The association between depression and non-compliance with COVID-19 preventive behaviors in South Korean older adults stratified by sex.

OBJECTIVES: This study evaluated the association between depression and non-compliance with COVID-19 preventive behaviors among community-dwelling South Korean older adults. METHODS: We utilized the 2020 Korean Community Health Survey-a community-based nationwide survey. A score of 10 points or higher on the Patient Health Questionnaire-9 was defined as depression. Non-compliance with COVID-19 preventive behaviors was assessed on the following three behaviors: washing hands, wearing masks, and watching distance. We also included socio-demographic characteristics, health behaviors, and COVID-19-related characteristics as covariates. Multiple logistic regression analyses were performed, and all statistical analyses were stratified by sex. RESULTS: The 70,693 participants included 29,736 men and 40,957 women. Notably, 2.3% of men and 4.2% of women had depression. Non-compliance with washing hands was significantly higher in men than women (1.3% vs. 0.9%), whereas no significant differences were observed in wearing masks and watching distance. The adjusted logistic regression analysis showed that depression was positively associated with non-compliance with washing hands and watching distance in both sexes. The association between depression and non-compliance with wearing masks was significant only in women. CONCLUSIONS: There was an association between depression and non-compliance with COVID-19 preventive behaviors in South Korean older adults. This signifies that health providers need to reduce depression to improve compliance with preventive behaviors in older adults.

Examining Cash Expenditures and Associated HIV-Related Behaviors Using Financial Diaries in Women Employed by Sex Work in Rural Uganda: Findings from the Kyaterekera Study.

BACKGROUND: Women employed by sex work (WESW) have a high risk of human immunodeficiency virus (HIV) infection and experience economic barriers in accessing care. However, few studies have described their financial lives and the relationship between expenditures and HIV-related behaviors. METHODS: This exploratory study used financial diaries to collect expenditure and income data from WESW in Uganda over 6 months. Data were collected as part of a larger trial that tested the efficacy of an HIV prevention intervention method. Descriptive statistics were used to quantify women's income, relative expenditures, and negative cash balances. Bivariate and multivariate logistic regressions were used to examine the odds of sexual risk behavior or use of HIV medications for several cash scenarios. RESULTS: A total of 163 WESW were enrolled; the participants mean age was 32 years old. Sex work was the sole source of employment for most WESW (99%); their average monthly income was $62.32. Food accounted for the highest proportion of spending (44%) followed by sex work (20%) and housing expenditures (11%). WESW spent the least on health care (5%). Expenditures accounted for a large but variable proportion of these women's income (56% to 101%). Most WESW (74%) experienced a negative cash balance. Some also reported high sex work (28%), health care (24%), and education (28%) costs. The prevalence of condomless sex (77%) and sex with drugs/alcohol (70%) was high compared to use of ART/PrEP (Antiretroviral therapy/Pre-exposure prophylaxis) medications (45%). Women's cash expenditures were not statistically significantly associated with HIV-related behaviors. However, the exploratory study observed a consistent null trend of lower odds of condomless sex (adjusted odds ratio (AOR) = 0.70, 95% confidence interval (CI): 0.28-1.70), sex with drugs/alcohol (AOR = 0.93, 95% CI: 0.42-2.05), and use of ART/PrEP (AOR = 0.80, 95% CI: 0.39-1.67) among women who experienced a negative cash balance versus those who did not. Similar trends were observed for other cash scenarios. CONCLUSION: Financial diaries are a feasible tool to assess the economic lives of vulnerable women. Despite having paid work, most WESW encountered a myriad of financial challenges with limited spending on HIV prevention. Financial protections and additional income-generating activities may improve their status. More robust research is needed to understand the potentially complex relationship between income, expenditures, and HIV risk among vulnerable sex workers.

Demographic, structural, and psychological predictors of risk-increasing and mask wearing behaviors among US adults between December 2020-March 2021.

