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Wang L, Slaughter F, Nguyen AT, Smith S, Prabhu S, Beima-Sofie K, Wallace S, Crane HM, Simoni JM, Graham SM. Impact of the COVID-19 pandemic on mental health and viral suppression among persons living with HIV in western Washington. AIDS Care 2024; 36:885-898. [PMID: 38623592 DOI: 10.1080/09540121.2024.2341220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
The COVID-19 pandemic and social distancing measures elevated stress levels globally, exacerbating mental health challenges for people with HIV (PWH). We examined the effect of COVID-19-related stress on mental health among PWH in western Washington, exploring whether social support and coping self-efficacy were protective. Data on COVID-19-related stress, mental health, social support, and coping self-efficacy were collected using online surveys during the pandemic. Pre-COVID-19 mental health data were available for a subset of participants and were linked with the survey data. In the total sample (N = 373), COVID-19-stress was associated with elevated depression (PHQ-8, β = 0.21, 95%CI [0.10, 0.32]) and anxiety (GAD-7, β = 0.28, 95%CI [0.17, 0.39]). Among the subset of respondents with pre-pandemic mental health data (N = 103), COVID-19-related stress was associated with elevated PHQ-8 scores (β = 0.35, 95%CI [0.15, 0.56]) and GAD-7 scores (β = 0.35, 95%CI [0.16, 0.54]), adjusted for baseline mental health and other confounders. Coping self-efficacy was negatively associated with GAD-7 scores (β = -0.01, 95%CI [-0.01, 0.00]), while social support was negatively associated with PHQ-8 scores (β = -0.06, 95%CI [-0.12, -0.01]). Viral suppression before and during the pandemic did not differ among participants with available data. While COVID-19-related stress predicted elevated depression and anxiety symptoms among PWH, social support and coping self-efficacy were protective.
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Affiliation(s)
- Liying Wang
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Francis Slaughter
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Anh T Nguyen
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sarah Smith
- Center on Gender Equity and Health (GEH), University of California, San Diego, USA
| | - Sandeep Prabhu
- Department of Medicine, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Kristin Beima-Sofie
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Stephaun Wallace
- Department of Global Health, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Heidi M Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Susan M Graham
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
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Siril H, Gitagno D, Kaaya S, Caputo M, Hirschhorn L, Nyamuhanga T, Mtei R, Festo C, Hawkins C. Generalized and COVID related anxiety as risk factors for health outcomes among adolescents with HIV during COVID-19 in Tanzania. RESEARCH SQUARE 2024:rs.3.rs-3921926. [PMID: 38410463 PMCID: PMC10896391 DOI: 10.21203/rs.3.rs-3921926/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
The COVID-19 pandemic and associated prevention strategies caused widespread interruptions to care and treatment for people living with HIV. Adolescents living with HIV (AWHIV) were particularly vulnerable to poor mental and physical health during COVID-19. We assessed the burden of generalized and COVID-19-related anxiety and associations with adherence to HIV care and treatment and viral load suppression (VLS) among AWHIV during the peak of the COVID-19 pandemic in Tanzania. Methods This cross-sectional study was conducted among AWHIV aged 15-19 years attending 10 clinics in Dar es Salaam from April 2022-February 2023. Study participants completed a self-administered questionnaire including Generalized Anxiety Disorder (GAD), COVID-19-related anxiety, and other psychosocial and physical health and support measures. HIV visit adherence, viral load and sociodemographic data were abstracted from patient health records.Analysis:: Multivariable (MV) quasibinomial and logistic regression models examined associations of Generalized and COVID-19-related anxiety with visit adherence and HIV virologic suppression (HIV VL < 50 copies/mL). Data were analyzed using R software. Results 658 AWHIV (52% male) were included in this analysis. Most (86%) had been on antiretroviral treatment (ART) for at least four years, 55% attended at least 75% of their scheduled clinic visits, and 78% were HIV virologically suppressed. The median GAD and COVID-19-related anxiety scores were 2 (IQR: 0-5, and 26 (IQR: 13-43; respectively. Only 2% scored moderate-severe generalized anxiety (score 10-21). We found no significant associations between COVID-19-related anxiety or GAD and visit adherence. Higher GAD was inversely associated with VLS (adjusted odds ratio (AOR): 0.89 (95% CI 0.81, 0.98)). Female gender and higher quality of physical life were significantly associated with VLS. Conclusion Low levels of generalized and COVID-19 related anxiety were reported among Tanzanian AWHIV. Integrating screening and management of generalized anxiety screening into HIV care for AWHIV could improve VLS among this population.
