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Impact of COVID-19 Response on the HIV Epidemic in Men Who Have Sex With Men in San Francisco County: The Importance of Rapid Return to Normalcy.
Liang, Citina; Suen, Sze-Chuan; Nguyen, Anthony; Moucheraud, Corrina; Hsu, Ling; Holloway, Ian W; Charlebois, Edwin D; Steward, Wayne T.
  • Liang C; Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, LA.
  • Suen SC; Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, LA.
  • Nguyen A; Daniel J. Epstein Department of Industrial and Systems Engineering, University of Southern California Viterbi School of Engineering, LA.
  • Moucheraud C; Department of Health Policy and Management, University of California Los Angeles Fielding School of Public Health, LA.
  • Hsu L; The Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), University of California Los Angeles, Los Angeles, CA.
  • Holloway IW; San Francisco Department of Public Health, HIV Surveillance Unit, San Francisco, CA.
  • Charlebois ED; The Center for HIV Identification, Prevention, and Treatment Services (CHIPTS), University of California Los Angeles, Los Angeles, CA.
  • Steward WT; Department of Social Welfare, Luskin School of Public Affairs, University of California Los Angeles, Los Angeles, CA; and.
J Acquir Immune Defic Syndr ; 92(5): 370-377, 2023 04 15.
Article in English | MEDLINE | ID: covidwho-2222949
ABSTRACT

BACKGROUND:

In response to the COVID-19 pandemic, San Francisco County (SFC) had to shift many nonemergency health care resources to COVID-19, reducing HIV control resources. We sought to quantify COVID-19 effects on HIV burden among men who have sex with men (MSM) as SFC returns to pre-COVID service levels and progresses toward the Ending the HIV Epidemic (EHE) goals.

SETTING:

Microsimulation model of MSM in SFC tracking HIV progression and treatment.

METHODS:

Scenario analysis where services affected by COVID-19 [testing, care engagement, pre-exposure prophylaxis (PrEP) uptake, and retention] return to pre-COVID levels by the end of 2022 or 2025, compared against a counterfactual where COVID-19 changes never occurred. We also examined scenarios where resources are prioritized to reach new patients or retain of existing patients from 2023 to 2025 before all services return to pre-COVID levels.

RESULTS:

The annual number of MSM prescribed PrEP, newly acquired HIV, newly diagnosed, and achieving viral load suppression (VLS) rebound quickly after HIV care returns to pre-COVID levels. However, COVID-19 service disruptions result in measurable reductions in cumulative PrEP use, VLS person-years, incidence, and an increase in deaths over the 2020-2035 period. The burden is statistically significantly larger if these effects end in 2025 instead of 2022. Prioritizing HIV care/prevention initiation over retention results in more person-years of PrEP but less VLS person-years and more deaths, influencing EHE PrEP outcomes.

CONCLUSIONS:

Earlier HIV care return to pre-COVID levels results in lower cumulative HIV burdens. Resource prioritization decisions may differentially affect different EHE goals.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Pre-Exposure Prophylaxis / Sexual and Gender Minorities / COVID-19 Type of study: Experimental Studies / Observational study Limits: Humans / Male Country/Region as subject: North America Language: English Journal: J Acquir Immune Defic Syndr Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2023 Document Type: Article Affiliation country: QAI.0000000000003156

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / Pre-Exposure Prophylaxis / Sexual and Gender Minorities / COVID-19 Type of study: Experimental Studies / Observational study Limits: Humans / Male Country/Region as subject: North America Language: English Journal: J Acquir Immune Defic Syndr Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2023 Document Type: Article Affiliation country: QAI.0000000000003156