OBJECTIVES: To assess demographic, structural, and psychological predictors of risk-increasing and risk-decreasing behaviors METHODS: This study used data from an online longitudinal, three-wave COVID-19 survey (12/20-03/21) regarding the behaviors, attitudes, and experiences of US Veteran (n = 584) and non-Veteran (n = 346) adults. RESULTS: Inability to get groceries delivered emerged as the strongest predictor of more frequent risk-increasing behavior across all timepoints. Other consistent predictors of more frequent risk-increasing behavior and less frequent mask wearing included less worry about getting COVID-19, disbelief in science, belief in COVID-19 conspiracies, and negative perceptions of the state response. No demographic factor consistently predicted risk-increasing behavior or mask wearing, though different demographic predictors emerged for more frequent risk-increasing behaviors (e.g., lower health literacy) and mask-wearing (e.g., older age and urban residence) at certain timepoints. The most frequently endorsed reasons for having contact with others concerned health-related (food, medical care, and exercise) and social needs (seeing friends/family and boredom). CONCLUSIONS: These findings highlight key individual-level determinants of risk-increasing behaviors and mask wearing which encompass demographic, structural, and psychological factors. PRACTICE IMPLICATIONS: Findings can support public health experts and health communicators promote engagement with risk-reducing behaviors and address key barriers to engaging in these behaviors.

A Cross-Sectional Survey of Different Types of School Bullying before and during COVID-19 in Shantou City, China.

BACKGROUND: Since the end of 2019, the COVID-19 pandemic has had serious wide-ranging effects on academic, occupational and other daily activities. Like other types of institutions, schools are facing unprecedented challenges. Students may face a variety of adverse consequences, including sleep disturbances and school bullying, if they are unable to adjust to the current learning and living environment. This study explored the effects of the COVID-19 pandemic on school bullying. METHODS: A total of 5782 middle school students were enrolled in this multi-stage, cross-sectional study (3071 before and 2711 during the pandemic). The pre-pandemic group had a mean age of 14.9 ± 1.73, the pandemic group of 14.75 ± 1.47. Three models were set up using binary logistic regression to adjust for confounding variables (gender, school type, alcohol consumption, smoking, playing violent video games). RESULTS: All types of bullying victimization and perpetration (physical, verbal, social and property bullying) were more common during the pandemic than before the pandemic. In terms of bullying victimization, property bullying victimization (crude odds ratio [OR]: 2.398, 95% CI: 2.014-2.854, p < 0.001; model 2 adjusted OR: 2.344, 95% CI: 1.966-2.795, p < 0.001; model 3 adjusted OR: 2.818, 95% CI: 2.292-3.464, p < 0.001) increased the most. In terms of bullying perpetration, verbal bullying perpetration (crude OR: 3.007, 95% CI: 2.448-3.693, p <0.001; model 2 adjusted OR: 2.954, 95% CI: 2.399-3.637, p < 0.001; model 3 adjusted OR:3.345, 95% CI: 2.703-4.139, p < 0.001) increased the most. CONCLUSION: This study corroborate the significance of the pandemic on traditional school bullying and suggests that we should further consider other types of bullying and establish and improve the response and prevention mechanisms during public health emergencies such as the COVID-19 pandemic.

Evolution of Risk Behaviors, Sexually Transmitted Infections and PrEP Care Continuum in a Hospital-Based PrEP Program in Barcelona, Spain: A Descriptive Study of the First 2 Years' Experience.

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is effective for HIV prevention, but the PrEP care continuum also involves improving PrEP awareness, uptake, adherence, and retention in care. Users' awareness is often compromised because of vulnerability factors and risk behaviors, such as chemsex practice or specific substance use, which could lead to risk compensation. Correct adherence and retention in care are essential to achieve the full effectiveness of PrEP. This study describes changes in users' risk behaviors and sexually transmitted infections (STIs), as well also PrEP care continuum details. METHODS: This was a descriptive single-center retrospective study including adults at high HIV risk screened between November 2019 and June 2021 in the PrEP program of our hospital. Demographic, behavioral, STI, adherence, and retention in care variables were assessed. Data were collected from medical records and self-report questionnaires. RESULTS: A total of 295 people were included, 94% men and 5% transgender women, with a mean age of 34 years (SD 10) and 10% sex workers. At baseline, 55% disclosed chemsex practice and 3% slamming. During follow-up, condom use for anal intercourse decreased from 41% to 13% (p ≤ 0.0001) and one HIV infection was detected; other risk behaviors and STIs remained stable. Chemsex, group sex, fluid exchange, and condomless anal intercourse were related to STI risk. Adherence was correct in 80% of users, and retention in care was 57%. Discontinuations and loss to follow-up were high, mainly affecting transgender women, sex workers, and people practicing fisting. CONCLUSION: PrEP program implementation in our hospital was adequate, since it allowed, in a population at high HIV risk, overall users' risk behaviors and STIs to remain stable, with only one HIV diagnosis during the follow-up. We should target specific strategies to improve adherence and retention in care, as vulnerable subgroups at higher risk of loss to follow-up are identified.