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Affiliation(s)
- Hellen Siril
- Muhimbili University of Health and Allied Sciences
| | | | - Sylvia Kaaya
- Muhimbili University of Health and Allied Sciences
| | | | | | | | - Rachel Mtei
- Muhimbili University of Health and Allied Sciences
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Ocampo FF, Promsena P, Chan P. Update on Central Nervous System Effects of the Intersection of HIV-1 and SARS-CoV-2. Curr HIV/AIDS Rep 2023; 20:345-356. [PMID: 37950846 DOI: 10.1007/s11904-023-00676-8] [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: 10/18/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE OF REVIEW Research has shown myriad neurologic and mental health manifestations during the acute and subsequent stages of COVID-19 in people with HIV (PWH). This review summarizes the updates on central nervous system (CNS) outcomes following SARS-CoV-2 infection in PWH and highlight the existing knowledge gaps in this area. RECENT FINDINGS Studies leveraging electronic record systems have highlighted the excess risk of developing acute and lingering neurological complications of COVID-19 in PWH compared to people without HIV (PWoH). However, there is a notable scarcity of neuroimaging as well as blood and cerebrospinal fluid (CSF) marker studies that can confirm the potential synergy between these two infections, particularly in PWH receiving suppressive antiretroviral therapy. Considering the unclear potential interaction between SARS-CoV-2 and HIV, clinicians should remain vigilant regarding new-onset or worsening neurological symptoms in PWH following COVID-19, as they could be linked to either infection.
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Affiliation(s)
- Ferron F Ocampo
- SEARCH Research Foundation, Block 28, 926 Tower C Room C114-C115 Soi Chula 7, Wang Mai, Pathum Wan, Bangkok, 10330, Thailand.
| | - Pathariya Promsena
- SEARCH Research Foundation, Block 28, 926 Tower C Room C114-C115 Soi Chula 7, Wang Mai, Pathum Wan, Bangkok, 10330, Thailand
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Pediatric Infectious Diseases and Vaccines, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Phillip Chan
- Department of Neurology, Yale University, New Haven, CT, USA
- Yale Center for Brain and Mind Health, Yale University, New Haven, CT, USA
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Gutiérrez-Velilla E, Barrientos-Casarrubias V, Gómez-Palacio Schjetnan M, Perrusquia-Ortiz LE, Cruz-Maycott R, Alvarado-de la Barrera C, Ávila-Ríos S, Caballero-Suárez NP. Mental health and adherence to antiretroviral therapy among Mexican people living with HIV during the COVID-19 pandemic. AIDS Res Ther 2023; 20:34. [PMID: 37287023 PMCID: PMC10245356 DOI: 10.1186/s12981-023-00532-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). METHODS We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. RESULTS 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p < 0.001). Vulnerable patients were more likely to be women, with low educational level and unemployed (p < 0.001). CONCLUSIONS It is important to address mental health of PLWH during the COVID-19 pandemic, with special attention to the most vulnerable individuals. Future studies are needed to understand the relationship between mental health and ART adherence.
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Affiliation(s)
- Ester Gutiérrez-Velilla
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Vania Barrientos-Casarrubias
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - María Gómez-Palacio Schjetnan
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Lydia E Perrusquia-Ortiz
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Rosa Cruz-Maycott
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Claudia Alvarado-de la Barrera
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México
| | - Nancy Patricia Caballero-Suárez
- Centro de Investigación en Enfermedades Infecciosas (CIENI) del Instituto Nacional de Enfermedades Respiratorias (INER), Calzada de Tlalpan 4502, Belisario Domínguez Secc 16, Tlalpan, 14080, Ciudad de México, México.
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Lea AN, Levine TM, Davy-Mendez T, Leibowitz A, Altschuler A, Flamm J, Hare CB, N Luu M, Silverberg MJ, Satre DD. Mental health and substance use screening in HIV primary care before and during the early COVID-19 pandemic. BMC Health Serv Res 2023; 23:494. [PMID: 37194051 PMCID: PMC10186313 DOI: 10.1186/s12913-023-09477-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/28/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Mental health and substance use disorders disproportionately affect people with HIV (PWH), and may have been exacerbated during COVID-19. The Promoting Access to Care Engagement (PACE) trial was designed to assess the effectiveness of electronic screening for mental health and substance use in HIV primary care and enrolled PWH from October 2018 to July 2020. Our objective here was to compare screening rates and results for PWH before (October 2018 - February 2020) and early in the COVID-19 pandemic (March-July 2020). METHODS Adult (≥ 18 years) PWH from 3 large HIV primary care clinics in a US-based integrated healthcare system were offered electronic screening online or via in-clinic tablet computer every 6 months. Screening completion and results (for depression, suicidal ideation, anxiety, and substance use) were analyzed using logistic regression with generalized estimating equations to estimate prevalence ratios (PR) before and after the start of the regional COVID-19 shelter-in-place orders on March 17, 2020. Models adjusted for demographics (age, sex, race/ethnicity), HIV risk factors (men who have sex with men, injection drug use, heterosexual, other), medical center, and modality of screening completion (online or tablet). We conducted qualitative interviews with providers participating in the intervention to evaluate how the pandemic impacted patient care. RESULTS Of 8,954 eligible visits, 3,904 completed screenings (420 during COVID, 3,484 pre-COVID), with lower overall completion rates during COVID (38% vs. 44%). Patients completing screening during COVID were more likely to be White (63% vs. 55%), male (94% vs. 90%), and MSM (80% vs., 75%). Adjusted PRs comparing COVID and pre-COVID (reference) were 0.70 (95% CI), 0.92 (95% CI), and 0.54 (95% CI) for tobacco use, any substance use, and suicidal ideation, respectively. No significant differences were found by era for depression, anxiety, alcohol, or cannabis use. These results were in contrast to provider-reported impressions of increases in substance use and mental health symptoms. CONCLUSION Findings suggest PWH had modest declines in screening rates early in the COVID-19 pandemic which may have been affected by the shift to telemedicine. There was no evidence that mental health problems and substance use increased for PWH in primary care. TRIAL REGISTRATION NCT03217058 (First registration date: 7/13/2017); https://clinicaltrials.gov/ct2/show/NCT03217058.
