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Smith S, Beima-Sofie K, Naveed A, Bhatia N, Micheni M, Nguyen AT, Slaughter F, Wang L, Prabhu S, Wallace S, Simoni J, Graham SM. Impact of the COVID-19 Pandemic on Persons Living with HIV in Western Washington: Examining Lived Experiences of Social Distancing Stress, Personal Buffers, and Mental Health. AIDS Behav 2024; 28:1822-1833. [PMID: 38493281 PMCID: PMC11161538 DOI: 10.1007/s10461-024-04273-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 03/18/2024]
Abstract
Pandemic-related stressors may disproportionately affect the mental health of people with HIV (PWH). Stratified, purposive sampling was used to recruit 24 PWH who participated in a quantitative survey on COVID-19 experiences for in-depth interviews (IDIs). IDIs were conducted by Zoom, audio recorded and transcribed. Thematic analysis was used to develop an adapted stress-coping model. Participants experienced acute stress following exposure events and symptoms compatible with COVID-19. Social isolation and job loss were longer-term stressors. While adaptive coping strategies helped promote mental health, participants who experienced multiple stressors simultaneously often felt overwhelmed and engaged in maladaptive coping behaviors. Healthcare providers were important sources of social support and provided continuity in care and referrals to mental health and social services. Understanding how PWH experienced stressors and coped during the COVID-19 pandemic can help healthcare providers connect with patients during future public health emergencies, address mental health needs and support adaptive coping strategies.
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Affiliation(s)
- Sarah Smith
- University of California, San Diego, CA, USA
| | | | | | | | | | | | | | | | - Sandeep Prabhu
- Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA
| | - Stephaun Wallace
- University of Washington, Seattle, WA, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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2
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Mangano KM, Fouhy LE, Zhang X, Noel SE, Rajabiun S, Merrill LC, Falcon LM, Tucker KL. The longitudinal impact of the SARS-CoV-2 pandemic on participants from the Boston Puerto Rican Health Study. AJPM FOCUS 2023; 2:100097. [PMID: 37362396 PMCID: PMC10076072 DOI: 10.1016/j.focus.2023.100097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Objective to investigate the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on older Hispanic adults. Methods A total of 522 participants (or their family member, if deceased) from the Boston Puerto Rican Health Study were asked whether they had been diagnosed with SARS-CoV-2, across 2 survey phases. In phase 1 (May - Aug 2020, n=497), participants answered survey questions related to SARS-CoV-2 exposure, diagnosis, and transmission and 5 family members reported deaths. In phase 2, participants were again surveyed (January - June 2021; n=420, and 2 family members reported deaths). SARS-CoV-2 diagnosis and/or death apparently from SARS-CoV-2 was self-reported. Results In 2020, 5.2% reported that they had been SARS-CoV-2 positive; by June 2021, a cumulative 11.0% reported having been SARS-CoV-2 positive (including cases and deaths in the first survey). A total of 7 participants (1.3%) reportedly died from SARS-CoV-2. Language acculturation was significantly lower among participants with SARS-CoV-2 (13.7 ± 17.9) vs. without SARS-CoV-2 (20.0 ± 21.4; P = 0.049). Mean length of return to usual health was 28 ± 38 days (range: 0-210 days; median = 15 days). Depressive symptomatology was significantly lower during the pandemic (CES-D score: 13.4 ± 11.6) compared to the same participants pre-pandemic (17.8 ± 11.7; P = 0.001). Compared to the months before the pandemic, 32% (n=135) of participants reported greater communication with friends and family, and 41% (n=172) reported no change. Conclusions Public health models should be personalized to communities, considering their unique structures and cultural beliefs. Social resiliency may be key for future programmatic responses to pandemics to reduce the mental health burden.