US Adults Practicing Healthy Lifestyles Before and During COVID-19: Comparative Analysis of National Surveys.

BACKGROUND: Practicing healthy lifestyles can reduce the risk to develop noncommunicable diseases and the related mortality. Studies showed that practicing healthy lifestyles could enhance disease-free life expectancy and preserve bodily functions. However, engagement in healthy lifestyle behavior was suboptimal. OBJECTIVE: This study aimed to define individuals' lifestyle characteristics before and during COVID-19 and determine the factors associated with practicing a healthy lifestyle. This cross-sectional study was conducted using data from the 2019 and 2021 Behavioral Risk Factor Surveillance System surveys. METHODS: US individuals aged ≥18 years were interviewed via phone call. Healthy lifestyles were assessed through corresponding questions regarding the maintenance of optimal body weight, physical activity, daily consumption of at least five portions of fruits and vegetables, current smoking status, and alcohol consumption. Missing data were imputed using a package in the R statistical software. The effects of practicing a healthy lifestyle on cases without missing data and those with imputation were reported. RESULTS: There were 550,607 respondents (272,543 and 278,064 from 2019 and 2021, respectively) included in this analysis. The rates of practicing a healthy lifestyle were 4% (10,955/272,543) and 3.6% (10,139/278,064) in 2019 and 2021, respectively. Although 36.6% (160,629/438,693) of all 2021 respondents had missing data, the results of the logistic regression analysis for cases without missing data and those with imputation were similar. Of the cases with imputation, women (odds ratio [OR] 1.87) residing in urban areas (OR 1.24) with high education levels (OR 1.73) and good or better health status (OR 1.59) were more likely to practice healthier lifestyles than young individuals (OR 0.51-0.67) with a low household income (OR 0.74-0.78) and chronic health conditions (OR 0.48-0.74). CONCLUSIONS: A healthy lifestyle should be strongly promoted at the community level. In particular, factors associated with a low rate of practice of healthy lifestyles should be targeted.

How has the COVID-19 epidemic affected the risk behaviors of people who inject drugs in a city with high harm reduction service coverage in Vietnam? A qualitative investigation.

INTRODUCTION: The COVID-19 outbreak disproportionally affects vulnerable populations including people who inject drugs (PWID). Social distancing and stay-at-home orders might result in a lack of access to medical and social services, poorer mental health, and financial precariousness, and thus, increases in HIV and HCV risk behaviors. This article explores how the HIV/HCV risk behaviors of PWID in Haiphong, a city with high harm reduction service coverage in Vietnam, changed during the early phase of the COVID-19 pandemic, and what shaped such changes, using the risk environment framework. METHOD: We conducted three focus group discussions with peer outreach workers in May 2020 at the very end of the first lockdown, and 30 in-depth interviews with PWID between September and October 2020, after the second wave of infection in Vietnam. Discussions and interviews centered on the impact of the COVID-19 pandemic on their lives, and how their drug use and sexual behaviors changed as a result of the pandemic. RESULTS: The national shutdown of nonessential businesses due to the COVID-19 epidemic caused substantial economic challenges to participants, who mostly were in a precarious financial situation before the start of the epidemic. Unsafe injection is no longer an issue among our sample of PWID in Haiphong thanks to a combination of different factors, including high awareness of injection-related HIV/HCV risk and the availability of methadone treatment. However, group methamphetamine use as a means to cope with the boredom and stress related to COVID-19 was common during the lockdown. Sharing of smoking equipment was a standard practice. Female sex workers, especially those who were active heroin users, suffered most from COVID-related financial pressure and may have engaged in unsafe sex. CONCLUSION: While unsafe drug injection might no longer be an issue, group methamphetamine use and unsafe sex were the two most worrisome HIV/HCV risk behaviors of PWID in Haiphong during the social distancing and lockdown periods. These elevated risks could continue beyond the enforced lockdown periods, given PWID in general, and PWID who are also sex workers in particular, have been disproportionately affected during the global crisis.