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Affiliation(s)
- Alexandra N Lea
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
| | - Tory M Levine
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Thibaut Davy-Mendez
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - Amy Leibowitz
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Andrea Altschuler
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Jason Flamm
- Sacramento Medical Center, Kaiser Permanente Northern California, Sacramento, CA, USA
| | - C Bradley Hare
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA
| | - Mitchell N Luu
- Oakland Medical Center, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Derek D Satre
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
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Chang MH, Moonesinghe R, Truman BI. Health Care Use among Medicare Beneficiaries with HIV and Depression during the COVID-19 Pandemic-United States, 2020. Healthcare (Basel) 2023; 11:healthcare11081126. [PMID: 37107960 PMCID: PMC10137947 DOI: 10.3390/healthcare11081126] [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: 02/15/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Access and use of health care services are essential to health and well-being for people with HIV and HIV-related comorbidities. Health care use during the COVID-19 pandemic among Medicare beneficiaries (MBs) with concurrent HIV and depression has not been investigated. We used 2020 Medicare data to assess the percentage of MBs with claims for HIV and depression who also received hospitalization, outpatient diagnostic services, drug treatment, and outpatient procedures. We assessed person-level association between service receipt and HIV and depression, adjusting for known risk factors. MBs with claims for HIV and depression were more likely than those with neither claim to have claims for short-stay hospitalization, long-stay hospitalization, outpatient diagnostic services, prescription drugs, or outpatient procedures, supplies, and products. Non-White beneficiaries were more likely than White beneficiaries to be hospitalized but were less likely to receive drug treatment, outpatient diagnostic services, or outpatient procedures, supplies, and products during the pandemic. Significant disparities in health care use by race/ethnicity existed among MBs. Policymakers and practitioners can use these findings to implement public health policies and programs that reduce disparities in health care access and optimize use among vulnerable populations during a public health emergency.
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Affiliation(s)
- Man-Huei Chang
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | - Ramal Moonesinghe
- Office of Genomics and Precision Public Health, Centers for Disease Control and Prevention, Atlanta, GA 30345, USA
| | - Benedict I Truman
- National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
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Zabel M, Wilson TW, Sayles H, May PE, Furl R, Bares SH. The Impact of the COVID-19 Pandemic on Mental Health and Substance Use among People with and without HIV. Pathogens 2023; 12:461. [PMID: 36986383 PMCID: PMC10051668 DOI: 10.3390/pathogens12030461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/03/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
People with HIV (PWH) may be particularly vulnerable to the psychological impacts of COVID-19. To assess this, participants were recruited from two established cohorts of PWH and HIV- adults with the available pre-pandemic baseline data and completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Alcohol Use Identification Test (AUDIT), National Institute on Drug Abuse Quick Screen (NIDA-QS), and Pittsburgh Sleep Quality Index (PSQI) at two distinct intra-pandemic time periods. All outcomes were evaluated using generalized linear mixed models. In total, 87 participants completed all the questionnaires; 45 were PWH and 42 were HIV-. The pre-pandemic mean BDI-II, BAI, AUDIT and PSQI scores were higher in the PWH cohort. After the onset of the pandemic, the mean BDI-II, AUDIT and PSQI scores increased within the sample as a whole (p < 0.001, p = 0.029 and p = 0.046, respectively). The intra-pandemic mean BDI-II scores fell slightly for both groups and the AUDIT scores increased slightly for the PWH group and fell slightly for the HIV- group, but not significantly. The intra-pandemic PSQI scores increased sharply for both groups. The percentage of PWH and HIV- participants who moved into a more severe category of depression was identical (18%), but more PWH met the criteria for clinical evaluation. The BAI and NIDA-QS scores did not increase significantly. In conclusion, the measures of mental health symptoms and alcohol use increased in both groups after the onset of the pandemic. Although there were no significant differences in the changes between the groups, the PWH had higher baseline scores and the changes in this group had more clinical impacts.
