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1.
Pharmacoepidemiology and Drug Safety ; 31:407-407, 2022.
Article in English | Web of Science | ID: covidwho-2083955
2.
J Acquir Immune Defic Syndr ; 90(5): 567-575, 2022 08 15.
Article in English | MEDLINE | ID: covidwho-2051763

ABSTRACT

OBJECTIVES: This study of people with HIV (PWH) and those without HIV conducted during the COVID-19 pandemic in the United States in 2020 examines the impact of posttraumatic stress disorder (PTSD) on COVID-19 burden, defined as pandemic-related disruptions. METHODS: Data consisted of survey responses on PTSD among participants (N = 2434) enrolled in the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV (WIHS) cohorts. Unadjusted and adjusted regression models were used to examine the association of PTSD with COVID-19 burden (overall and domain-specific burdens). Quasi-Poisson regression models were used to assess associations with the COVID-19 burden score and 2 domain-specific burdens: (1) changes in resources and (2) interruptions in health care. Analyses was adjusted for age, race/ethnicity, HIV serostatus, current smoking status, number of comorbidities, education, and study regions. RESULTS: Study participants were a median age of 58 (interquartile range, 52-65) years. In both bivariate and multivariable models, PTSD severity was associated with greater overall COVID-19 burden. PTSD severity was associated with the number of resource changes and number of interruptions in medical care. These findings were also consistent across cohorts (MACS/WIHS) and across HIV serostatus, suggesting a greater risk for COVID-19 burden with greater PTSD severity, which remained significant after controlling for covariates. CONCLUSIONS: This study builds on emerging literature demonstrating the impact of mental health on the burden and disruption associated with the COVID-19 pandemic, providing context specific to PWH. The ongoing pandemic requires structural and social interventions to decrease disruption to resources and health resource needs among these vulnerable populations.


Subject(s)
COVID-19 , HIV Infections , Stress Disorders, Post-Traumatic , Aged , COVID-19/epidemiology , Cohort Studies , Female , HIV Infections/complications , HIV Infections/epidemiology , HIV Infections/psychology , Humans , Male , Middle Aged , Pandemics , Stress Disorders, Post-Traumatic/complications , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , United States/epidemiology
3.
Wellbeing Space Soc ; 3: 100092, 2022.
Article in English | MEDLINE | ID: covidwho-1937307

ABSTRACT

Introduction: Restrictions and guidelines to limit the spread of COVID-19 caused considerable and rapid changes to individuals' daily routines. This study examines how activity locations changed during the COVID-19 pandemic and associated social distancing restrictions, and whether these changes were associated with depression, anxiety, loneliness, and alcohol use. Methods: A web-based survey was conducted early in the COVID-19 pandemic (May-June 2020) in Allegheny County (Pittsburgh), Pennsylvania. Participants (n = 265) reported visits to activity locations in the last 30 days and retrospectively for February 2020 (pre-pandemic). A principal components analysis was conducted to assess change in utilization of activity locations. Component scores of changes to activity locations were compared by sociodemographics. Poisson and zero-inflated negative binomial models were used to examine the relationship between component scores and pandemic depression symptoms, anxiety symptoms, loneliness, and drinking days. Results: Five distinct principal components of activity location changes were identified. The first component, characterizing broad reductions in activity locations during the early phases of the pandemic, was associated with increased depression and loneliness. Conclusions: Results indicate non-uniform shifts in routine activities during the pandemic and highlight the importance of understanding how changes to the social environment affect individuals' psychological wellbeing and alcohol use.

