Trends in Pediatric Firearm-Related Encounters during the COVID-19 Pandemic by Age Group, Race/Ethnicity, and Schooling Mode in Tennessee (preprint)

Purpose Increases in pediatric firearm-related injuries during the COVID-19 pandemic may be due to changes in where children and adolescents spent their time. This paper examines changes in the frequency of pediatric firearm-related encounters as a function of schooling mode overall and by race/ethnicity and age group at a large trauma center through 2021. Methods We use data from a large pediatric and adult trauma center in Tennessee from January 2018 to December 2021 (N=211 encounters) and geographically linked schooling mode data. We use Poisson regressions to estimate smoothed monthly pediatric firearm-related encounters as a function of schooling mode overall and stratified by race and age. Results Compared to pre-pandemic, we find a 42% increase in pediatric encounters per month during March 2020 to August 2020, when schools were closed, and a 23% increase in encounters after schools returned to in-person instruction. Effects of schooling mode are heterogeneous by race. Encounters increased among non-Hispanic Black children and adolescents across all periods relative to pre-pandemic. Among non-Hispanic white children and adolescents, encounters increased during the closure period and decreased on return to in-person instruction. Effects of schooling mode are also heterogeneous by age. Relative to pre-pandemic, pediatric firearm-related encounters increased 205% for children aged 5 to 11 and 69% for adolescents aged 12 to 15 during the school closure period. Conclusion COVID-19-related changes to school instruction mode in 2020 and 2021 are associated with changes in the frequency and composition of pediatric firearm-related encounters at a major trauma center in Tennessee.

The COVID-19 Pandemic and Sexual Behavior among Gay and Bisexual Men in the United States (preprint)

After decades of navigating HIV and other sexually transmitted infections, gay and bisexual men are again responding to new and uncertain risks presented by the coronavirus (COVID-19) pandemic by adapting aspects of their sexual behavior. We fielded a survey of LGBTQ Americans’ responses to the COVID-19 pandemic collected from April 10 to May 10, 2020, an important time period during which most states issued stay-at-home orders (April 10 to April 30) and also began implementing phased reopening (May 1 to May 10). In this paper, we limit analyses to a subsample of 728 gay and bisexual men and focus on changes to sexual behavior in response to the pandemic. We find that many gay and bisexual men made significant changes to their sexual behavior and partner selection. Nine out of 10 men in our sample reported having either one sexual partner or no sexual partner in the last 30 days, which, for many, was a substantial decrease compared to just before the pandemic. Men also made changes to the kinds of partners they had and their sexual activities with partners (e.g., more virtual sex), engaged in new strategies to reduce their risks of infection from partners, and expressed high levels of concern about how HIV may affect COVID-19 risk, treatment, and recovery. We expect these changes to be important not only for reducing the impact of the coronavirus pandemic, but also for reducing new sexually transmitted infections. Despite substantial changes in sexual behavior for most men in our sample, we note concerns around the sustainability of sexual behavior change over time and nondisclosure of COVID-19 symptoms to partners.