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Affiliation(s)
- Morgan Zabel
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE 68010, USA
| | - Harlan Sayles
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Pamela E. May
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Renae Furl
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sara H. Bares
- College of Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
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Hong C, Queiroz A, Hoskin J. The impact of the COVID-19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review. J Int AIDS Soc 2023; 26:e26060. [PMID: 36912238 PMCID: PMC10009802 DOI: 10.1002/jia2.26060] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/19/2023] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic and associated measures implemented by authorities have created additional stressors and increased the risk of psychological illnesses among people living with HIV (PLWH). Yet, there is no collective evidence on the mental health status of this population during the global pandemic and associated factors. This scoping review aimed to synthesize the evidence in the current literature related to the mental health outcomes and challenges faced by PLWH during the COVID-19 pandemic, identify the associated factors with psychological distress and summarize various coping strategies to ease these psychological distresses used by this population. METHODS We conducted a scoping review following the PRISMA-ScR guideline and a literature search in four electronic databases in August 2022. Three reviewers independently screened all the search records and extracted the data from studies that met the inclusion criteria. Factors associated with worsened mental health outcomes were synthesized according to the socio-ecological framework. RESULTS Among 1100 research records, 45 articles met the eligibility criteria and were included in the final review and data extraction, most of which were quantitative analyses. PLWH reported high rates of mental health problems during the pandemic. Multi-level factors were associated with increased psychological distress, including substance use, antiretroviral adherence, social support, financial hardship and economic vulnerability during the pandemic. PLWH used social media as a coping strategy to foster social support to deal with growing mental distress. Increased mental health illnesses were associated with increased substance use, it was also found associated with suboptimal medication adherence and antiretroviral therapy (ART) care engagement. DISCUSSION PLWH experienced high rates of mental health illnesses, such as depression during the global COVID-19 pandemic. There is an urgent need to provide comprehensive HIV treatment and mental health services as the pandemic continues to evolve. CONCLUSIONS The review summarized how the mental health of PLWH was affected during the COVID-19 pandemic. Future work in the implementation of effective interventions to promote mental health in this population is needed, not only to ensure their quality of life but also to help them maintain ART adherence and healthcare during more unprecedented times.
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Affiliation(s)
- Chenglin Hong
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, California, USA
| | - Artur Queiroz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois, USA
| | - Jordan Hoskin
- State of California Department of Rehabilitation, Los Angeles, California, USA
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Aliverdi F, Bayat Jozani Z, Ghavidel N, Qorbani M, Mohammadian Khonsari N, Mohamadi F, Mohraz M, Mahmoodi Z. Relationships among COVID-19 phobia, health anxiety, and social relations in women living with HIV in Iran: A path analysis. PLoS One 2022; 17:e0275455. [PMID: 36194595 PMCID: PMC9531807 DOI: 10.1371/journal.pone.0275455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/17/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction The COVID-19 pandemic and its consequences have caused fear and anxiety worldwide and imposed a significant physical and psychological burden on people, especially women living with HIV (WLHIV). However, WLHIV were not studied as well as others during the pandemic. Hence, this study aimed to determine the relationships between COVID-19 phobia, health anxiety, and social relations in WLHIV. Materials and methods This cross-sectional study enrolled 300 WLHIV who had records at the Iranian Research Center for HIV/AIDS of Tehran University of Medical Sciences. Data were collected using sociodemographic questionnaire, the fear of COVID-19 scale, the social relations questionnaire, the socioeconomic status scale and the health anxiety inventory. Path-analysis was used to assess the direct and indirct associations between variables. Results Based on the path analysis, among variables that had significant causal relationships with social relations, socioeconomic status (β = -0.14) showed the greatest negative relationship, and health anxiety (β = 0.11) had the strongest positive relationship on the direct path. On the indirect path, fear of COVID-19 (β = 0.049) displayed the greatest positive relationship. The level of education (β = 0.29) was the only variable showing a significant positive relationship with social relations on both direct and indirect paths. Conclusion Our result showed that increased fear and health anxiety related to a higher social relations score in WLHIV. Hence, due to their vulnerability, these people require more support and education to adhere to health protocols in future pandemics and similar situations.
