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1.
Sexually Transmitted Infections ; 98:A33-A34, 2022.
Article in English | EMBASE | ID: covidwho-1956908

ABSTRACT

Introduction COVID-19 restrictions severely impacted in-person sexual health services, an important access point for condoms. We examine whether MSM in the UK had difficulty accessing condoms because of COVID-19 restrictions and associated factors. Methods Data on difficulty accessing condoms since the start of the pandemic (23rd March 2020) were collected as part of a short, online cross-sectional survey of MSM in November/ December 2021, recruited via social media and Grindr. Eligible participants were UK-resident MSM (cis/trans/non-binary person assigned male at birth - AMAB), aged ≥16 years who were sexually active (reported sex with men in the last year). Multivariable logistic regression to adjust for age and numbers of new sex partners was used to examine if and how reporting this outcome varied by key sociodemographic factors. Results Of all participants (N=1039), over 1 in 7 (13.3%;n=138) reported ever having difficulty accessing condoms, of whom, over half (55.8%;n=77) reported difficulty due to the pandemic (7.4% of all participants). Reporting difficulty accessing condoms was significantly higher among: Younger MSM (aged 16-29 years vs. ≥45;12.8% vs. 4.9%;aOR=2.78);trans/non-binary AMAB participants (vs. cisgender males;24.4% vs. 6.6%;aOR=4.86);bisexually-identifying MSM (vs. gay-identifying;11.1% vs. 6.5%;aOR=1.78);and MSM without degree level education (vs. having a degree;9.8% vs. 5.6%;aOR=2.01). Discussion A minority of sexually active MSM reported difficulty accessing condoms because of the pandemic, however, this was more common among those who already experience a disproportionate burden of poor sexual health. Interventions are needed to address these inequalities in accessing this important primary STI/HIV prevention measure. (Table Presented).

2.
Sexually Transmitted Infections ; 98:A7, 2022.
Article in English | EMBASE | ID: covidwho-1956893

ABSTRACT

Introduction We examine changes in sexual behaviour, STI & HIV testing and testing need among MSM in the UK preand post-COVID-19 restrictions. Methods An online survey of 1,309 MSM recruited via social media and Grindr over three weeks in November/December 2021. Questions on sexual behaviour and service use had an approximate three-month lookback period corresponding to a period of no/limited COVID-19 restrictions. Unmet testing need was defined as reporting any new and/or multiple condomless anal sex (CAS) partners without a recent STI/HIV test. MSM recruited through Grindr who were UK-resident, cisgender, aged ≥16 years who reported sex with men in the last year (N=430) were compared to those from a related 2017 survey (N=1914) using multivariable regression to adjust for demographic differences between the samples. Results Compared to the 2017 survey, sexual risk behaviour was higher in the 2021 survey: ≥1 recent new sex partner (71.5% vs. 81.5%, respectively, aOR=1.80);≥2 recent CAS partners (30.1% vs. 48.8%, aOR=2.23). Reporting recent testing for STIs/HIV was also higher in late 2021 (37.3% vs. 42.6%, aOR=1.34;and 48.7% vs. 45.1%, aOR=1.27, respectively). However, there was no significant change in the proportion with unmet need for STIs (41.4% vs. 44.2%) and HIV (34.8% vs. 39.3%). Discussion These large, community surveys of MSM in the UK suggest greater sexual risk behaviour post-restrictions in 2021 compared to 2017. However, while we found no evidence of reduced service accessibility following the removal of most restrictions, there remains considerable unmet STI/HIV testing need among UK MSM. (Table Presented).

3.
Embase; 2021.
Preprint in English | EMBASE | ID: ppcovidwho-330530

ABSTRACT

We investigated anti-spike IgG antibody responses and correlates of protection following second doses of ChAdOx1 or BNT162b2 SARS-CoV-2 vaccines in the UK general population. In 222,493 individuals, we found significant boosting of anti-spike IgG by second doses of both vaccines in all ages and using different dosing intervals, including the 3-week interval for BNT162b2. After second vaccination, BNT162b2 generated higher peak levels than ChAdOX1. Older individuals and males had lower peak levels with BNT162b2 but not ChAdOx1, while declines were similar across ages and sexes with ChAdOX1 or BNT162b2. Prior infection significantly increased antibody peak level and half-life with both vaccines. Anti-spike IgG levels were associated with protection from infection after vaccination and, to an even greater degree, after prior infection. At least 67% protection against infection was estimated to last for 2-3 months after two ChAdOx1 doses and 5-8 months after two BNT162b2 doses in those without prior infection, and 1-2 years for those unvaccinated after natural infection. A third booster dose may be needed, prioritised to ChAdOx1 recipients and those more clinically vulnerable.

