Epidemiology of Reported HIV and Other Sexually Transmitted Infections During the COVID-19 Pandemic, New York City

Sexually transmitted infections, the epidemic that persists after the COVID-19 pandemic: an analysis of the primary care electronic health records covering about 5 million people in Catalonia

BACKGROUND

The aim of our study is to analyse the trends in the diagnosis of sexually transmitted infections (STIs) during the COVID-19 pandemic.

METHODS

We conducted an observational retrospective population-based study using data from primary care electronic health records spanning from January 2016 to December 2022 (involving 5.1 million people older than 14 years). We described the daily number of new STI diagnoses from 2016 to 2022; as well as the monthly accumulation of new STI diagnoses for each year. We compared the monthly averages of new diagnoses in 2019, 2020, 2021 and 2022 using the T-test. Finally, we performed a segmented regression analysis of the daily number of STI diagnoses.

RESULTS

We analysed 200,676 new STI diagnoses. The number of diagnoses abruptly decreased coinciding with the lockdown. Overall in 2020, we observed a reduction of 15%, with higher reductions for specific STIs such as gonorrhoea (-21%), chlamydia (-24%), and HIV (-31%) compared to 2019. Following this drastic drop, which was temporarily associated with the lockdown, we observed a rapid rebound. In 2021, the number of STI diagnoses was similar to that of 2019. Notably, we found a considerable increase in 2022, particularly for non-specific STI, which lack laboratory confirmation (67% increase). HIV was the only STI with a reduction of up to -38% in diagnoses at the end of 2022 compared to 2019.

CONCLUSIONS

After a significant reduction in 2020, the number of STIs recorded in primary care rapidly rebounded, and the current trend is similar to that of 2019, except for HIV. These findings underscore the dynamic impact of the COVID-19 pandemic on STI diagnoses and highlight the importance of ongoing monitoring and public health interventions in the post-pandemic period.

A Neglected Narrative in the COVID-19 Pandemic: Epidemiological and Clinical Impacts of the COVID-19 Outbreak on Syphilis

The COVID-19 pandemic has profoundly changed our lives. While healthcare resources were redistributed and mobilized to focus on dealing with the COVID-19 crisis, there have been unmet medical needs of patients with other diseases such as syphilis, weaving an integral but neglected component of the pandemic story. In different countries, the epidemiology of newly reported syphilis underwent diverse changes during the COVID-19 pandemic. Asymptomatic cases experienced the largest decline in number. From the perspective of transmission, on one hand, the implementation of lockdown measures led to a higher degree of abstinence and sex distancing in many countries, thereby reducing the transmission of syphilis. On the other hand, vertical transmission was reported to have increased significantly during COVID-19. Meanwhile, the volume of STI clinic capacity declined, and STI staff were redeployed to facilitate the contact tracing of COVID-19. As a result, many STI centers converted traditional in-person clinical services to telemedicine and self-testing. However, syphilis testing and clinical treatment cannot fully adapt to this conversion. In syphilis diagnosis, COVID-19 infection and vaccination were reported to cause false positivity in syphilis serological tests. Diverse cutaneous manifestations of COVID-19 could resemble the skin lesions in syphilis patients, requiring differential diagnosis from clinicians. As for the post-pandemic years, consequent to service interruptions and diagnosis delays, a surge in the number of confirmed cases of syphilis is expected. The COVID-19 pandemic has also been a meaningful lesson for the control and prevention of infectious diseases. The experience in combating COVID-19 has underscored the importance of maintaining a robust and well-supported medical system for the provision of sexual health services and better healthcare equality even during eras of crisis, not least for syphilis patients.

Changes in human papillomavirus prevalence, incidence, and clearance among men who have sex with men in Xinjiang, China after implementation of nonpharmaceutical interventions to control COVID-19: An interrupted time series analysis

OBJECTIVES

This study aimed to assess the effects of COVID-19 nonpharmaceutical interventions (NPIs) on the human papillomavirus (HPV) epidemic among men who have sex with men (MSM) in Xinjiang, China.