Health-Risk Behaviors among Chinese Adults during the COVID-19 Pandemic.

This study analyzed archived data from a previous large-scale survey study on multiple health-risk behaviors among Chinese adults in Hong Kong between 21 June and 31 August 2021. In addition, this study examined participants' perceptions of the risks associated with their behaviors, their attitudes toward adopting healthy behaviors, and the impact of COVID-19 on their health-risk behaviors. A total of 4605 participants who had at least one health-risk behavior were included in the analysis. The results showed that about half of the participants were unaware that non-communicable diseases (NCDs) can be caused by health-risk behaviors such as tobacco use, harmful use of alcohol, physical inactivity, and an unhealthy diet. More than half of the participants did not have regular body checkups or monitor their physical health at home. Many participants paid more attention to their health due to the COVID-19 pandemic, but few made changes to their unhealthy habits or adopted a healthier lifestyle. Of the 704 smokers, 60.9% did not realize that smoking increases the risk of transmitting COVID-19 to others. Only 32.2% and 11.9% smokers had the intention to quit smoking and reduced their cigarette consumption, respectively. Additionally, 13.6% reported that their daily cigarette consumption had increased, and 78.8% changed their smoking behavior during the pandemic. Healthcare professionals must educate the public about the association between health-risk behaviors and NCDs and between COVID-19 and NCDs. The government should formulate a long-term plan to strengthen the primary healthcare system and address the challenges posed by the rising prevalence of NCDs.

Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation.

BACKGROUND: The ongoing COVID-19 pandemic has disproportionately affected structurally vulnerable populations including people who use drugs (PWUD). Increased overdose risk behaviors among PWUD during the pandemic have been documented, with research underscoring the role of influencing factors such as isolation and job loss in these behaviors. Here, we use qualitative methods to examine the impact of the COVID-19 pandemic and pandemic-related response measures on drug use behaviors in a sample of PWUD in Rhode Island. Using a social-ecological framework, we highlight the nested, interactive levels of the pandemic's influence on increased overdose risk behaviors. METHODS: From July to October 2021, semi-structured interviews were conducted with 18 PWUD who self-reported any increase in behaviors associated with overdose risk (e.g., increased use, change in drug type and/or more solitary drug use) relative to before the pandemic. Thematic analysis was conducted using a codebook with salient themes identified from interview guides and those that emerged through close reading of transcribed interviews. Guided by a social-ecological framework, themes were grouped into individual, network, institutional, and policy-level influences of the pandemic on drug use behaviors. RESULTS: Individual-level influences on increased overdose risk behaviors included self-reported anxiety and depression, isolation and loneliness, and boredom. Network-level influences included changes in local drug supply and changes in social network composition specific to housing. At the institutional level, drug use patterns were influenced by reduced access to harm reduction or treatment services. At the policy level, increased overdose risk behaviors were related to financial changes, job loss, and business closures. All participants identified factors influencing overdose risk behaviors that corresponded to several nested social-ecological levels. CONCLUSIONS: Participants identified multi-level influences of the COVID-19 pandemic and pandemic-related response measures on their drug use behavior patterns and overdose risk. These findings suggest that effective harm reduction during large-scale crises, such as the COVID-19 pandemic, must address several levels of influence concurrently.

Association between Cooperative Attitude and High-Risk Behaviors on the Spread of COVID-19 Infection among Medical Students in Japan.

