Modification of HIV pre-exposure prophylaxis (PrEP) access during the COVID-19 pandemic HIV infection A national survey found that among sexual minority young men and gender-diverse individuals who identify as Black and/or Hispanic/Latino.
“The public health crisis surrounding COVID-19 has had a clear impact on access to PrEP and overall risk of acquiring HIV,” said The Ohio State University School of Nursing and Infectious Diseases Institute, Columbus, Ohio. Dr. Ethan Morgan, Principal Investigator, said.
“This is a tough lesson that when a new public health emergency arises, we cannot stand by and sit on existing emergencies, or risk exacerbating them, as we see here. he said. Medscape Medical News.
This online survey was conducted four times during the first year and a half of the pandemic, which began in March 2020. Participants were recruited through mailing lists, national networks, community partners and social media.
Of 796 baseline respondents, 300 consented to 3 follow-up surveys taking place between February-March 2021, July-August 2021 and October-November 2021 .
Inclusion required that participants identified as Black and/or Hispanic/Latino, were 18-29 years of age, assigned male at birth, resided in the United States, and had anal sex with a male in the last 12 months. Given the limited uptake and adherence to PrEP in the target population, researchers were required to be currently using PrEP or to have used it at least once in their lifetime. Priority was given to baseline respondents who reported that
The researchers used individualized multivariate logistic regression models to determine the probability of positive HIV and other sexually transmitted infections (STIs) test results in four online survey visits and (a) PrEP access. Pandemic-related changes and (b) pandemic relevance were assessed. – Changes related to sexual activity.
Change in PrEP access was reported by a total of 109 (13.8%) baseline respondents, and HIV seroconversion was reported by 25 (8.6%) of 292 respondents who reported HIV and other STI status at follow-up. %). STI positivity was reported in 25.6% (n = 204) of the baseline cohort.
Respondents who reported a change in PrEP access were significantly more likely to report HIV seroconversion compared to those who reported no change in PrEP access (adjusted odds ratio [aOR], 2.80; 95% CI, 1.02–7.68).But Morgan stressed that the research question didn’t ask how PrEP was changed only when it was changed.
“While we speculate that the questions in this survey correspond to the decline in access to PrEP medications during the COVID-19 pandemic, the question was: ‘Will your access to PrEP be impacted by the COVID-19 pandemic? have you received?” So, unfortunately, we don’t know if access has decreased or improved,” he explained. STI positivity was not associated with PrEP access.
The survey also asked respondents how much the pandemic had affected their sexual activity (measured on a Likert scale of none, little, moderate, considerable, and very much). Respondents reporting greater impact on sexual activity were more likely to report sexually transmitted infections during the study period (aOR, 1.24; 95% CI, 1.10-1.40).
Additionally, participants reported an average of 2.8 sexual partners in the past 3 months, although more respondents were more likely to report an STI (aOR, 1.29; 95% CI, 1.21 -1.38).
The researchers found that expanding telemedicine and mail-order prescriptions, as well as structural-level interventions to address pandemic-related job losses and health insurance losses, may have helped maintain access to PrEP. I suggested something.
Commenting on the study, Monica Gandhi, M.D., M.P.H., who was not involved in the study, noted that self-reported data can be biased. “However, declines in other health services have been frequently reported throughout COVID, so this finding of reduced PrEP access and subsequent HIV transmission is fully consistent with other studies,” she said. rice field. Medscape Medical News.
Dr. Gandhi, Director of the Center for AIDS Research at the University of California, San Francisco, and Medical Director of the HIV/AIDS Clinic (“Ward 86”) at San Francisco General Hospital, added: A Pandemic Declining PrEP Access and Uptake Based on data from Boston’s Fenway Research Institute.”
Boston data, reported at a virtual international AIDS conference in July 2020, prompted a “real attempt” to increase access and uptake of PrEP by clinicians, raise community awareness, and promote PrEP via mobile units. Gandhi said he has dispense and changed his prescribing pattern. “For PrEP we normally see him every three months, but with HIV self-testing, that interval he can extend to every six months, and during COVID, A lot of centers did that.”
This study was funded by the National Institute of substance abuse, Part of the National Institutes of Health.
Morgan and Gandhi have reported no conflicts of interest.
J Acquired immunodeficiency syndrome. Published online on October 1, 2022. Overview
Kate Johnson is a Montreal-based freelance medical journalist who has written on all areas of medicine for over 30 years.