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Affiliation(s)
- Fatemeh Aliverdi
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Zahra Bayat Jozani
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Ghavidel
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- * E-mail: (MQ); (ZM)
| | | | - Farima Mohamadi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
- * E-mail: (MQ); (ZM)
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Devlin SA, Johnson AK, McNulty MC, Joseph OL, Hall A, Ridgway JP. "Even if I'm undetectable, I just feel like I would die": a qualitative study to understand the psychological and socioeconomic impacts of the COVID-19 pandemic on women living with HIV (WLWH) in Chicago, IL. BMC Womens Health 2022; 22:218. [PMID: 35689277 PMCID: PMC9185710 DOI: 10.1186/s12905-022-01812-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/31/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has affected the health and well-being of people worldwide, yet few studies have qualitatively examined its cumulative effects on ciswomen living with HIV (WLWH). We aimed to explore how the pandemic has impacted WLWH, including challenges related to HIV care, employment, finances, and childcare. We also investigated how HIV status and different psychosocial stressors affected their mental health. METHODS We performed 25 semi-structured qualitative interviews with WLWH regarding the ways in which COVID-19 impacted their social determinants of health and physical well-being during the pandemic. 19 WLWH who received care at the University of Chicago Medicine (UCM) and 6 women who received care at Howard Brown Health, a federally qualified health center (FQHC) in Chicago, were interviewed remotely from June 2020 to April 2021. All interviews were audio recorded and transcribed. Interviews were thematically analyzed for commonalities regarding HIV-specific and general experiences of WLWH during the pandemic. RESULTS The majority of participants reported COVID-19 impacted their HIV care, such as appointment cancellations and difficulties adhering to antiretroviral therapy. In addition to HIV care obstacles, almost all participants described perceived heightened vulnerability to or fear of COVID-19. The pandemic also affected the socioeconomic well-being of participants, with reported financial strains and employment disruptions. Some mothers took on additional childcare responsibilities, such as homeschooling. Increased mental health concerns and negative psychological effects from the social isolation associated with the pandemic were also experienced by most participants. CONCLUSIONS We gained invaluable insight into how WLWH were challenged by and adapted to the COVID-19 pandemic, including its destabilizing effects on their HIV care and mental health. Women described how they undertook additional childcare responsibilities during the pandemic and how their HIV status compounded their concerns (e.g., perceived heightened vulnerability to COVID-19). Strategies to better support WLWH in maintaining their overall health throughout the pandemic include childcare assistance, access to affordable mental health services, support groups, and education from HIV care providers. These findings have significant implications for examining future health crises through the perspective of potential gender inequalities.
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Affiliation(s)
- Samantha A. Devlin
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - Amy K. Johnson
- Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL USA
| | - Moira C. McNulty
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - Olivier L. Joseph
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - André Hall
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
| | - Jessica P. Ridgway
- Department of Medicine, University of Chicago, 5837 S. Maryland Avenue, L-038, Chicago, IL 60637 USA
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11
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Parisi CE, Varma DS, Wang Y, Vaddiparti K, Ibañez GE, Cruz L, Cook RL. Changes in Mental Health Among People with HIV During the COVID-19 Pandemic: Qualitative and Quantitative Perspectives. AIDS Behav 2022; 26:1980-1991. [PMID: 34993668 PMCID: PMC8736305 DOI: 10.1007/s10461-021-03547-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 12/20/2022]
Abstract
People with HIV (PWH) are at risk for adverse mental health outcomes, which could be elevated during the COVID-19 pandemic. This study describes reasons for changes in mental health among PWH during the pandemic. Data come from closed- and open-ended questions about mental health changes from a follow-up to a cohort study on PWH in Florida during part of the COVID-19 pandemic (May 2020-March 2021). Qualitative data were analyzed using thematic analysis. Among the total sample of 227 PWH (mean age 50.0, 49.7% men, 69.2% Black/African American, 14.1% Hispanic/Latino), 30.4% reported worsened mental health, 8.4% reported improved mental health, and 61.2% reported no change. The primary reasons for worsened mental health were concerns about COVID-19, social isolation, and anxiety/stress; reasons for improved mental health included increased focus on individual wellness. Nearly one-third of the sample experienced worsened mental health. These results provide support for increased mental health assessments in HIV treatment settings.
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Affiliation(s)
- Christina E Parisi
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA.
| | - Deepthi S Varma
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Yan Wang
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Krishna Vaddiparti
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Gladys E Ibañez
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Liset Cruz
- Department of Epidemiology, Florida International University, Miami, FL, USA
| | - Robert L Cook
- Department of Epidemiology, University of Florida, 2004 Mowry Road, Gainesville, FL, 32610, USA
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12
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Lee KW, Ang CS, Lim SH, Siau CS, Ong LTD, Ching SM, Ooi PB. Prevalence of mental health conditions among people living with HIV during the COVID-19 pandemic: A rapid systematic review and meta-analysis. HIV Med 2022; 23:990-1001. [PMID: 35304829 PMCID: PMC9111307 DOI: 10.1111/hiv.13299] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/28/2021] [Accepted: 03/01/2022] [Indexed: 12/24/2022]
Abstract
Background The COVID‐19 pandemic has generated many mental health problems worldwide. People living with HIV (henceforth known as PLHIV) bear a higher mental health burden in comparison with the general population. Therefore, their risk of mental health problems may be elevated during the pandemic. Methods We conducted a systematic review and meta‐analysis to assess the prevalence of depression, anxiety, psychological stress, insomnia and loneliness among PLHIV during the COVID‐19 pandemic. Observational studies in four databases published from 1 January 2020 to 30 April 2021 investigating the prevalence of mental health conditions during the COVID‐19 pandemic were searched, and 197 articles were retrieved. After the processes of duplication removal, eligibility screening and full‐text assessment, 10 articles were included in the systematic review and six articles for meta‐analyses. A random‐effects model was applied to derive the pooled prevalence of mental health conditions. The risk of bias was assessed using the STROBE checklist. Results Overall, the pooled prevalence rates of (moderate‐to‐severe) depression and anxiety among PLHIV were 16.9% [95% confidence interval (CI): 3.8%–30.0%] and 23.0% (95% CI: 12.0%–34.0%), respectively. Conclusions More research is needed to investigate the mechanism by which the pandemic affects the mental health of PLHIV. Support and programmes are needed to ameliorate the mental health problems in this marginalized population.