The impact of high-risk behaviors on the spread of COVID-19 infection among young people is an important problem to address. This study analyzed the association between cooperativeness and high-risk behaviors. We conducted a cross-sectional study among fourth-year medical students at Tokyo Medical and Dental University. The students were asked about cooperative attitude in a hypothetical situation of performing a task together with an unfamiliar classmate, who did not cooperate to complete the task previously. The response items were as follows: "cooperate", "don't want to cooperate and do it alone (non-cooperative)", and "don't want to cooperate and let the partner do it alone (punishment)". Eating out and vaccine hesitancy were also treated as high-risk behaviors. Poisson regression was used to investigate the association between cooperative attitude and each high-risk behavior, adjusted for demographics. Of the 98 students, 23 (23.5%), 44 (44.9%), and 31 (31.6%) students chose "noncooperative", "cooperative", and "punishment", respectively. Cooperative-type students exhibited 2.77-fold (PR: 2.77, 95% CI: 1.03-7.46), and punishment-type students exhibited 3.16-fold greater risk of eating or drinking out (PR: 3.16, 95% CI: 1.14-8.75) compared with those of the noncooperative type. Among medical students, the "cooperative" type and "punishment" type comprised the high-risk group for eating out during the pandemic.

Health-Risk Behaviors, COVID-19 Preventive Behaviors, and the Impact of the COVID-19 Pandemic on the Working-Age Population of Bangkok, Thailand.

Although studies have extensively discussed the effects of COVID-19 on global health behaviors, little is known about the extent of COVID-19 preventive behaviors and their negative effects on the working-age population of Bangkok, Thailand. Therefore, this study aimed to examine health-risk behaviors, COVID-19 preventive behaviors, and the impact of the COVID-19 pandemic among the Thai working-age population. An online cross-sectional survey was conducted among working-age adults through a self-administered questionnaire. Data were analyzed with descriptive statistics and stepwise multiple regression. Of the 313 Thai participants (227 females, 72.5%), 84.0% had high levels of health-risk behaviors for preventing COVID-19 infection, most respondents (89.1%) had high levels of knowledge about COVID-19, and most respondents (61.7%) had high levels of overall COVID-19 preventive behaviors. Stepwise multiple regression revealed that health-risk behaviors (ß = 0.445), knowledge of COVID-19 (ß = 0.148), gender (ß = 0.145), and age (ß = 0.133) were predictive of COVID-19 preventive behaviors. Additionally, most respondents (48.9%) had moderate overall effects from COVID-19. Based on our findings, these factors must be considered when implementing public policies to improve COVID-19 preventive behaviors among the currently employed working-age population. In addition, appropriate interventions must be established and evaluated for the pandemic's long-term effects.

Impact of COVID-19 on the life of higher-education students in Istanbul: Relationship between social support, health-risk behaviors, and mental/academic well-being

Objective: This study aimed to draw a general picture of the impact of the coronavirus disease 2019 (COVID-19) pandemic on the life of higher-education students in Istanbul, with specific emphasis on the relationship between students' social support systems, health-risk behaviors, and mental/academic well-being. Methods: A total of 2583 higher-education students from different fields of study participated in an online survey gathering information from several domains, including available social networks, support-seeking attitudes, substance use patterns, physical activity levels, academic stress, academic satisfaction, and psychological well-being during the pandemic. Results: Our findings pointed to major changes in students' life circumstances and daily routines during COVID-19, including a significant decrease in contact with friends, overall substance use, and physical activity as well as high levels of depression, academic stress, and academic dissatisfaction. Depressive symptoms were significantly predicted by the loneliness score (OR = 2.08, 95% CI = 1.88-2.29), female gender (OR = 1.65, 95% CI = 1.21-2.24), frequency of binge drinking (OR = 1.4, 95% CI = 1.06-1.86), and level of academic stress (OR = 1.15, 95% CI = 1.1-1.19), whereas the number of people to easily borrow money from was found to be a protective factor against depression (OR = 0.95, 95% CI = 0.92-0.99). Conclusion: Our results highlight the need for higher-education institutions to take the appropriate social and mental health interventions, tailored to fit the specific requirements of the COVID-19-related measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Risky business: A mixed methods study of decision-making regarding COVID-19 risk at a public university in the United States.