5.
Sexually Transmitted Infections ; 97(SUPPL 1):A121-A122, 2021.
Article in English | EMBASE | ID: covidwho-1379650

ABSTRACT

Background The introduction of social distancing in response to the COVID-19 pandemic led to reduced STI/HIV service provision in the UK. We investigated sexual risk behaviours among MSM and unmet need for sexual healthcare during the pandemic. Methods A cross-sectional online survey (N=2,018) fielded via social media and dating apps (23/06-14/07/2020). We examined sexual behaviour and service use since lockdown (23/03/ 2020) and in the three previous months, and 'unmet need for STI testing' since lockdown (any new male partners and/or multiple condomless anal sex (CAS) partners without testing for STIs). We compared behaviours over the past three months between socio-demographically equivalent sub-samples recruited via Grindr into the present survey (N=956) and a 2017 survey (N=1,918). Results In 2020, 36.7% of participants reported new male partners and 17.3% reported multiple CAS partners since lockdown. Comparing time since lockdown vs previous three months, HIV testers were less likely to test at sexual health clinics (22.3% vs 70.2%) and more likely to use free online self-sampling services (64.3% vs 17.1%), and PrEP users were less likely to report PrEP use (21.7% vs 65.7%). Since lockdown, 25.3% of participants had unmet need for STI testing. Unmet need was more likely among Asian vs White participants (aOR=1.76,[1.14-2.72],p=.01);living in Scotland (aOR=2.02,[1.40-2.91],p<.001) or Northern Ireland (aOR=1.93,[1.02-3.63],p=.04) vs England;and living with HIV (aOR=1.83,[1.32-2.53],p<.001). Compared to 2017, the 2020 sub-sample were less likely to report new male partners (46.8% vs 71.1%, p<.001), multiple CAS partners (20.3% vs 30.8%, p<.001) and unmet need (32.8% vs 42.5%, p<.001) in the past three months. Conclusion We found ongoing potential STI/HIV transmission among MSM during the initial UK lockdown, despite a reduction in sexual activity, and potential inequalities in access to sexual healthcare. These findings will support public health planning to mitigate against health risks during and after the COVID-19 response..

7.
Blood ; 136:30-31, 2020.
Article in English | EMBASE | ID: covidwho-1348294

ABSTRACT

Introduction: The treatment landscape for hematologic malignancies is evolving rapidly, and a range of therapeutic options with differing routes of administration is now available. The shifting dynamics of these novel therapies and increasing total treatment costs highlight the importance of value-based healthcare decisions that take patient, payer, and societal perspectives into account. It is therefore increasingly important to consider both direct and indirect costs when evaluating therapeutic options. Reducing healthcare visits for administration of non-oral therapies (injectable and/or mixed therapies) results in indirect cost savings and is of particular relevance during the current coronavirus disease (COVID-19) pandemic where there are distinct challenges with respect to visiting hospital settings. However, the indirect cost savings of utilizing oral versus non-oral treatments have yet to be fully assessed from a patient and societal perspective. The objective of this review was to assess the differences in indirect non-treatment-related costs between oral and non-oral therapies for hematologic malignancies. Methods: A systematic literature review (SLR) was conducted by searching the Embase®, MEDLINE®, EconLit, and Health Technology Assessment/National Health Service economic evaluation (HTA/NHS EED) databases from inception to June 2020. Additionally, literature searches of proceedings from the 2018-2020 American Society of Clinical Oncology (ASCO), American Society of Hematology (ASH), and The Professional Society for Health Economics and Outcomes Research (ISPOR) conferences were performed to capture recent studies not indexed in the main databases. A manual search of the reference list from all included study publications was also performed. Eligibility criteria for study identification were developed using the Population, Intervention, Comparator, and Outcome (PICO) framework. Eligible studies included cost models and observational studies reporting indirect costs from a patient and/or societal perspective for oral versus non-oral therapies. Results: A total of 4,012 records were identified by the searches. Following title/abstract screening, the full text of 25 publications was reviewed, and 5 studies conducted in the USA (n = 3), Italy (n = 1), and Finland (n = 1) were identified as eligible and selected for qualitative evidence synthesis (Table). Although the SLR protocol included all hematologic malignancies, only studies including patients with multiple myeloma (MM) were identified. The indirect costs reported across the selected studies varied and included costs such as loss of productivity, transportation, and patient and/or caregiver time. Among all 5 studies, total indirect costs for patients with MM were lower for oral versus non-oral regimens. In the USA-based studies, indirect costs were USD 70-1,202 per month for oral regimens versus USD 432-1,526 per month for non-oral regimens. In Europe-based studies, indirect cost estimates were EUR 1,800 versus EUR 17,000 per year for oral versus non-oral regimens (Italian study), and EUR 114 versus EUR 358 per 28-day cycle for oral versus non-oral regimens (Finnish study;averages calculated from ranges in Table). Conclusions: This SLR demonstrates a paucity of data on the indirect costs to patients and society of oral versus non-oral therapies for hematologic malignancies. The studies included in this review assessed differing types of indirect costs, including loss of productivity, transportation costs, and patient and/or caregiver time;however, all indicated that the administration of oral regimens is associated with lower indirect costs compared with non-oral regimens. This finding is compelling given the current global health crisis due to COVID-19, where prioritizing the concept of “value” means assessing more complex issues, such as indirect costs that may have a meaningful impact on patients and society. [Formula presented] Disclosures: Fazeli: Evidinno Outcomes Research Inc.: Current Employment. Pushkarna: Evidinno Outcomes Research I c.: Current Employment. Howarth: Evidinno Outcomes Research Inc.: Current Employment. Hux: Evidinno Outcomes Research Inc.: Consultancy. Pourrahmat: Evidinno Outcomes Research Inc.: Current Employment. Chen: Bristol Myers Squibb: Current Employment, Current equity holder in publicly-traded company.