METHODS

In our cohort study, we enrolled and followed HIV-negative MSM in Xinjiang, China, between 2016 and 2022. Anal swab samples were collected to test for HPV DNA. We used interrupted time series analysis to characterize the temporal trends in HPV prevalence, incidence, and clearance before (September 01, 2016, to July 16, 2020) and during the implementation of COVID-19 NPIs in Xinjiang (July 17, 2020, to March 31, 2022). We used binomial segmented regression models to estimate the impact of COVID-19 NPIs on HPV prevalence, incidence, and clearance.

RESULTS

We recruited 1296 MSM who contributed to a total of 5374 HPV tests in our study. COVID-19 NPIs were associated with a 37.9% decrease in the prevalence (prevalence ratio, 0.621; 95% confidence interval, 0.465-0.830), 52.2% decrease in the incidence (risk ratio, 0.478; 0.377-0.606), and 40.4% increase in the clearance (risk ratio, 1.404; 1.212-1.627) of HPV of any genotype after the implementation of COVID-19 NPIs in Xinjiang.

CONCLUSION

COVID-19 NPIs may lead to lower transmission and higher clearance of HPV among MSM. Future studies are needed to clarify the longer-term impact of COVID-19 on the transmission and natural history of HPV among MSM.

Incidence, risk factors, and clinical findings of syphilis among men living with HIV in Croatia during the COVID-19 pandemic

We conducted a nationwide longitudinal observational study to estimate the incidence of syphilis in a cohort of male persons living with HIV (MLWH) in Croatia in the pre-COVID-19 and COVID-19 years. Data were reviewed and extracted from the clinical database. We analyzed 1187 MLWH (≥ 18 years) in care in Croatia from 2018 to 2021 and used Poisson regression to calculate rates. We observed a 91.4% increase in incidence between 2019 and 2020; the overall rate was 6.0/100 person-years, and the annual rate ranged from 3.3/100 person-years in 2018 to 9.3/100 person-years in 2021. We found higher rates in men who have sex with men, MLWH with a baseline history of syphilis, MLWH with a more recent HIV diagnosis, and a lower rate in those who had clinical AIDS. The rate of syphilis serological testing was 3.5% lower in 2020 compared to 2019. Recurrent syphilis was more likely asymptomatic compared to the first episodes. In conclusion, during the COVID-19 epidemic years, there was a huge increase in syphilis. Results highlight the need for enhanced and novel prevention interventions.

Immediate and long-term changes in infectious diseases in China at the "First-level-response", "Normalized-control" and "Dynamic-COVID-zero" stages from 2020 to 2022: a multistage interrupted-time-series-analysis

BACKGROUND

From January 2020 to December 2022, China implemented "First-level-response", "Normalized-control" and "Dynamic-COVID-zero" to block the COVID-19 epidemic; however, the immediate and long-term impact of three strategies on other infectious diseases and the difference in their impact is currently unknown. We aim to provide a more comprehensive understanding of the impact of non-pharmacological interventions (NPIs) on infectious diseases in China.

METHODS

We collected data on the monthly case count of infectious diseases in China from January 2015 to July 2022. After considering long-term trends using the Cox-Stuart test, we performed the two ratio Z tests to preliminary analyze the impact of three strategies on infectious diseases. Next, we used a multistage interrupted-time-series analysis fitted by the Poisson regression to evaluate and compare the immediate and long-term impact of three strategies on infectious diseases in China.

