would increase infections among key populations disproportionately, particularly FSW in Cotonou, who need uninterrupted condom provision. Disruptions in HIV prevention/treatment services have the biggest impacts on HIV infections and deaths overall, only partially mitigated by equal reductions in casual/commercial sexual partnerships. Maintaining ART provision must be prioritized to minimize short-term excess HIV-related deaths.
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Affiliation(s)
- Romain Silhol
- MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom
| | - Lily Geidelberg
- MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom
| | - Kate M. Mitchell
- MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom
| | - Sharmistha Mishra
- Department of Medicine, Division of Infectious Disease, University of Toronto, Toronto, Ontario, Canada
| | | | - Anna Bowring
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Luc Béhanzin
- National School of Public Health and Epidemiological Surveillance workers, Parakou University, Bénin
| | - Fernand Guédou
- Free STI clinic, Cotonou Communal Health Center, Cotonou, Bénin
| | - Souleymane Diabaté
- Population Health and Optimal Health Practices, Québec University Hospital Research Center, Laval University, Québec, Quebec, Canada
| | - Sheree Schwartz
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Serge C. Billong
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - Daniel Levitt
- HIV/AIDS Heath Equity and Rights, CARE USA, New York, NY
| | - Christinah Mukandavire
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mathieu Maheu-Giroux
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, Quebec, Canada
| | - Minttu M. Rönn
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Shona Dalal
- Department of HIV/AIDS, World Health Organization, Geneva, Switzerland; and
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Michel Alary
- Population Health and Optimal Health Practices, Québec University Hospital Research Center, Laval University, Québec, Quebec, Canada
| | - Marie-Claude Boily
- MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom
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49
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Guaraldi G, Borghi V, Milic J, Carli F, Cuomo G, Menozzi M, Santoro A, Orlando G, Puzzolante C, Meschiari M, Franceschini E, Bedini A, Ferrari F, Gennari W, Sarti M, Mussini C. The Impact of COVID-19 on UNAIDS 90-90-90 Targets: Calls for New HIV Care Models. Open Forum Infect Dis 2021; 8:ofab283. [PMID: 34307725 PMCID: PMC8294683 DOI: 10.1093/ofid/ofab283] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/11/2021] [Indexed: 01/09/2023] Open
Abstract
We compared 90-90-90 targets in 2020, during the coronavirus disease 2019 (COVID-19) pandemic, with the targets across the period 2017-2019 in people with HIV. We observed a significant loss in the 90-90-90 objectives in 2020 when compared with 2017-2019 that might be attributable to the COVID-19 crisis.
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Affiliation(s)
- Giovanni Guaraldi
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy,Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy,Correspondence: Giovanni Guaraldi, MD, Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Largo del Pozzo, 71, 41124 Modena, Italy ()
| | - Vanni Borghi
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Jovana Milic
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Federica Carli
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Gianluca Cuomo
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Marianna Menozzi
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Antonella Santoro
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Gabriella Orlando
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Cinzia Puzzolante
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Marianna Meschiari
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Erica Franceschini
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Andrea Bedini
- Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
| | - Filippo Ferrari
- Clinical Microbiology, Ospedale Civile di Baggiovara-Policilinico di Modena, Modena, Italy
| | - William Gennari
- Clinical Microbiology, Ospedale Civile di Baggiovara-Policilinico di Modena, Modena, Italy
| | - Mario Sarti
- Clinical Microbiology, Ospedale Civile di Baggiovara-Policilinico di Modena, Modena, Italy
| | - Cristina Mussini
- Department of Surgical, Medical, Dental and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy,Department of Infectious Diseases, Azienda Ospedaliero-Universitaria Policlinico of Modena, Modena, Italy
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50
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Lunt A, Llewellyn C, Bayley J, Nadarzynski T. Sexual healthcare professionals' views on the rapid provision of remote services at the beginning of COVID-19 pandemic: A mixed-methods study. Int J STD AIDS 2021; 32:1138-1148. [PMID: 34106016 PMCID: PMC8593338 DOI: 10.1177/09564624211023018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Introduction: The COVID-19 pandemic and social distancing measures forced sexual health services to engage with patients remotely. We aimed to understand perceived barriers and facilitators to the provision of digital sexual health services during the first months of the pandemic. Methods: An online survey and qualitative interviews with UK sexual healthcare professionals recruited online and via snowball sampling were conducted in May–July 2020. Results: Amongst 177 respondents (72% female, 86% White, mean age = 46, SD = 9), most utilised telephone and email as their main communication channels; however, their perceived effectiveness varied (94% and 66%, respectively). Most agreed that staff needed additional training (89%), the available technology was not adequate (66%) and health professionals were hesitant to provide online consultations (46%). They had positive attitudes towards digitalisation, improving service quality and cost-effectiveness but were concerned about exacerbating health inequalities. Discussion: The study identifies a need for clear guidelines and training around the use of digital tools as well as a demand for investment in hardware and software required for the provision of remote services. Future research needs to explore the acceptability, safety and effectiveness of various digital tools to narrow health inequalities in sexual health service users.
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