4.
Value in Health ; 25(1):S255, 2022.
Article in English | EMBASE | ID: covidwho-1650255

ABSTRACT

Objectives: Patients with the coronavirus disease 2019 (COVID-19) have an increased risk of thrombotic and cardiac events. We assessed the incidence and trends in selected thrombotic and cardiac events among hospitalized COVID-19 patients from a large, geographically diverse US electronic health records (EHR) database. Methods: This retrospective study analyzed Optum® de-identified COVID-19 EHR dataset to identify patients hospitalized between 03/01/2020 and 10/31/2020 with a COVID-19 diagnosis code. Patients were members of an integrated delivery network with ≥1 encounter during the 12 months prior to admission. Events of interest, including acute coronary syndrome (ACS), venous thromboembolism (VTE), stroke and myocarditis, were identified by diagnosis codes during hospitalization. Patients with any such events in their 12-month baseline were excluded. A composite event was defined by the occurrence of any of these events. Events were reported as proportions, in total as well as by month of admission and age group. Results: Among 25,574 hospitalized COVID-19 patients, the median age was 60 years (IQR: 44-72), and 54.5% were female. The composite event occurred in 3,052 (11.9%) patients (ACS=6.4%, VTE=4.1%, stroke=2.4%, myocarditis=0.6%) and its incidence increased with age (≤19=4.6%, 20-49=6.2%, 50-59=11.7%, 60-69=13.4%, ≥70=17.3%). In the youngest age group, myocarditis (2.2%) and VTE (1.7%) contributed to the majority of events, while in the oldest, ACS (10.9%), VTE (4.2%) and stroke (4.1%) were observed most often. Patients admitted during March had the highest incidence (20.6%), which decreased to 9.1% by July and remained steady through October (9.6%). The percentage decline in the composite event incidence during the study period was higher in younger versus older patients (≤19=77.0% 20-49=61.9%, 50-59=66.0%, 60-69=58.6%, ≥70=44.1%). Conclusions: The incidence of the composite event was highest among patients hospitalized early in the pandemic. The composite event occurred in almost 5% patients ≤19 years old and this group experienced the largest decline during the study period.

5.
J Acquir Immune Defic Syndr ; 88(5): 426-438, 2021 12 15.
Article in English | MEDLINE | ID: covidwho-1593405

ABSTRACT

OBJECTIVES: This study describes prevention behavior and psychosocial health among people living with HIV (PLHIV) and HIV-negative people during the early wave of the coronavirus disease 2019 (COVID-19) pandemic in the United States. We assessed differences by HIV status and associations between social disruption and psychosocial health. DESIGN: A cross-sectional telephone/videoconference administered survey of 3411 PLHIV and HIV-negative participants in the Multicenter AIDS Cohort Study/WIHS Combined Cohort Study (MWCCS). METHODS: An instrument combining new and validated measures was developed to assess COVID-19 prevention efforts, social disruptions (loss of employment, childcare, health insurance, and financial supports), experiences of abuse, and psychosocial health. Interviews were performed between April and June 2020. Associations between social disruptions and psychosocial health were explored using multivariable logistic regression, adjusting for sociodemographics and HIV status. RESULTS: Almost all (97.4%) participants reported COVID-19 prevention behavior; 40.1% participants reported social disruptions, and 34.3% reported health care appointment disruption. Men living with HIV were more likely than HIV-negative men to experience social disruptions (40.6% vs. 32.9%; P < 0.01), whereas HIV-negative women were more likely than women with HIV to experience social disruptions (51.1% vs. 39.8%, P < 0.001). Participants who experienced ≥2 social disruptions had significantly higher odds of depression symptoms [aOR = 1.32; 95% confidence interval (CI): 1.12 to 1.56], anxiety (aOR = 1.63; 95% CI: 1.17 to 2.27), and social support dissatisfaction (aOR = 1.81; 95% CI: 1.26 to 2.60). CONCLUSIONS: This study builds on emerging literature demonstrating the psychosocial health impact related to the COVID-19 pandemic by providing context specific to PLHIV. The ongoing pandemic requires structural and social interventions to decrease social disruption and address psychosocial health needs among the most vulnerable populations.


Subject(s)
COVID-19/epidemiology , HIV Seronegativity , HIV Seropositivity/epidemiology , HIV Seropositivity/psychology , Mental Health/statistics & numerical data , COVID-19/psychology , Cohort Studies , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , Prevalence , United States/epidemiology
6.
Atlantis-Critical Studies in Gender Culture & Social Justice ; 42(1):47-57, 2021.
Article in English | Web of Science | ID: covidwho-1576584

ABSTRACT

What is the result of bringing unrealistic and overwhelming conditions of motherhood into the context of a global pandemic? This article aims to explore the impacts of maternal expectations and experiences in the context of COVID-19. Through first-person accounts of eighty self-identified mothers parenting through COVID, we aim to explore "good" mother myths, feelings of failure, and the paradoxical freedoms that occur under pandemic time.