Introduction: Until vaccines became available in late 2020, our ability to prevent the spread of COVID-19 within countries depended largely on voluntary adherence to mitigation measures. However, individual decision-making regarding acceptable COVID-19 risk is complex. To better understand decision-making regarding COVID-19 risk, we conducted a qualitative substudy within a larger Berkeley COVID-19 Safe Campus Initiative (BCSCI) during the summer of 2020, and completed a mixed-methods analysis of factors influencing decision-making. Materials and methods: We interviewed 20 participants who tested positive for SARS-CoV-2 and 10 who remained negative, and analyzed quantitative survey data from 3,324 BCSCI participants. The BCSCI study enrolled university-affiliated people living in the local area during summer of 2020, collected data on behaviors and attitudes toward COVID-19, and conducted SARS-CoV-2 testing at baseline and endline. Results: At baseline, 1362 students (57.5%) and 285 non-students (35.1%) said it had been somewhat or very difficult to comply with COVID-19-related mandates. Most-cited reasons were the need to go out for food/essentials, difficulty of being away from family/friends, and loneliness. Eight interviewees explicitly noted they made decisions partially because of others who may be at high risk. We did not find significant differences between the behaviors of students and non-students. Discussion: Despite prevailing attitudes about irresponsibility of college students during the COVID-19 pandemic, students in our study demonstrated a commitment to making rational choices about risk behavior, not unlike non-students around them. Decision-making was driven by perceived susceptibility to severe disease, need for social interaction, and concern about risk to others. A harm reduction public health approach may be beneficial.

Cross-sectional Study of College Students' Depression, Coping Techniques, and Health Risk Behaviors during the Initial Transition to Remote Learning: COVID-19 Pandemic

Objective: COVID-19 has brought many challenges to college campuses. In this cross-sectional study, we assessed depression, coping, and past 30-day health risk behaviors of college students attending a mid-sized liberal arts university in Florida. Methods: We sent a survey link to all undergraduates. The data, which included depression scores (PHQ-9), coping techniques (Brief COPE), health risk behaviors (alcohol and vape use) and demographics were collected approximately 40 days after the university transitioned from face-to-face to online learning during the COVID-19 pandemic. We used descriptive and regression analyses using SPSS to analyze data. Results: A total 45.6% of the respondents (N = 759) self-reported moderate to severe depression (PHQ-9 mean = 9.96, SD = 6.2). Students indicated positive and negative coping strategies. Alcohol and vape use increased with higher depressive symptoms scores (p < 0.01). Seniors had a greater odds of alcohol consumption (p < .01);however, freshmen and juniors had greater odds of vape use. Our data revealed some opportunities for positive behavior change. Conclusion: The online transition did modify students' behaviors. Students who self-reported depressive symptoms were most vulnerable to adopting greater risk behaviors. These students require ongoing monitoring and resources. Colleges should implement rapid assessment of students' depressive status and risk behaviors during volatile times.

Protocol of the Luebeck longitudinal investigation of SARS-CoV-2 infection (ELISA) study - a prospective population-based cohort study.

BACKGROUND: Considering the insufficiently controlled spread of new SARS-CoV-2 variants, partially low vaccination rates, and increased risk of a post-COVID syndrome, well-functioning, targeted intervention measures at local and national levels are urgently needed to contain the SARS-CoV-2 pandemic. Surveillance concepts (cross-sectional, cohorts, clusters) need to be carefully selected to monitor and assess incidence and prevalence at the population level. A critical methodological gap for identifying specific risks/dynamics for SARS-Cov-2 transmission and post-COVID-19-syndrome includes repetitive testing for past or present infection of a defined cohort with simultaneous assessment of symptoms, behavior, risk, and protective factors, as well as quality of life. METHODS: The ELISA-Study is a longitudinal, prospective surveillance study with a cohort approach launched in Luebeck in April 2020. The first part comprised regular PCR testing, antibody measurements, and a recurrent App-based questionnaire for a population-based cohort of 3000 inhabitants of Luebeck. The follow-up study protocol includes self-testing for antibodies and PCR testing for a subset of the participants, focusing on studying immunity after vaccination and/or infection and post-COVID-19 symptoms. DISCUSSION: The ELISA cohort and our follow-up study protocol will enable us to study the effects of a sharp increase of SARS-CoV-2 infections on seroprevalence of Anti-SARS-CoV-2 antibodies, post-COVID-19-symptoms, and possible medical, occupational, and behavioral risk factors. We will be able to monitor the pandemic continuously and discover potential sequelae of an infection long-term. Further examinations can be readily set up on an ad-hoc basis in the future. Our study protocol can be adapted to other regions and settings and is transferable to other infectious diseases. TRIAL REGISTRATION: DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00023418 , Registered on 28 October 2020.