RESULTS

Compared to before COVID-19, the incidence of almost all infectious diseases decreased immediately at stages 1, 2, and 3; meanwhile, the slope in the incidence of many infectious diseases also decreased at the three stages. However, the slope in the incidence of all sexually transmitted diseases increased at stage 1, the slope in the incidence of all gastrointestinal infectious diseases increased at stage 2, and the slope in the incidence of some diseases such as pertussis, influenza, and brucellosis increased at stage 3. The immediate and long-term limiting effects of "Normalized-control" on respiratory-transmitted diseases were weaker than "First-level-response" and the long-term limiting effects of "Dynamic-COVID-zero" on pertussis, influenza, and hydatid disease were weaker than "Normalized-control".

CONCLUSIONS

Three COVID-19 control strategies in China have immediate and long-term limiting effects on many infectious diseases, but there are differences in their limiting effects. Evidence from this study shows that pertussis, influenza, brucellosis, and hydatid disease began to recover at stage 3, and relaxation of NPIs may lead to the resurgence of respiratory-transmitted diseases and vector-borne diseases.

Factors Associated With Rapid Linkage to HIV Medical Care Among Persons Newly Diagnosed With HIV Infection in the United States, 2019 to 2020

BACKGROUND

Rapid linkage to HIV medical care, ideally within 7 days of a person's diagnosis with HIV infection, is a vital strategy of the Ending the HIV Epidemic initiative in the United States. We analyzed HIV testing data to evaluate the prevalence of and factors associated with rapid linkage to HIV medical care.

METHODS

We used HIV testing data reported by Centers for Disease Control and Prevention-funded 60 state and local health departments and 29 community-based organizations from 2019 to 2020. Variables analyzed include rapid linkage to HIV medical care (within 7 days of diagnosis), demographic/population characteristics, geographic region, test site type, and test year. Multivariable Poisson regression analysis was conducted to evaluate the characteristics associated with rapid linkage to HIV medical care.

RESULTS

A total of 3,678,070 HIV tests were conducted, and 11,337 persons were newly diagnosed with HIV infection. Only 4710 persons (41.5%) received rapid linkage to HIV medical care, which was more likely among men who have sex with men or persons who were diagnosed in Phase I Ending the HIV Epidemic jurisdictions and less likely among persons diagnosed in sexually transmitted disease clinics or the South region.

CONCLUSIONS

Less than one-half of persons newly diagnosed with HIV infection in Centers for Disease Control and Prevention-funded HIV testing programs were linked to HIV medical care within 7 days of diagnosis. Rapid linkage to care varied significantly by population characteristics and setting. Identifying and removing potential individual, social, or structural barriers to rapid linkage to care can help improve HIV-related health equity and contribute to the national goal of ending the HIV epidemic.

Collateral impacts of pandemic COVID-19 drive the nosocomial spread of antibiotic resistance: A modelling study

BACKGROUND

Circulation of multidrug-resistant bacteria (MRB) in healthcare facilities is a major public health problem. These settings have been greatly impacted by the Coronavirus Disease 2019 (COVID-19) pandemic, notably due to surges in COVID-19 caseloads and the implementation of infection control measures. We sought to evaluate how such collateral impacts of COVID-19 impacted the nosocomial spread of MRB in an early pandemic context.