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Affiliation(s)
- Kelsey M. Mangano
- Department of Biomedical & Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
| | - Liam E. Fouhy
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts
| | - Xiyuan Zhang
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
| | - Sabrina E. Noel
- Department of Biomedical & Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
| | - Serena Rajabiun
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts
| | - Lisa C. Merrill
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts
| | - Luis M. Falcon
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
- College of Fine Arts, Humanities & Social Sciences, University of Massachusetts, Lowell, Massachusetts
| | - Katherine L. Tucker
- Department of Biomedical & Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, Massachusetts
- Center for Population Health, University of Massachusetts, Lowell, Massachusetts
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3
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Beltran RM, Holloway IW, Hong C, Miyashita A, Cordero L, Wu E, Burris K, Frew PM. Social Determinants of Disease: HIV and COVID-19 Experiences. Curr HIV/AIDS Rep 2022; 19:101-112. [PMID: 35107810 PMCID: PMC8808274 DOI: 10.1007/s11904-021-00595-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The differential impact of the COVID-19 and HIV pandemics on marginalized communities has renewed calls for more robust and deeper investigation into structural and social causes of health inequities contributing to these infections, including underlying factors related to systematic racism. Using the Social Determinants of Health (SDOH) framework, we analyzed parallel and divergent factors associated with COVID-19 and HIV/AIDS and the prevalence of disparate disease in diverse communities. We utilized PRISMA guidelines to identify relevant literature (N = 210 articles) that resulted in a review of 125 articles included in our synthesis. RECENT FINDINGS With racial health inequities as a core contributor to disease vulnerability, we also identified other factors such as economic stability, social and community support, the neighborhood and built environment, healthcare access and quality, and education access and quality as important socioecological considerations toward achieving health equity. Our review identifies structural and systematic factors that drive HIV and COVID-19 transmission. Our review highlights the importance of not solely focusing on biomedical interventions as solutions to ending HIV and COVID-19, but rather call for building a more just public health and social service safety net that meets the needs of people at the intersection of multiple vulnerabilities.
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Affiliation(s)
- Raiza M Beltran
- David Geffen School of Medicine, Department of Infectious Diseases, UCLA Global HIV Prevention Research Program, 10833 Le Conte Avenue, Los Angeles, CA, 90095, USA.
- UCLA Hub for Health Intervention, Policy and Practice (HHIPP), CA, Los Angeles, USA.
| | - Ian W Holloway
- UCLA Hub for Health Intervention, Policy and Practice (HHIPP), CA, Los Angeles, USA
- Department of Social Welfare, School of Public Affairs, UCLA Luskin, Los Angeles, CA, USA
- California HIV/AIDS Research Program, Los Angeles, CA, USA
| | - Chenglin Hong
- UCLA Hub for Health Intervention, Policy and Practice (HHIPP), CA, Los Angeles, USA
- Department of Social Welfare, School of Public Affairs, UCLA Luskin, Los Angeles, CA, USA
- California HIV/AIDS Research Program, Los Angeles, CA, USA
| | - Ayako Miyashita
- UCLA Hub for Health Intervention, Policy and Practice (HHIPP), CA, Los Angeles, USA
- Department of Social Welfare, School of Public Affairs, UCLA Luskin, Los Angeles, CA, USA
| | - Luisita Cordero
- UCLA Hub for Health Intervention, Policy and Practice (HHIPP), CA, Los Angeles, USA
| | - Elizabeth Wu
- UCLA Hub for Health Intervention, Policy and Practice (HHIPP), CA, Los Angeles, USA
- Department of Social Welfare, School of Public Affairs, UCLA Luskin, Los Angeles, CA, USA
- California HIV/AIDS Research Program, Los Angeles, CA, USA
| | - Katherine Burris
- UNLV School of Public Health, UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Paula M Frew
- UNLV School of Public Health, UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
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4
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Brandt K, Goel V, Keeler C, Bell GJ, Aiello AE, Corbie-Smith G, Wilson E, Fleischauer A, Emch M, Boyce RM. SARS-CoV-2 testing in North Carolina: Racial, ethnic, and geographic disparities. Health Place 2021; 69:102576. [PMID: 33915376 PMCID: PMC8212571 DOI: 10.1016/j.healthplace.2021.102576] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 01/03/2023]
Abstract
SARS-CoV-2 testing data in North Carolina during the first three months of the state's COVID-19 pandemic were analyzed to determine if there were disparities among intersecting axes of identity including race, Latinx ethnicity, age, urban-rural residence, and residence in a medically underserved area. Demographic and residential data were used to reconstruct patterns of testing metrics (including tests per capita, positive tests per capita, and test positivity rate which is an indicator of sufficient testing) across race-ethnicity groups and urban-rural populations separately. Across the entire sample, 13.1% (38,750 of 295,642) of tests were positive. Within racial-ethnic groups, 11.5% of all tests were positive among non-Latinx (NL) Whites, 22.0% for NL Blacks, and 66.5% for people of Latinx ethnicity. The test positivity rate was higher among people living in rural areas across all racial-ethnic groups. These results suggest that in the first three months of the COVID-19 pandemic, access to COVID-19 testing in North Carolina was not evenly distributed across racial-ethnic groups, especially in Latinx, NL Black and other historically marginalized populations, and further disparities existed within these groups by gender, age, urban-rural status, and residence in a medically underserved area.