Urban-regional disparities in mental health signals in Australia during the COVID-19 pandemic: a study via Twitter data and machine learning models

This study establishes a novel empirical framework using machine learning techniques to measure the urban-regional disparity of the public's mental health signals in Australia during the pandemic, and to examine the interrelationships amongst mental health, demographic and socioeconomic profiles of neighbourhoods, health risks and healthcare access. Our results show that the public's mental health signals in capital cities were better than those in regional areas. The negative mental health signals in capital cities are associated with a lower level of income, more crowded living space, a lower level of healthcare availability and more difficulties in healthcare access.

Post-lockdown Rebounding High-risk Behaviors and HIV Testing Among MSM in China in the Era of the COVID-19 Pandemic.

BACKGROUND: Lockdown measures for controlling the COVID-19 epidemic were enforced in China between January and May 2020. Previous studies showed a decrease in HIV high- Risk Behaviors (HRBs) and updated testing during the lockdown, but little is known about these behaviors during the post-lockdown period. OBJECTIVE: We conducted quantitative and qualitative assessments of HIV-related behaviors among MSM during the lockdown and post-lockdown periods in Changsha, south-central China. METHODS: Face-to-face structured interviews with open-ended questions were conducted using the TimeLine Follow Back (TLFB) method for collecting retrospective data on frequencies of HRBs and testing. McNemar's Chi-square test and Wilcoxon signed-rank test were used to comparing frequencies of behaviors between lockdown (January-May 2020) and post-lockdown periods (June- October 2020). Content analysis was used to analyze qualitative data on the reasons for rebounding HRBs and testing. RESULTS: Of 159 MSM participants, 64% had at least one HRB during the post-lockdown period. Men had increased condomless sex (from 24% to 35%), multiple partners (23% to 35%), and substance abuse (16% to 27%) between the two study periods due to the negative emotions and increased use of social networks during the lockdown. HIV testing frequency also increased from 37% to 66% due to resuming routine testing services in the community-based organizations and increased HRBs among MSM during post-lockdown. CONCLUSION: After lifting the lockdown measures, MSM had rebounding HRBs and uptake of testing. Effective preventive measures and healthcare services should be available to MSM after the lockdown measures are lifted.

Risk Behaviors, Family Support, and Emotional Health among Adolescents during the COVID-19 Pandemic in Israel.

We investigated the prevalence of risk behaviors among Israeli adolescents (tobacco smoking, alcohol consumption, drug use) during the COVID-19 pandemic. Associations between different risk behaviors were examined and so was whether specific characteristics could predict risk behaviors in adolescents. The study consisted of 1020 Israeli adolescents aged 15-18. Study subjects completed an online survey between the first and second lockdowns in Israel (April 2020 to September 2020). Participants reported the frequency at which they engaged in four different risky behaviors: general risky behavior, tobacco smoking, alcohol consumption (binge drinking), and cannabis use. The most prevalent risky behavior in the sample was binge drinking (33.8%). The four measured risky behaviors were significantly correlated. Among participants who had previously engaged in a risky behavior assessed, most did not change the behavior frequency during the pandemic. All independent variables (sociodemographic characteristics, family support, and emotional, health excluding friends' support, physical activity volume, and coronavirus restrictions) were significantly different between participants engaging vs. not engaging in risky behaviors. Our findings suggest that family support is one of the most influential factors in preventing risky behavior during the pandemic, and they emphasize the importance of family-based interventions with children and adolescents from elementary to high school.

The Impacts of the COVID-19 Pandemic on HIV Testing Utilization Among Men Who Have Sex With Men in China: Cross-sectional Online Survey.