9.
Value in Health ; 24:S114, 2021.
Article in English | EMBASE | ID: covidwho-1284307

ABSTRACT

Objective: R0, the number of cases resulting from one infectious person in a susceptible population, is a common metric in infectious disease research. Newly-developed methods for real-time approximations (Rt) offer promise for monitoring COVID-19 trends using real-world data. The objective was to compare available methods of calculating Rt and understand drivers in variability, using available regional public surveillance data. Methods: Longitudinal public health data describing infections, recoveries, and deaths from New Jersey (NJ), British Columbia (BC), and Ontario were visualized. Two methods for calculating Rt, by Cori et al. (growth in cases) and Contreras et al. (cases, recoveries, deaths), were implemented and compared. The sensitivity of estimated Rt parameter to changes in infection rates, duration of infection, and mortality rates was investigated, and the relationship with public health measures explored visually. Results: Rates of COVID-19 infections per 100,000 residents from May to December ranged from 2,856 (NJ) to 622 (BC), and total cases ranged from 253,696 (NJ) to 31,782 (BC). Using Cori et al. method, Rt estimates ranged from 0.5 to 1.5 across jurisdictions;even with large rises in incidence, estimates remained relatively stable. In contrast, Rt estimates based on Contreras et al. markedly fluctuated. Estimates for BC and Ontario were generally 0.5 to 3, but exceeded 10 for NJ for much of the observation period due to limited reporting of recoveries. Conclusions: Rt estimates for COVID-19, calculated using two recent methods, vary;and each method considers different parameters in its derivation. The Cori et al. method may be better suited to tracking COVID-19 burden in jurisdictions with incomplete recovery data reported;the choice of measure should depend on accuracy and timing of the reporting of required metrics. Accurate estimates and visualizations of Rt will be informative for understanding changing COVID-19 burden and comparing the impact of interventions across jurisdictions.

10.
Environmental Reviews ; 29(2):111-118, 2021.
Article in English | Scopus | ID: covidwho-1280462

ABSTRACT

Public health and safety concerns around the SARS-CoV-2 novel coronavirus and the COVID-19 pandemic have greatly changed human behaviour. Such shifts in behaviours, including travel patterns, consumerism, and energy use, are variously impacting biodiversity during the human-dominated geological epoch known as the Anthropocene. Indeed, the dramatic reduction in human mobility and activity has been termed the “Anthropause”. COVID-19 has highlighted the current environmental and biodiversity crisis and has provided an opportunity to redefine our relationship with nature. Here we share 10 considerations for conservation policy makers to support and rethink the development of impactful and effective policies in light of the COVID-19 pandemic. There are opportunities to leverage societal changes as a result of COVID-19, focus on the need for collaboration and engagement, and address lessons learned through the development of policies (including those related to public health) during the pandemic. The pandemic has had devastating impacts on humanity that should not be understated, but it is also a warning that we need to redefine our relationship with nature and restore biodiversity. The considerations presented here will support the development of robust, evidence-based, and transformative policies for biodiversity conservation in a post-COVID-19 world. © 2021, Canadian Science Publishing. All rights reserved.

11.
Fisheries Research ; 240:105961, 2021.
Article in English | ScienceDirect | ID: covidwho-1179476

ABSTRACT

The COVID-19 pandemic and corresponding public health mitigation strategies have altered many facets of human life. And yet, little is known about how public health measures have impacted complex socio-ecological systems such as recreational fisheries. Using an online snowball survey, we targeted resident anglers in Ontario, Canada, to obtain preliminary insights on how the pandemic has impacted recreational fishing and related activity. We also explored angler perspectives on pandemic-related restrictions and other aspects of fisheries management. Our results point to the value of recreational fisheries for the mental and physical well-being of participants, as well as the value and popularity of outdoor recreation during a pandemic. Although angling effort and fish consumption appeared to decline during the early phases of the pandemic, approximately 21 % of the anglers who responded to our survey self-identified as new entrants who had begun or resumed fishing in that time. Self-reported motivations to fish during the pandemic suggest that free time, importance to mental and physical health, and desires for self-sufficiency caused some anglers to fish more, whereas a lack of free time, poor or uncertain accessibility, and perceived risks caused some anglers to fish less. Respondents also expressed their desires for more clear and consistent communication about COVID-19 fishing restrictions from governments, and viewed angling as a safe pandemic activity. Information on recreational angler behaviours, motivations, and perspectives during the pandemic may prove valuable to fisheries managers and policy makers looking to optimize their strategies for confronting this and other similar crises.

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