Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 9 de 9
Filter
1.
PLoS Med ; 18(11): e1003867, 2021 11.
Article in English | MEDLINE | ID: covidwho-1599642

ABSTRACT

Zibusiso Ndlovu and Tom Ellman discuss the potential value of task sharing in provision of testing for HIV and other infectious diseases.


Subject(s)
Delivery of Health Care , HIV Infections/diagnosis , Health Personnel , Health Services , Point-of-Care Testing , Cost-Benefit Analysis , HIV Infections/economics , Health Planning Guidelines , Health Policy , Health Services/economics , Humans , Point-of-Care Testing/economics
2.
Lancet ; 397(10279): 1127-1138, 2021 03 20.
Article in English | MEDLINE | ID: covidwho-1525996

ABSTRACT

In 2010, the US health insurance system underwent one of its most substantial transformations with the passage of the Affordable Care Act, which increased coverage for millions of people in the USA, including those with and at risk of HIV. Even so, the system of HIV care and prevention services in the USA is a complex patchwork of payers, providers, and financing mechanisms. People with HIV are primarily covered by Medicaid, Medicare, private insurance, or a combination of these; many get care through other programmes, particularly the Ryan White HIV/AIDS Program, which serves as the nation's safety net for people with HIV who remain uninsured or underinsured but offers modest to no support for prevention services. While uninsurance has drastically declined over the past decade, the USA trails other high-income countries in key HIV-specific metrics, including rates of viral suppression. In this paper in the Series, we provide an overview of the coverage and financing landscape for HIV treatment and prevention in the USA, discuss how the Affordable Care Act has changed the domestic health-care system, examine the major programmes that provide coverage and services, and identify remaining challenges.


Subject(s)
Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/economics , HIV Infections/drug therapy , HIV Infections/prevention & control , Insurance Coverage/legislation & jurisprudence , Insurance, Health/legislation & jurisprudence , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Aged , Anti-Retroviral Agents/therapeutic use , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Female , Gender Identity , HIV Infections/economics , HIV Infections/epidemiology , Humans , Incidence , Male , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Medicare/statistics & numerical data , Middle Aged , Patient Protection and Affordable Care Act , Risk Assessment , SARS-CoV-2/genetics , United States/epidemiology
6.
J Neurovirol ; 27(1): 168-170, 2021 02.
Article in English | MEDLINE | ID: covidwho-1009224

ABSTRACT

People living with HIV (PLWH) may be at higher risk for adverse outcomes indirectly associated with the severe acute respiratory syndrome coronavirus (SARS-CoV-2). When comparing responses to questionnaires administered when social distancing and quarantine guidelines were first implemented, we found that PLWH were more likely to have restricted access to medical care, increased financial stress, increased symptoms of anxiety and depression, and increased substance use compared to demographically-similar people without HIV.


Subject(s)
Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , HIV Infections/epidemiology , Pandemics , Stress, Psychological/epidemiology , Substance-Related Disorders/epidemiology , Adult , Aged , Anxiety/economics , Anxiety/psychology , Anxiety/virology , COVID-19/economics , COVID-19/psychology , COVID-19/virology , Comorbidity , Depression/economics , Depression/psychology , Depression/virology , Female , HIV Infections/economics , HIV Infections/psychology , HIV Infections/virology , HIV-1/pathogenicity , Health Services Accessibility/economics , Health Services Accessibility/ethics , Humans , Male , Middle Aged , Missouri/epidemiology , Physical Distancing , Quarantine/economics , Quarantine/psychology , SARS-CoV-2/pathogenicity , Stress, Psychological/economics , Stress, Psychological/virology , Substance-Related Disorders/economics , Substance-Related Disorders/psychology , Substance-Related Disorders/virology , Surveys and Questionnaires
7.
PLoS One ; 15(12): e0244421, 2020.
Article in English | MEDLINE | ID: covidwho-1004463

ABSTRACT

We conducted a rapid, mixed-methods assessment to understand how COVID-19 affected Latinx sexual minority men (LSMM) and transgender women (LTGW). Using a computer-assisted telephone interviewing software, one interviewer called 52 participants (randomly sampled from a larger HIV prevention pilot study aiming to increase HIV knowledge and testing frequency; n = 36 LSMM and n = 16 LTGW) between 04/27/20-05/18/20. We quantified core domains using the Epidemic-Pandemic Impacts Inventory scale and provided important context through open-ended qualitative questions assessing: 1) COVID-19 infection history and experiences with quarantine; 2) Health and healthcare access; 3) Employment and economic impact of COVID-19. Participants reported increases in physical conflict or verbal arguments with a partner (13.5%) or other adult(s) (19.2%) due to stressors associated with the safer-at-home order. Participants also reported increased alcohol consumption (23.1%), problems with sleep (67.3%) and mental health (78.4%). Further, disruptions in access to Pre-Exposure Prophylaxis or PrEP-a daily pill to prevent HIV-occurred (33.3% of 18 participants who reported being on PrEP). Many said they received less medical attention than usual (34.6%), and LTGW reported delays in critical gender-affirming hormones/procedures. Half of the participants lost their jobs (50.0%); many undocumented participants relayed additional financial concerns because they did not qualify for financial assistance. Though no COVID-19 infections were noted, COVID-19 dramatically impacted other aspects of health and overall wellbeing of LSMM and LTGW. Public health responses should address the stressors faced by LSMM and LTGW during the COVID-19 pandemic and the impact on wellbeing.


Subject(s)
COVID-19 , HIV Infections , HIV-1 , Homosexuality, Male , SARS-CoV-2 , Transgender Persons , Adult , COVID-19/economics , COVID-19/epidemiology , Female , HIV Infections/economics , HIV Infections/epidemiology , Humans , Male , Middle Aged
9.
J Public Health Policy ; 41(4): 421-435, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-695134

ABSTRACT

This paper assesses the possibility of using debt relief funds to sustain HIV treatment in sub-Saharan Africa, suppress transmission, and reach global goals to quell the epidemic by 2030. The cost of providing antiretroviral treatment is a huge burden on African countries. Concerns for Africa's capacity to keep pace with global advances are well founded. By analysing levels of 'debt distress', health expenditure per capita, and HIV antiretroviral therapy requirements in sub-Saharan African countries, the need for innovative finance with international cooperation emerges clearly. In addition to the HIV epidemic, African countries may become more vulnerable to disasters and other public health diseases such as malaria, tuberculosis, Ebola and COVID-19, especially without alternatives to current means of financing. Relief from debt service payments could release funds for sub-Saharan African countries to support universal HIV antiretroviral treatment with sustainable results.


Subject(s)
External Debt/statistics & numerical data , HIV Infections/economics , HIV Infections/epidemiology , International Cooperation , Africa South of the Sahara/epidemiology , Anti-Retroviral Agents/economics , Anti-Retroviral Agents/therapeutic use , HIV Infections/drug therapy , Health Expenditures/statistics & numerical data , Humans
SELECTION OF CITATIONS
SEARCH DETAIL