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Affiliation(s)
- Kai Wei Lee
- Department of Pre-Clinical Sciences, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang, Malaysia.,Centre for Research on Communicable Diseases, Universiti Tunku Abdul Rahman, Kajang, Malaysia
| | - Chin Siang Ang
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Sin How Lim
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lai Teik Derek Ong
- Department of Marketing Strategy and Innovation, Sunway University Business School (SUBS), Sunway University, Bandar Sunway, Selangor, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Kajang, Malaysia.,Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia.,Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
| | - Pei Boon Ooi
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
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13
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Coronavirus Disease 2019 Pandemic Associated with Anxiety and Depression among Non-Hispanic Whites with Chronic Conditions in the US. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022; 8:100331. [PMID: 35224528 PMCID: PMC8861147 DOI: 10.1016/j.jadr.2022.100331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/08/2021] [Accepted: 02/14/2022] [Indexed: 01/04/2023] Open
Abstract
Objectives During the coronavirus 2019 (COVID-19) pandemic, increased anxiety and depression were reported, with mixed findings among individuals of different races/ethnicities. This study examines whether anxiety and depression increased during the COVID-19 pandemic compared to the pre-COVD-19 period among different racial/ethnic groups in the US. Methods The Health Information National Trend Surveys 5 (HINTS 5) Cycle 4 data was analyzed. We used the time when the survey was administered as the pre-COVID-19 period (before March 11, 2020, weighted N = 77,501,549) and during the COVID-19 period (on and after March 11, 2020, weighted N = 37,222,019). The Patient Health Questionnaire (PHQ) was used to measure anxiety/depression and further compared before and during COVID-19. Separate multivariable logistic regression analyses were used to determine the association of the COVID-19 pandemic with anxiety/depression after adjusting for age, sex, insurance, income, and education. Result A higher percentage of Non-Hispanic whites (NHW) with chronic conditions reported anxiety (24.3% vs. 11.5%, p = 0.0021) and depression (20.7% vs. 9.3%, p = 0.0034) during COVID-19 than pre-COVID-19. The adjusted odds ratio (AOR) of anxiety and depression for NHWs with chronic conditions during the COVID-19 pandemic was 2.02 (95% confidence interval of 1.10–3.73, p = 0.025) and 2.33 (1.17–4.65, p = 0.018) compared to NHWs who participated in the survey before the COVID-19. Limitations Limited to the NHW US population. PHQ can only be used as the initial screening tool. Conclusion The COVID-19 pandemic was associated with an increased prevalence of anxiety and depression among NHW adults with chronic conditions, but not among people of color.
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14
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Karjadi TH, Maria S, Yunihastuti E, Widhani A, Kurniati N, Imran D. Knowledge, Attitude, Behavior, and Socioeconomic Conditions of People Living with HIV in Indonesia During the COVID-19 Pandemic: A Cross-Sectional Study. HIV AIDS (Auckl) 2021; 13:1045-1054. [PMID: 34938124 PMCID: PMC8685388 DOI: 10.2147/hiv.s333469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/12/2021] [Indexed: 02/04/2023] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Teguh Harjono Karjadi
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Suzy Maria
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
- Correspondence: Suzy Maria Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Jalan Pangeran Diponegoro No. 71, Senen, Central Jakarta, IndonesiaTel +62 21 3141160Fax +62 21 3904546 Email
| | - Evy Yunihastuti
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Alvina Widhani
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Internal Medicine Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Nia Kurniati
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Allergy and Clinical Immunology Division, Pediatric Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
| | - Darma Imran
- Integrated HIV Center, Dr. Cipto Mangunkusumo General Hospital, Central Jakarta, DKI Jakarta, Indonesia
- Infection and Immunology Division, Neurology Department, Faculty of Medicine of Universitas Indonesia, Central Jakarta, DKI Jakarta, Indonesia
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15
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Winwood JJ, Fitzgerald L, Gardiner B, Hannan K, Howard C, Mutch A. Exploring the Social Impacts of the COVID-19 Pandemic on People Living with HIV (PLHIV): A Scoping Review. AIDS Behav 2021; 25:4125-4140. [PMID: 34019203 PMCID: PMC8137806 DOI: 10.1007/s10461-021-03300-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 01/05/2023]
Abstract
Understanding the clinical impact of COVID-19 has been central to emerging research in the HIV field, but in focusing on the biomedical, researchers must not overlook the socially embedded nature of HIV and the potential social impacts of this new pandemic on PLHIV. We conducted a scoping review to explore emerging research examining the social impacts of COVID-19 on PLHIV in OECD countries over the first 12 months of the pandemic. Twenty articles were identified and included for review. Key themes included: impacts on HIV care access/telehealth; stress and mental health; social isolation and loneliness; food insecurity; changes to sexual behaviour; changes to substance use; impacts on income, education and employment; and racial and social inequality. Results from this review can help guide research into areas where it is needed to help minimise the negative social impacts of the COVID-19 pandemic.
