Alcohol Misuse Among Youth Living With and at High Risk for Acquiring HIV During the COVID-19 Stay-at-Home Orders: A Study in Los Angeles and New Orleans.

BACKGROUND: To slow the spread of the COVID-19 virus, governments across the globe instituted stay-at-home orders leading to increased stress and social isolation. Not surprisingly, alcohol sales increased during this period. While most studies primarily focused on alcohol consumption among college students or adults, this study investigates alcohol misuse among marginalized youth in the USA. We examined risk factors associated with hazardous alcohol use and binge drinking including risk behaviors, life stressors and demographic characteristics. METHODS: In October 2020, youth living with or at high risk for acquiring human immunodeficiency virus (HIV), participating in community-based research to improve HIV prevention and care, were invited to complete an online survey to assess the impact of the stay-at-home orders on multiple aspects of their daily life. RESULTS: Respondents (n = 478) were on average 23 years old; cisgender (84%), not-heterosexual (86.6%), Latino or Black/African American (73%) and assigned male at birth (83%); 52% reported being employed and 14% reported living with HIV. White participants and those who use drugs had higher odds of hazardous alcohol use and binge drinking, compared with other race categories and non-drug users, respectively. CONCLUSION: Contrary to findings from adult studies, we did not observe an increase in hazardous or binge drinking among youth at risk for HIV. Hazardous alcohol use and binge drinking was more likely among White participants, those who use drugs and those who were hazardous/binge drinkers prior to the COVID-19 lockdown, which points to the importance of identifying and treating youth who misuse alcohol early to prevent future alcohol misuse.

Student, Staff, and Faculty Perspectives on Intimate Partner and Sexual Violence on 3 Public University Campuses: Protocol for the UC Speaks Up Study and Preliminary Results.

BACKGROUND: Intimate partner and sexual violence are pervasive public health issues on college and university campuses in the United States. Research is recommended for creating and maintaining effective, relevant, and acceptable prevention programs and response services for student survivors. OBJECTIVE: The University of California (UC) Speaks Up study aims to examine factors contributing to intimate partner and sexual violence on 3 UC campuses and use the findings to develop and test interventions and policies to prevent violence, promote health, and lay the groundwork for subsequent large-scale quantitative research. METHODS: A mixed methods study was conducted at UC Los Angeles, UC San Diego, and UC Santa Barbara. Phase I (2017-2020) involved a resource audit; cultural consensus modeling of students' perceptions of sexual consent; in-depth interviews (IDIs) and focus group discussions with students to understand perceptions of campus environment related to experiences as well as prevention of and responses to violence; and IDIs with faculty, staff, and community stakeholders to investigate institutional and community arrangements influencing students' lives and experiences. Phase II (2020-ongoing) involves IDIs with student survivors to assess the use and perceptions of campus and community services. Qualitative content analysis is used to generate substantive codes and subthemes that emerge, using a thematic analysis approach. RESULTS: In January 2019, we conducted 149 free-listing interviews and 214 web-based surveys with undergraduate and graduate and professional students for the cultural consensus modeling. Between February 2019 and June 2019, 179 IDIs were conducted with 86 (48%) undergraduate students, 21 (11.7%) graduate and professional students, 34 (19%) staff members, 27 (15.1%) faculty members, and 11 (6.1%) community stakeholders, and 35 focus group discussions (27/35, 77% with undergraduate students and 8/35, 23% with graduate and professional students) were conducted with 201 participants. Since September 2020, 50% (15/30) of the planned student survivor interviews have been conducted. This segment of data collection was disrupted by the COVID-19 pandemic. Recruitment is ongoing. CONCLUSIONS: Data analysis and phase II data collection are ongoing. The findings will be used to develop and test interventions for preventing violence, promoting health and well-being, and ensuring that survivor services are relevant and acceptable to and meet the needs of all individuals in the campus community, including those who are typically understudied. The findings will also be used to prepare for rigorous, UC-system-wide public health prevention research. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/31189.

Vaccine Attitudes and COVID-19 Vaccine Intentions and Prevention Behaviors among Young People At-Risk for and Living with HIV in Los Angeles and New Orleans.

Sexual and gender minority (SGM) and racial or ethnic minority youth at-risk for or living with HIV may have higher risk of SARS-CoV-2 infection. However, there are few data on vaccine hesitancy/acceptance and COVID-19 self-protective behaviors among this population. Youth aged 15-24 years (n = 440), predominantly African American and Latine (73%, n = 320) SGM, from Los Angeles and New Orleans reported their vaccine attitudes and COVID-19 and HIV preventive behaviors in October 2020. Latent class analyses categorized individuals into groups based on their vaccine attitudes and preventive behaviors. Relationships between these groups and other factors were analyzed using Fisher's exact tests, ANOVA, and logistic regression. Most youth had accepting vaccine attitudes (70.2%, n = 309), with 20.7% hesitant (n = 91), and 9.1% resistant (n = 40). SGM and African Americans were significantly less accepting than their cis-gender and heterosexual peers. About two-thirds (63.2%, n = 278) of the respondents reported consistent COVID-19 self-protective behaviors. Youth with pro-vaccine attitudes were most consistently self-protective; however, only 54.4% (n= 168/309) intended to take a COVID-19 vaccine. Homelessness history, race, and sexual orientation were associated with vaccine attitudes. Accepting vaccine attitudes and consistent COVID-19 self-protective behaviors were closely related. COVID-19 attitudes/behaviors were not associated with HIV risk and only loosely associated with SARS-CoV-2 vaccine intentions.

Intersection of COVID-19, HIV and exercise: a commentary with home-based exercise recommendations for practice.

The worldwide spread of COVID-19 has led to closures or reduced capacity of non-essential businesses and recreational areas and stay-at-home orders to promote social distancing. Although effective to reduce transmission, these policies may negatively impact exercise behaviors. Exercise is effective at mitigating the risk of developing or exacerbating several of underlining risk factors for a more severe COVID-19 disease course and may be particularly important for people with HIV (PWH). In this commentary, we discuss the intersection of COVID-19 and exercise with a specific focus on people living with HIV. We then provide a pragmatic, home-based exercise routine that can be performed with little to no equipment or supervision. It is important for PWH (and others) to start or maintain at least some level of exercise to reduce the risk of a severe COVID-19 disease course and to improve other health outcomes in this unfamiliar climate.

Adolescents may accurately self-collect pharyngeal and rectal clinical specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae infection.

BACKGROUND: The COVID-19 pandemic illuminated the benefits of telemedicine. Self-collected specimens are a promising alternative to clinician-collected specimens when in-person testing is not feasible. In this study, we assessed the adequacy of self-collected pharyngeal and rectal specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae among individuals undergoing chlamydia and gonorrhea screening. METHODS: We used data from a large cohort study that included male and female adolescents between the ages of 12-24 years. We considered self-collected specimens adequate for clinical use if the human synthase gene (a control target of the assay) was detected in the specimen. RESULTS: In total, 2,458 specimens were included in the analysis. The human synthase gene was detected in 99.2% (2,439/2,458) of all self-collected specimens, 99.5% (1,108/1,114) of the pharyngeal specimens, and 99.0% (1,331/1,344) of the rectal specimens. CONCLUSION: Self-collected pharyngeal and rectal specimens demonstrated a very high proportion of human gene presence, suggesting that self-collection was accurate. A limitation of this study is that the sample adequacy control detects the presence or absence of the human hydroxymethylbilane synthase gene, but it does not indicate the specific anatomic origin of the human hydroxymethylbilane synthase gene. Self-collected specimens may be an appropriate alternative to clinician-collected specimens.