METHODS AND FINDINGS

We developed a mathematical model in which Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and MRB cocirculate among patients and staff in a theoretical hospital population. Responses to COVID-19 were captured mechanistically via a range of parameters that reflect impacts of SARS-CoV-2 outbreaks on factors relevant for pathogen transmission. COVID-19 responses include both "policy responses" willingly enacted to limit SARS-CoV-2 transmission (e.g., universal masking, patient lockdown, and reinforced hand hygiene) and "caseload responses" unwillingly resulting from surges in COVID-19 caseloads (e.g., abandonment of antibiotic stewardship, disorganization of infection control programmes, and extended length of stay for COVID-19 patients). We conducted 2 main sets of model simulations, in which we quantified impacts of SARS-CoV-2 outbreaks on MRB colonization incidence and antibiotic resistance rates (the share of colonization due to antibiotic-resistant versus antibiotic-sensitive strains). The first set of simulations represents diverse MRB and nosocomial environments, accounting for high levels of heterogeneity across bacterial parameters (e.g., rates of transmission, antibiotic sensitivity, and colonization prevalence among newly admitted patients) and hospital parameters (e.g., rates of interindividual contact, antibiotic exposure, and patient admission/discharge). On average, COVID-19 control policies coincided with MRB prevention, including 28.2% [95% uncertainty interval: 2.5%, 60.2%] fewer incident cases of patient MRB colonization. Conversely, surges in COVID-19 caseloads favoured MRB transmission, resulting in a 13.8% [-3.5%, 77.0%] increase in colonization incidence and a 10.4% [0.2%, 46.9%] increase in antibiotic resistance rates in the absence of concomitant COVID-19 control policies. When COVID-19 policy responses and caseload responses were combined, MRB colonization incidence decreased by 24.2% [-7.8%, 59.3%], while resistance rates increased by 2.9% [-5.4%, 23.2%]. Impacts of COVID-19 responses varied across patients and staff and their respective routes of pathogen acquisition. The second set of simulations was tailored to specific hospital wards and nosocomial bacteria (methicillin-resistant Staphylococcus aureus, extended-spectrum beta-lactamase producing Escherichia coli). Consequences of nosocomial SARS-CoV-2 outbreaks were found to be highly context specific, with impacts depending on the specific ward and bacteria evaluated. In particular, SARS-CoV-2 outbreaks significantly impacted patient MRB colonization only in settings with high underlying risk of bacterial transmission. Yet across settings and species, antibiotic resistance burden was reduced in facilities with timelier implementation of effective COVID-19 control policies.

CONCLUSIONS

Our model suggests that surges in nosocomial SARS-CoV-2 transmission generate selection for the spread of antibiotic-resistant bacteria. Timely implementation of efficient COVID-19 control measures thus has 2-fold benefits, preventing the transmission of both SARS-CoV-2 and MRB, and highlighting antibiotic resistance control as a collateral benefit of pandemic preparedness.

Impact of the COVID-19 pandemic on access to HIV testing and condom use among two-spirit, gay, bisexual, and queer (2SGBQ+) men in Manitoba

This cross-sectional online survey (n = 347) examined the impact of the COVID-19 pandemic on access to HIV testing and condom use among Two-Spirit, gay, bisexual, and queer (2SGBQ+) men in Manitoba. Logistic regression assessed the relationship between socio-demographics and the impact of COVID-19 on access to HIV testing and condom use. Among those who answered a question on testing (n = 282), 27.7% reported reduced access to HIV testing. Among those who answered questions on condom use (n = 327), 54.4% reported decreased use of condoms. Compared to living in Winnipeg, living in a medium-sized city (Brandon) and in rural and remote areas were both associated with higher odds of reporting reduced access to HIV testing due to COVID-19. Participants who were dating (vs. married or partnered) were significantly more likely to report reduced access to HIV testing, but less likely to report decreased use of condoms, while younger age was associated with decreased use of condoms. Service providers must be prepared to respond to the impact of COVID-19 on HIV testing and condom use among younger, sexually active 2SGBQ + men, as well as those who live in small, rural, and remote areas in Manitoba.

Impact of the COVID-19 pandemic on the epidemiology of other communicable diseases in Japan

OBJECTIVES

To elucidate the impact of the COVID-19 pandemic on the epidemiology of other infectious diseases.

DESIGN

We investigated the epidemiology of 36 communicable diseases during 2015-2021 in Japan and compared the number of cases in each disease between the prepandemic (2015-2019) and intrapandemic (2020-2021) periods. Relationships between the incidence of the infectious diseases and the COVID-19 pandemic were also investigated.