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Affiliation(s)
- Jordan J Winwood
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia.
| | - Lisa Fitzgerald
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Bernard Gardiner
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Kate Hannan
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
| | - Chris Howard
- Queensland Positive People (QPP), 21 Manilla St, East Brisbane, QLD, 4169, Australia
| | - Allyson Mutch
- School of Public Health, University of Queensland, 288 Herston Road, Brisbane, QLD, 4006, Australia
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16
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Nitpolprasert C, Anand T, Phanuphak N, Reiss P, Ananworanich J, Peay HL. A qualitative study of the impact of coronavirus disease (COVID-19) on psychological and financial wellbeing and engagement in care among men who have sex with men living with HIV in Thailand. HIV Med 2021; 23:227-236. [PMID: 34634181 PMCID: PMC8653254 DOI: 10.1111/hiv.13190] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 11/30/2022]
Abstract
Objectives The coronavirus disease (COVID‐19) pandemic is an unprecedented event with massive global health and socio‐economic impacts on vulnerable populations, especially people living with HIV. The epidemic has severely affected Thailand’s economy and potentially impacted the financial and psychological wellbeing of Thai HIV‐positive men who have sex with men (MSM). Methods Between 15 June and 10 December 2020, we conducted qualitative interviews with 26 MSM living with HIV in Thailand who participate in an Adam’s Love We Care Study. We intentionally recruited individuals who may have experienced a greater impact of COVID‐19. Interviews explored worry, stigma and stress surrounding COVID‐19, and multiple domains of potential COVID‐19 impact: financial/employment, HIV service delivery and antiretroviral (ART) adherence during the first 10 months of the COVID‐19 pandemic. Results Participants perceived themselves as immunocompromised and susceptible, and feared contracting COVID‐19. Participants worried that contracting COVID‐19 would lead to HIV status disclosure and stigmatization. Participants had considerable worry about job loss as a result of the economic downturn, and some shared challenges associated with relocation and re‐engaging with HIV care. Financial stress and lack of basic necessities caused by job losses were commonly reported. Participants reported optimal ART adherence as a consequence of local HIV service delivery responses, convenient ART refills and Adam’s Love online support interventions. Conclusions Our study highlights that the COVID‐19 pandemic produced high levels of anxiety and concerns about additional stigma among MSM living with HIV. It had a significant negative effect on the daily lives of our participants. These findings indicate a need for the provision of confidential COVID‐19 diagnosis and care, relief programmes, vaccination roll‐out equity, and addressing employment needs of vulnerable populations.
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Affiliation(s)
| | - Tarandeep Anand
- Adam's Love Global Foundation for MSM and Transgender Health (ALGO), Bangkok, Thailand
| | | | - Peter Reiss
- Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Jintanat Ananworanich
- Department of Global Health, Amsterdam University Medical Centers, University of Amsterdam, and Amsterdam Institute for Global Health and Development, Amsterdam, The Netherlands
| | - Holly Landrum Peay
- Center for Newborn Screening, Ethics, and Disability Studies, RTI International, Research Triangle Park, NC, USA
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17
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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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18
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Barbera LK, Kamis KF, Rowan SE, Davis AJ, Shehata S, Carlson JJ, Johnson SC, Erlandson KM. HIV and COVID-19: review of clinical course and outcomes. HIV Res Clin Pract 2021; 22:102-118. [PMID: 34514963 PMCID: PMC8442751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Background:Understanding the relationship between HIV and SARS-CoV-2 has important public health implications.Objective:To summarize current research on COVID-19 among people with HIV (PWH) as published through 15 July 2021.Methods: We conducted a search of PubMed, Scopus, preprint databases (medRxiv, bioRxiv), and the references of publications found using key terms relevant to COVID-19 ('COVID-19' OR 'SARS-CoV-2' OR 'coronavirus') AND to HIV ('HIV' OR 'Human Immunodeficiency Virus' OR 'AIDS' OR 'Acquired Immunodeficiency Syndrome'). We summarized all articles that reported data or opinions on SARS-CoV-2 and HIV coinfection.Conclusions: Although many initial case series and cohort studies found no increased risk for SARS-CoV-2 infection or severe COVID-19 outcomes among PWH, recent studies have signaled an increased risk for severe COVID-19 disease progression even in the setting of well-controlled HIV. Whether this is due to the increased prevalence of comorbidities in PWH and other social determinants of health is unknown. These conflicting findings highlight the continued need for COVID-19 related research among PWH that addresses COVID-19 disease course as well as exacerbation of existing comorbidities already disproportionately represented among PWH.