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Affiliation(s)
- Katerina Brandt
- UNC Department of Geography, Chapel Hill, NC, USA; Carolina Population Center, Chapel Hill, NC, USA
| | - Varun Goel
- UNC Department of Geography, Chapel Hill, NC, USA; Carolina Population Center, Chapel Hill, NC, USA
| | | | | | - Allison E Aiello
- Carolina Population Center, Chapel Hill, NC, USA; UNC Department of Epidemiology, Chapel Hill, NC, USA
| | | | - Erica Wilson
- North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Aaron Fleischauer
- North Carolina Department of Health and Human Services, Raleigh, NC, USA
| | - Michael Emch
- UNC Department of Geography, Chapel Hill, NC, USA; Carolina Population Center, Chapel Hill, NC, USA; UNC Department of Epidemiology, Chapel Hill, NC, USA.
| | - Ross M Boyce
- Division of Infectious Diseases, UNC School of Medicine, Chapel Hill, NC, USA.
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5
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Salvatore M, Gu T, Mack JA, Prabhu Sankar S, Patil S, Valley TS, Singh K, Nallamothu BK, Kheterpal S, Lisabeth L, Fritsche LG, Mukherjee B. A Phenome-Wide Association Study (PheWAS) of COVID-19 Outcomes by Race Using the Electronic Health Records Data in Michigan Medicine. J Clin Med 2021; 10:jcm10071351. [PMID: 33805886 PMCID: PMC8037108 DOI: 10.3390/jcm10071351] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 12/16/2022] Open
Abstract
Background: We performed a phenome-wide association study to identify pre-existing conditions related to Coronavirus disease 2019 (COVID-19) prognosis across the medical phenome and how they vary by race. Methods: The study is comprised of 53,853 patients who were tested/diagnosed for COVID-19 between 10 March and 2 September 2020 at a large academic medical center. Results: Pre-existing conditions strongly associated with hospitalization were renal failure, pulmonary heart disease, and respiratory failure. Hematopoietic conditions were associated with intensive care unit (ICU) admission/mortality and mental disorders were associated with mortality in non-Hispanic Whites. Circulatory system and genitourinary conditions were associated with ICU admission/mortality in non-Hispanic Blacks. Conclusions: Understanding pre-existing clinical diagnoses related to COVID-19 outcomes informs the need for targeted screening to support specific vulnerable populations to improve disease prevention and healthcare delivery.
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Affiliation(s)
- Maxwell Salvatore
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; (M.S.); (T.G.); (J.A.M.); (S.P.); (L.G.F.)
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI 48109, USA;
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
| | - Tian Gu
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; (M.S.); (T.G.); (J.A.M.); (S.P.); (L.G.F.)
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Jasmine A. Mack
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; (M.S.); (T.G.); (J.A.M.); (S.P.); (L.G.F.)
| | - Swaraaj Prabhu Sankar
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI 48109, USA;
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI 48109, USA
- Data Office for Clinical and Translational Research, University of Michigan, Ann Arbor, MI 41809, USA
| | - Snehal Patil
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; (M.S.); (T.G.); (J.A.M.); (S.P.); (L.G.F.)