RESULTS

Of 36 communicable diseases, the number of cases in the 27 diseases (75%) mainly caused by pathogens transmitted by droplet or contact was lower intrapandemic than prepandemic, and the cases of 21 diseases (58%) continued to decrease intrapandemic. The number of cases of six diseases (17%) was higher intrapandemic than prepandemic, and the cases of two diseases (5.6%), Japanese spotted fever and syphilis, continued to increase intrapandemic. Time trend analyses revealed a positive correlation between case numbers of communicable diseases and the COVID-19 pandemic, whereas the case numbers of hand-foot-and-mouth disease and respiratory syncytial virus infection rebounded in 2021 after decreasing in 2020.

CONCLUSION

The COVID-19 pandemic has greatly impacted the epidemiology of communicable diseases, suggesting that countermeasures against COVID-19 and lifestyle changes might be involved in these epidemiological changes.

Pre-exposure Prophylaxis Persistence at a Diverse Sexual Health Clinic: Comparison of the pre-COVID-19 era to the COVID-19 era

The COVID-19 pandemic interrupted health care delivery and exacerbated disparities. Many sexual health clinics transitioned to telemedicine, including for pre-exposure prophylaxis (PrEP). We conducted a retrospective cohort study of patients at an urban sexual health clinic to assess the likelihood and predictors of PrEP persistence in the year following PrEP initiation. We compared patients starting PrEP in the four months preceding the first COVID surge to those starting PrEP one year prior. We found lower PrEP persistence in the COVID cohort compared to the pre-COVID cohort (50.8% vs. 68.9%, respectively). In both cohorts, most care was provided through in-person visits and telemedicine was rare. In the pre-COVID cohort, older patients and those identifying as non-Hispanic White were more likely to persist on PrEP. In the COVID cohort, these disparities in PrEP persistence were not observed. Flexible models of care may facilitate equitable care engagement and re-engagement.

[Sexually transmitted infections under the influence of the COVID-19 pandemic]

Sexually transmitted infections (STI) in Germany are constantly rising. STI screening and testing decreased during the coronavirus disease 2019 (COVID-19) pandemic due to redistribution of public health resources. During the pandemic, there was a decline in the diagnosis of STIs. A minor aspect of this could be explained by reductions in the number of sexual contacts and therefore actual reduced infections, but the greater aspect seems to be due to underdiagnosis. A dramatic surge of infections is expected in the next few years. It is of utmost importance to resume STI screening for early detection and treatment and thereby lowering the transmission of STIs.

Sexuality Transmitted Infection in the COVID-19 Pandemic and Non-Pandemic Time

On March 11, 2020, the World Health Organization recognized the SARS-CoV-2 infection as a pandemic. The pandemic itself in addition to its containment measures affects individuals' lifestyles and welfare including their sexual behaviors. Thus, we hypothesized that sexually transmitted infection (STI) incidence may be changed and so we evaluate urethritis incidence as the most common STI in men and some other related factors. Two cross-sectional surveys during the first 6 months of 2019 and 2020 were undertaken and data were collected from 11 urology offices located in different parts of the capital city. In total, 34,611 male participants were included in our study, and 191 (.55%) patients' clinical diagnoses were urethritis. The urethritis incidence significantly decreased from 149 of 17,950 (.83%) to 42 of 16,661 (.25%) individuals in the same period of the years 2019 and 2020, respectively (p-value < .001). There was a higher percentage of single (p-value = .049) and older (p-value < .001) urethritis patients in the first 6 months of the year 2020 compared with 2019. Our survey provided urethritis incidence, demographics, symptoms, and treatment characterization. As our results show, the proportion of urethritis patients in all populations admitted to urologist offices had dramatically decreased during the COVID-19 pandemic compared with prior. The indirect effects of the pandemic and its containment measures on people's sexual health should be noticed and an appropriate reaction and policy-making are recommended to manage issues properly in different aspects of sexual health.