BACKGROUND: The COVID-19 pandemic has created disruptions in HIV prevention and sexual health services for men who have sex with men (MSM). OBJECTIVE: This study compared HIV testing utilization in 3 different reference periods (period 1: before the COVID-19 outbreak, November 2019-January 2020; period 2: after the outbreak, February-April 2020; and period 3: after the pandemic was under initial control, May-July 2020). Factors associated with HIV testing utilization after the COVID-19 outbreak (combined periods 2 and 3) were also investigated. METHODS: Participants were MSM aged ≥18 years living in Shenzhen, China. Those self-reporting as HIV positive were excluded. A total of 595 participants recruited through multiple sources completed a self-administered online survey during August-September 2020. HIV testing utilization after the COVID-19 outbreak was the dependent variable, and multivariate logistic regression models were fitted. RESULTS: HIV testing utilization was significantly lower in period 2 than in period 1 (n=262 vs 363, 44.0% vs 61.0%, P<.001). However, HIV testing utilization was not significantly higher in period 3 than in period 2 (n=277 vs 262, 46.6% vs 44.0%, P=.21). The prevalence of HIV testing utilization after the COVID-19 outbreak was seen in 331 (55.6%) participants. After adjusting for significant background characteristics, condomless anal intercourse (CAI) with regular male sex partners (RPs; adjusted odds ratio [AOR] 2.15, 95% CI 1.29-3.57) and sexualized drug use (SDU; AOR 2.94, 95% CI 1.41-6.06) both before and after the COVID-19 outbreak, CAI with RPs (AOR 2.07, 95% CI 1.06-4.07) and nonregular male sex partners (NRPs; AOR 3.57, 95%CI: 1.43-8.89) only after the COVID-19 outbreak was positively associated with the dependent variable. Regarding HIV prevention service utilization, HIV testing utilization before the COVID-19 outbreak (AOR 10.75, 95% CI 7.22-16.02) and the use of sexually transmitted infection (STI) testing (AOR 7.02, 95% CI 4.10-12.02), other HIV/STI prevention (AOR 3.15, 95% CI 2.16-4.60), and preexposure prophylaxis (PrEP; AOR 3.58, 95% CI 1.54-8.34) after the COVID-19 outbreak were associated with higher HIV testing utilization. The current perceived risk of HIV infection was higher than that before the COVID-19 outbreak (AOR 1.15, 95% CI 1.01-1.30), and perceived COVID-19 preventive measures taken by HIV testing service providers to be effective (AOR 1.52, 95% CI 1.29-1.78) and perceived higher behavioral control to undergo HIV testing (AOR 1.18, 95% CI 1.00-1.40) were positively associated with HIV testing utilization. Concerns about COVID-19 infection during HIV testing (AOR 0.78, 95% CI 0.68-0.89), avoiding crowded places (AOR 0.68, 95% CI 0.48-0.98), and HIV testing service providers reducing their working hours (AOR 0.59, 95% CI 0.48-0.98) were negatively associated with the dependent variable. CONCLUSIONS: HIV testing utilization among Chinese MSM declined after the COVID-19 outbreak and did not increase after the pandemic was under initial control. Removing structural barriers to accessing HIV testing caused by COVID-19, modifying perceptions related to HIV testing, and making use of HIV self-testing (HIVST) might be useful strategies to improve HIV testing among MSM during the pandemic.

COVID-19 vaccination, Peltzman Effect and possible increase in high-risk behaviors: a growing concern on risk compensation and reduced compliance to Public Health protective Measures after vaccines rollout.

World is still struggling with widespread dissemination and many unanswered questions about Coronavirus disease-19(COVID-19). Global efforts introduced several candidate vaccines against causing COVID-19, mostly requires require 2 doses of injections and some with about 90-95% efficacy. All strategies against the spread of infection are placed on breaking the chain of virus transmission though protective public health measures and mass vaccination, as yet. The current situation emphasis on the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory states that a drop in perceived risk caused by access to prevention measures may lead to an increase in risky behaviors. The current pandemic has faced people to the sense of risk compensation and behavior change in response to a perceived risk level. Risk compensation phenomenon may significantly defeat the benefits of COVID-19 vaccination, especially if the vaccine is not very effective in real life or in high-risk populations. Acknowledging and be conscious of Peltzman risk compensation has crucial importance in counteracting and neutralizing the false complacency of community also lend more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important that as efforts made to encourage mass vaccination of population other NPIs needs to be re-established and implemented to ensuring strike the balance of learning to live with COVID-19 in parallel with daily activities and job tasks.