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Affiliation(s)
| | | | - Sarah E. Rowan
- Denver Public Health, Denver, CO, USA
- Denver Health, Division of Infectious Diseases, Denver, CO, USA
- University of Colorado, Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA
| | | | - Soraya Shehata
- University of Colorado, School of Medicine, Aurora, CO, USA
| | | | - Steven C. Johnson
- University of Colorado, Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA
| | - Kristine M. Erlandson
- University of Colorado, Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA
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19
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Fehr D, Lebouché B, Ruppenthal L, Brownc M, Obasc N, Bourbonnière E, Girouard J, Massicotte A, Jenabian MA, Almomen AA, Frenette C, de Pokomandy A, Cox J, Giannakis A, Cheng M, Kronfli N, Tsoukas C, Zahedi N, Szabo J, Dehghani K, Brouillette MJ, Falutz J, Turner H, Hamel A, Duchesneau C, Lanthier-Brun J, Klein M, Routy JP, Costiniuk CT. Characterization of people living with HIV in a Montreal-based tertiary care center with COVID-19 during the first wave of the pandemic. AIDS Care 2021; 34:663-669. [PMID: 33779425 DOI: 10.1080/09540121.2021.1904500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
People living with HIV (PLWH) often have worse health outcomes compared to HIV-uninfected individuals. We characterized PLWH followed at a tertiary care clinic in Montreal who acquired COVID-19 and described their outcomes during the first wave of the pandemic. A retrospective chart review was performed for PLWH followed at the Chronic Viral Illness Service with a positive COVID-19 nasopharyngeal PCR or symptoms suggestive of COVID-19 between 1 March and 15 June 2020. Data on demographics, socioeconomic status, co-morbidities and severity of COVID-19 and outcomes were extracted. Of 1702 individuals, 32 (1.9%) had a positive COVID-19 test (n = 24) or symptoms suspicious for COVID-19 (n = 3). Median age was 52 years [IQR 40, 62]. Nearly all (97%) earned $34,999 Canadian dollars or less. Eleven (34%) individuals worked in long-term care (LTC) homes while 5 (6%) lived in LTC homes. Median CD4 count was 566 cells/mm3 [347, 726] and six had detectable plasma HIV viral loads. Median duration of HIV was 17 years [7, 22] and 30 individuals had been prescribed antiretroviral therapy. Five persons were asymptomatic. Of symptomatic persons, 21 (12%), 1 (4%) and 3 (12%) individuals had mild, moderate and severe disease, respectively. Three individuals died with COVID-19. In one case, the cause of death was due to COVID-19, whereas in the other two cases, the individuals died with positive COVID-19 test results but the immediate cause of death is unclear. PLWH who tested positive for COVID-19 had low socioeconomic status and had employment or living conditions that put them at high risk. PLWH may be disproportionately impacted by the social determinants of health which predispose them to COVID-19.
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Affiliation(s)
- Derek Fehr
- Department of Psychiatry, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Luciana Ruppenthal
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Department of Nursing, McGill University Health Centre, Montreal, Canada.,Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Melodie Brownc
- Department of Nursing, McGill University Health Centre, Montreal, Canada.,Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Nancy Obasc
- Department of Nursing, McGill University Health Centre, Montreal, Canada.,Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Emilie Bourbonnière
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Department of Nursing, McGill University Health Centre, Montreal, Canada.,Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Josee Girouard
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Angie Massicotte
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Mohammad-Ali Jenabian
- Department of Biological Sciences, Université du Québec à Montréal, Montreal, Canada.,Department of Microbiology & Immunology, McGill University, Montreal, Canada
| | - Abdul-Aziz Almomen
- Department of Medical Microbiology, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Charles Frenette
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Department of Medical Microbiology, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Alexandra de Pokomandy
- Department of Family Medicine, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Joseph Cox
- Department of Family Medicine, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Andreas Giannakis
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Matthew Cheng
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Nadine Kronfli
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Christos Tsoukas
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada.,Department of Microbiology & Immunology, McGill University, Montreal, Canada
| | - Navid Zahedi
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Jason Szabo
- Department of Family Medicine, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Kianoush Dehghani
- Department of Family Medicine, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Marie-Josee Brouillette
- Department of Psychiatry, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Julian Falutz
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Howard Turner
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Alexandra Hamel
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Claire Duchesneau
- Department of Social Work, McGill University Health Centre, Montreal, Canada
| | | | - Marina Klein
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada
| | - Jean-Pierre Routy
- Division of Infectious Diseases/Chronic Viral Illness Service, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada.,Department of Microbiology & Immunology, McGill University, Montreal, Canada.,Division of Hematology, Department of Medicine, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada
| | - Cecilia T Costiniuk
- Department of Family Medicine, McGill University Health Centre, Royal Victoria Hospital: Glen Site, Montreal, Canada.,Infectious Diseases and Immunity in Global Health, Research Institute of McGill University Health Centre, Montreal, Canada.,Department of Microbiology & Immunology, McGill University, Montreal, Canada
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