Factors Associated with HIV Testing Among People Who Inject Drugs: Findings from a Multistate Study at the Start of the COVID-19 Pandemic

Few studies have examined HIV testing among people who inject drugs (PWID) during the COVID-19 pandemic. This study examines factors associated with PWID who have been recently (past six months) tested for HIV during the COVID-19 pandemic. PWID were recruited between August 2020 and January 2021 from 22 drug treatment and harm reduction programs in nine states and the District of Columbia. We used logistic regression to identify correlates of recent HIV testing among PWID (n = 289). Most (52.9%) PWID reported having been recently tested for HIV. Factors associated with recent HIV testing included: having attended college [adjusted odds ratio (aOR) 2.32, 95% confidence interval (95% CI) 1.32-4.10], weekly hunger (aOR 2.08, 95% CI 1.20-3.60), crystal methamphetamine injection (aOR 2.04, 95% CI 1.05-3.97), and non-metropolitan residence (aOR 0.33, 95% CI 0.13, 0.88). Findings suggest HIV testing initiatives should be expanded during times of crisis, such as global pandemics.

HIV Testing Services Outcomes in CDC-Funded Health Departments During COVID-19

BACKGROUND

Organizations offering HIV prevention services have reported interruptions during the COVID-19 pandemic. The national extent of these interruptions and their public health impact remain largely unexplored.

METHODS

Using data from 60 state and local health departments, we compared HIV testing services outcomes in calendar years 2019 and 2020, including the number of Centers for Disease Control and Prevention (CDC)-funded HIV tests conducted, the percentage of persons with newly diagnosed HIV infection (ie, HIV positivity), and the percentage linked to HIV medical care within 30 days after new diagnoses (ie, linkage to care) using χ2 and robust Poisson models. We also assessed the independent associations between the pandemic period (ie, March-December 2020) and the number of COVID-19 cases with monthly HIV testing services outcomes using multivariable robust Poisson models.

RESULTS

There was a 46.0% (P < 0.001) reduction in the number of CDC-funded HIV tests conducted in 2020 (n = 1,255,895) compared with 2019 (n = 2,324,421). Although there were fewer persons with newly diagnosed HIV in 2020 (n = 5581 vs. n = 7739 in 2019), HIV positivity was greater in 2020 (0.4% vs. 0.3% in 2019; adjusted prevalence ratio [aPR] = 1.33, 95% confidence interval [CI]: 1.05 to 1.69). When adjusting for the monthly number of COVID-19 cases, the pandemic period was associated with a 56% reduction in the number of monthly CDC-funded HIV tests (adjusted rate ratio = 0.44, 95% CI: 0.37 to 0.52) but 28% higher monthly HIV positivity (aPR = 1.28 95% CI: 1.16 to 1.41) and 10% higher linkage to care (aPR = 1.10, 95% CI: 1.02 to 1.18).

DISCUSSION

Despite increased HIV positivity, a drastic reduction in the number of CDC-funded HIV tests was observed in 2020, affecting the ability to identify persons with newly diagnosed HIV. CDC and health departments will need to expand testing strategies to cover tests not conducted in 2020 while adapting to the continuing pandemic.A visual abstract is available for this article at: http://links.lww.com/QAI/B941.

Sexually Transmitted Infections Diagnosed Among Sexual and Gender Minority Communities During the First 11 Months of the COVID-19 Pandemic in Midwest and Southern Cities in the United States

BACKGROUND

The COVID-19 pandemic adversely affected sexual health services. Given the burden of sexually transmitted infections (STIs) on sexual and gender minorities (SGMs), we estimated incidence of self-reported STI diagnoses and factors associated with STI diagnoses among SGMs during the pandemic's first year.

METHODS

A cohort of 426 SGM persons, 25 years or older, recruited in Chicago, Milwaukee, Detroit, Minneapolis, and Houston completed 5 online surveys from April 2020 to February 2021. Persons self-reported on each survey all health care provider STI diagnoses. Kaplan-Meier was used to estimate the cumulative risk of STI diagnoses, stratified by human immunodeficiency virus (HIV) status. Factors associated with STI diagnoses were assessed with a longitudinal negative binomial regression.