7.
Value in Health ; 23:S569-S569, 2020.
Article in English | PMC | ID: covidwho-1386137

ABSTRACT

Objectives: The SARS-CoV-2 pandemic has had unprecedented clinical and economic effects worldwide, with global efforts to develop a protective vaccine. Mass vaccination strategies have been employed to reduce seasonal influenza outbreaks. We identified published economic models assessing influenza vaccination strategies to determine which key economic modeling components could be useful for future models in support of a SARS-CoV-2 vaccine. Methods: Economic models published between January 2009 and June 2020 were identified by searching Medline (through National Library of Medicine’s PubMed) and GoogleScholar. The search strategy combined terminology for influenza vaccines with terminology for economic models (e.g., cost-effectiveness, cost-benefit, cost-consequence, decision trees, Markov). Results: 1,154 records were screened for inclusion;21 publications were included in the analysis. Sixteen identified models employed a Markov cohort or patient-level simulation approach, while 18 models incorporated quality-of-life and 13 incorporated a societal perspective;typical health states included uninfected, incubating, asymptomatic, symptomatic+isolated, symptomatic+circulating, partially immune, and dead. Common clinical outcomes included avoidance of virus cases, hospitalizations, and deaths;economic outcomes included cost savings associated with reduced hospitalizations, increased quality-of-life, and productivity gains. All but 1 model considered transmission rate, vaccination rate, vaccine efficacy, and rate of complications as key model drivers, whereas only 3 models considered vaccination plus broader public health strategies. Only 7 models incorporated herd immunity, citing uncertainty around availability and efficacy. While all models considered age and risk stratifications, no models assessed the implications of vaccination across different racial and ethnic groups. Conclusions: Future economic modeling in support of a SARS-CoV-2 vaccine should incorporate the components of existing model frameworks for influenza vaccination strategies as well as account for differences specific to SAR-CoV-2 including broader public health strategies (e.g., face masks, social distancing) and racial disparities. Without these elements, future models may fail to accurately capture the potential benefits of a SARS-CoV-2 vaccine.

8.
Pharmacoepidemiology and Drug Safety ; 30:366-367, 2021.
Article in English | Web of Science | ID: covidwho-1381689
9.
Harefuah ; 160(5):279-284, 2021.
Article in Hebrew | MEDLINE | ID: covidwho-1239411

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has forced countries worldwide to face major issues and challenges. Among those challenges is breastfeeding from the first hours after birth until late infancy, in hospitals and communities. There is a consensus throughout the world and among leading international professional medical associations that breastfeeding is of significant importance for short- and long-term health outcomes in mothers and infants, as well as for its public health impact and reduction of national health expenditures. Moreover, breastfeeding or human milk feeding have been shown to reduce morbidity, specifically respiratory infections, among infants and children. This is not the first time health systems are dealing with coronavirus outbreaks, although currently, in the COVID-19 pandemic, there is still much that is unknown. Dealing with the unknown can lead to guidelines that may not fully take into consideration relevant risk benefit ratios for individuals and groups. In this review, we aim to summarize the guidelines of different leading professional groups around the world dealing with the COVID-19 pandemic. Evidence-based medicine rests on relevant scientific evidence, patients' values and preferences and clinical judgment. We wish to propose guidelines based on available evidence concerning breastfeeding, the current pandemic and weighing in potential risks and benefits while highlighting the need for ongoing breastfeeding research.

10.
Value in Health ; 23:S569-S569, 2020.
Article in English | Web of Science | ID: covidwho-1097688
11.
American Journal of Public Health ; 111(1):12-14, 2021.
Article in English | ProQuest Central | ID: covidwho-1049405

ABSTRACT

Social stigma inhibits provision and uptake of HIV prevention and care;experiences and anticipation of stigma in health care settings are associated with lower rates of HIV testing, preexposure prophylaxis uptake, retention in care, and antiretroviral therapy adherence. [...]relying solely on biomedical HIV prevention for young Black and Latinx gay and bisexual men and transwomen will not constitute a sufficient response to their needs. In response, local researchers collaborated with local sexual and gender minority youths of color to develop, implement, and evaluate a multilevel HIV-prevention and care intervention.3 The Pennsylvania Department of Health and the state's HIV Planning Group, whose composition has robustly included most-at-risk populations empowered to identify priority populations and recommend resource allocations, supported and promoted the project for statewide scale-up. Emerging research incorporating wraparound clinical harm reduction4 and intersectional stigma reduction5 into biomedical HIV prevention shows promise. Because of their complexity, such interventions are difficult to operationalize, field, and consolidate into cost-per-person metrics;for these reasons, multilevel, social determinants-based interventions are excluded from allocation models provided. The proposed EqEA framework may help achieve Ending the HIV Epidemic endpoints and offers insights for other infectious diseases, such as directing COVID-19 prevention resources to minority communities wherein SARSCoV-2 is exacting a disproportionately lethal toll and federal aid formulas for hospitals have large-scale racial biases.7 Adopting equitable allocation strategies will ensure that resources do not remain woefully misaligned and our systems do not exacerbate the welldefined shortcomings of decades of efforts. >4jPH CORRESPONDENCE Correspondence should be sent to M. Reuel Friedman, PhD, PO Box 7319, Pittsburgh, PA 15213 (e-mail: mrf9@pitt.edu).

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