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Thomas S. Valley
- Division of Pulmonary and Critical Care Medicine, University of Michigan Medicine, Ann Arbor, MI 48109, USA;
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI 48109, USA;
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA; (K.S.); (S.K.)
| | - Karandeep Singh
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA; (K.S.); (S.K.)
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI 48109, USA
| | - Brahmajee K. Nallamothu
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI 48109, USA;
- Division of Cardiovascular Medicine, Michigan Medicine, Ann Arbor, MI 48109, USA
| | - Sachin Kheterpal
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, USA; (K.S.); (S.K.)
- Department of Anesthesiology, Michigan Medicine, Ann Arbor, MI 48109, USA
| | - Lynda Lisabeth
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
| | - Lars G. Fritsche
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; (M.S.); (T.G.); (J.A.M.); (S.P.); (L.G.F.)
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI 48109, USA;
- Rogel Cancer Center, Michigan Medicine, Ann Arbor, MI 48109, USA
- Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA; (M.S.); (T.G.); (J.A.M.); (S.P.); (L.G.F.)
- Center for Precision Health Data Science, University of Michigan, Ann Arbor, MI 48109, USA;
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA;
- Correspondence: ; Tel.: +1-(734)-764-6544
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6
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Salvatore M, Gu T, Mack JA, Sankar SP, Patil S, Valley TS, Singh K, Nallamothu BK, Kheterpal S, Lisabeth L, Fritsche LG, Mukherjee B. A phenome-wide association study (PheWAS) of COVID-19 outcomes by race using the electronic health records data in Michigan Medicine. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021. [PMID: 32793923 PMCID: PMC7418740 DOI: 10.1101/2020.06.29.20141564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background: We perform a phenome-wide scan to identify pre-existing conditions related to COVID-19 susceptibility and prognosis across the medical phenome and how they vary by race. Methods: The study is comprised of 53,853 patients who were tested/positive for COVID-19 between March 10 and September 2, 2020 at a large academic medical center. Results: Pre-existing conditions strongly associated with hospitalization were renal failure, pulmonary heart disease, and respiratory failure. Hematopoietic conditions were associated with ICU admission/mortality and mental disorders were associated with mortality in non-Hispanic Whites. Circulatory system and genitourinary conditions were associated with ICU admission/mortality in non-Hispanic Blacks. Conclusions: Understanding pre-existing clinical diagnoses related to COVID-19 outcomes informs the need for targeted screening to support specific vulnerable populations to improve disease prevention and healthcare delivery.
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Affiliation(s)
- Maxwell Salvatore
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Tian Gu
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Jasmine A Mack
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Swaraaj Prabhu Sankar
- Rogel Cancer Center, University of Michigan Medicine, Ann Arbor, MI 48109, United States.,Data Office for Clinical and Translational Research, University of Michigan, Ann Arbor, MI 41809, United States
| | - Snehal Patil
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States.,Precision Health, University of Michigan, Ann Arbor, MI 48109, United States
| | - Thomas S Valley
- Division of Pulmonary and Critical Care Medicine and Department of Internal Medicine, University of Michigan Medicine, Ann Arbor, MI 48109, United States.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, United States
| | - Karandeep Singh
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, United States.,Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI 48109, United States
| | - Brahmajee K Nallamothu
- Division of Cardiovascular Medicine and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, United States
| | - Sachin Kheterpal
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI 48109, United States.,Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI 48109, United States
| | - Lynda Lisabeth
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Lars G Fritsche
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States.,Rogel Cancer Center, University of Michigan Medicine, Ann Arbor, MI 48109, United States.,Center for Statistical Genetics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI 48109, United States.,Rogel Cancer Center, University of Michigan Medicine, Ann Arbor, MI 48109, United States.,Precision Health, University of Michigan, Ann Arbor, MI 48109, United States
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