RESULTS

Median age was 37 years, and 27.0% were persons living with HIV (PLH). Participants reported 63 STIs for a cumulative incidence for PLH and HIV-negative persons of 0.19 (95% confidence interval [CI], 0.13-0.29) and 0.12 (95% CI, 0.09-0.17), respectively. Regardless of HIV, a younger age and changes in health care use were associated with STI diagnoses. Among HIV-negative persons, the rate of STI diagnoses was higher in Houston than the Midwest cities (adjusted relative risk, 2.37; 95% CI, 1.08-5.20). Among PLH, a decrease in health care use was also associated with STI diagnoses (adjusted relative risk, 3.53; 95% CI, 1.01-12.32 vs no change in health care services), as was Hispanic ethnicity and using a dating app to meet a sex partner.

CONCLUSIONS

Factors associated with STI diagnoses during the COVID-19 pandemic generally reflected factors associated with STI incidence before the pandemic like geography, HIV, age, and ethnicity.

Effects of the Covid-19 pandemic on head lice and scabies infestation dynamics: a population based study in France

BACKGROUND

Lockdowns and physical distancing have dramatically limited the circulation of SARS-CoV-2 and other common communicable infections. However, little is known about their impact on head lice and scabies.

OBJECTIVES

To assess the impact of the 2020 French National lockdowns (March 17^th -May 11^th , and Oct 30^th -Dec 15^th ) and physical distancing recommendations (from February 2020) on the head lice and scabies infestation dynamics.

METHODS

The weekly sales of topical head lice treatments, topical scabies treatments, and oral ivermectin were extracted from the IQVIA database (60% of all French retail pharmacies) and analysed over a 5-year period (March 2016 - December 2020). A periodic regression model was fit to drug sales before the COVID-19 period (i.e. 2016-2019) and extrapolated afterwards in order to compare the sales observed in 2020 to the expected sales.

RESULTS

A decrease of the sales of tracer topical treatments for head lice and scabies was observed from March 2020, synchronously with the first French national lockdown. For the period March 2020-December 2020, the mean reduction in observed versus expected sales were 44% and 14% for head lice and scabies topical treatments, respectively. On the other hand, the observed decrease of oral ivermectin sales after March 2020 was much lower (4%), probably because of studies reporting the potential positive effects of this drug on the Covid-19 infection.

CONCLUSION

COVID-19 lockdown and physical distancing reduce circulation of head lice and scabies in France. Further studies are needed to assess long term impact of these social behaviour changes.

HIV and COVID-19: review of clinical course and outcomes

Background:Understanding the relationship between HIV and SARS-CoV-2 has important public health implications.Objective:To summarize current research on COVID-19 among people with HIV (PWH) as published through 15 July 2021.Methods: We conducted a search of PubMed, Scopus, preprint databases (medRxiv, bioRxiv), and the references of publications found using key terms relevant to COVID-19 ('COVID-19' OR 'SARS-CoV-2' OR 'coronavirus') AND to HIV ('HIV' OR 'Human Immunodeficiency Virus' OR 'AIDS' OR 'Acquired Immunodeficiency Syndrome'). We summarized all articles that reported data or opinions on SARS-CoV-2 and HIV coinfection.Conclusions: Although many initial case series and cohort studies found no increased risk for SARS-CoV-2 infection or severe COVID-19 outcomes among PWH, recent studies have signaled an increased risk for severe COVID-19 disease progression even in the setting of well-controlled HIV. Whether this is due to the increased prevalence of comorbidities in PWH and other social determinants of health is unknown. These conflicting findings highlight the continued need for COVID-19 related research among PWH that addresses COVID-19 disease course as well as exacerbation of existing comorbidities already disproportionately represented among PWH.