The emergence of the novel coronavirus disease known as COVID-19 creates another health burden for people living with HIV (PLWH) who face multiple morbidities and may be at heightened risk for severe ...physical health illness from COVID-19. Our abilities to address these morbidities in PLWH must be considered alongside the socially-produced burdens that both place this population at risk for COVID-19 and heighten the likelihood of adverse outcomes. These burdens can affect the physical, emotional, and social well-being of PLWH and interfere with the delivery of effective healthcare and access to HIV treatment. We posit that a syndemic framework can be used to conceptualize the potential impact of COVID-19 among PLWH to inform the development of health programming services.
Implications of the COVID-19 Pandemic on LGBTQ Communities Krause, Kristen D
Journal of public health management and practice,
2021 Jan/Feb, Volume:
27 Suppl 1, COVID-19 and Public Health: Looking Back, Moving Forward
Journal Article
We used an internet-based survey platform to conduct a cross-sectional survey regarding the impact of COVID-19 on the LGBTQ + population in the United States. While this method of data collection was ...quick and inexpensive, the data collected required extensive cleaning due to the infiltration of bots. Based on this experience, we provide recommendations for ensuring data integrity. Recruitment conducted between May 7 and 8, 2020 resulted in an initial sample of 1251 responses. The Qualtrics survey was disseminated via social media and professional association listservs. After noticing data discrepancies, research staff developed a rigorous data cleaning protocol. A second wave of recruitment was conducted on June 11–12, 2020 using the original recruitment methods. The five-step data cleaning protocol led to the removal of 773 (61.8%) surveys from the initial dataset, resulting in a sample of 478 participants in the first wave of data collection. The protocol led to the removal of 46 (31.9%) surveys from the second two-day wave of data collection, resulting in a sample of 98 participants in the second wave of data collection. After verifying the two-day pilot process was effective at screening for bots, the survey was reopened for a third wave of data collection resulting in a total of 709 responses, which were identified as an additional 514 (72.5%) valid participants and led to the removal of an additional 194 (27.4%) possible bots. The final analytic sample consists of 1090 participants. Although a useful and efficient research tool, especially among hard-to-reach populations, internet-based research is vulnerable to bots and mischievous responders, despite survey platforms’ built-in protections. Beyond the depletion of research funds, bot infiltration threatens data integrity and may disproportionately harm research with marginalized populations. Based on our experience, we recommend the use of strategies such as qualitative questions, duplicate demographic questions, and incentive raffles to reduce likelihood of mischievous respondents. These protections can be undertaken to ensure data integrity and facilitate research on vulnerable populations.
People who are 50 and older constitute the majority of those living with HIV/AIDS (PLWHA) in the US. Aging PLWHA face myriad biopsychosocial health challenges related to HIV/AIDS and the aging ...process. Resilience may act as a buffer to the negative impact of these challenges however measuring it among PLWHA has been inconsistent, so the HIV-Related Resilience Screener (HIV-RRS) was developed. Data for the present study are drawn from 250 sociodemographically diverse HIV-positive gay men ages 50–69 in NYC. Tests of reliability and validity were conducted, and an Exploratory Factor Analysis indicated a three-factor model was the most parsimonious solution. Items were examined for their underlying relationships and labeled: adaptive coping, optimism, and effective coping. The total HIV-RRS yielded a Cronbach’s α of 0.84. Convergent and face validity were established using psychosocial and physical outcomes. The HIV-RRS is a psychometrically sound instrument to assess resilience among older HIV-positive gay men.
Although racial/ethnic disparities in police contact are well documented, less is known about other dimensions of inequity in policing. Sexual minority groups may face disproportionate police ...contact. We used data from the P18 Cohort Study (Version 2), a study conducted to measure determinants of inequity in STI/HIV risk among young sexual minority men (YSMM) in New York City, to measure across-time trends, racial/ethnic disparities, and correlates of self-reported stop-and-frisk experience over the cohort follow-up (2014-2019). Over the study period, 43% reported stop-and-frisk with higher levels reported among Black (47%) and Hispanic/Latinx (45%) than White (38%) participants. Stop-and-frisk levels declined over follow-up for each racial/ethnic group. The per capita rates among P18 participants calculated based on self-reported stop-and-frisk were much higher than rates calculated based on New York City Police Department official counts. We stratified respondents' ZIP codes of residence into tertiles of per capita stop rates and observed pronounced disparities in Black versus White stop-and-frisk rates, particularly in neighborhoods with low or moderate levels of stop-and-frisk activity. YSMM facing the greatest economic vulnerability and mental disorder symptoms were most likely to report stop-and-frisk. Among White respondents levels of past year stop-and-frisk were markedly higher among those who reported past 30 day marijuana use (41%) versus those reporting no use (17%) while among Black and Hispanic/Latinx respondents stop-and-frisk levels were comparable among those reporting marijuana use (38%) versus those reporting no use (31%). These findings suggest inequity in policing is observed not only among racial/ethnic but also sexual minority groups and that racial/ethnic YSMM, who are at the intersection of multiple minority statuses, face disproportionate risk. Because the most socially vulnerable experience disproportionate stop-and-frisk risk, we need to reach YSMM with community resources to promote health and wellbeing as an alternative to targeting this group with stressful and stigmatizing police exposure.
As the epidemiological landscape of HIV/AIDS changed over the last 40 years, more people are now living with HIV/AIDS deeper into senior adulthood. People over age 50 living with HIV face myriad ...challenges including medical, psychological, and social comorbidities. In this analysis, we consider the social realities and social networks of older adults living with HIV and assess how relationships and communities have been affected by stigma and other challenges of aging with HIV. A total of 40 participants, ages 51-69 years, living with HIV in the Newark metropolitan area were interviewed. A thematic analysis was conducted, and four main themes were identified: (1) friends and relationships; (2) support groups; (3) stigma and discrimination; (4) family. The role of social support within this community is discussed within these key themes. This study helps us to better understand how support networks affect older adults living with HIV and how stigma and fragmented relationships can ultimately contribute to negative health outcomes.
•On average, racial and ethnic minority participants reported more days of methamphetamine use.•A majority of methamphetamine use days occurred during the weekend.•Daily polydrug methamphetamine use ...occurred most frequently with cannabis and GHB.
Knowledge on methamphetamine use among a new generation of sexual minority men (SMM) is limited. This study describes the event-level patterns of methamphetamine use and characteristics of methamphetamine users across time among Millennial SMM emerging into adulthood.
A prospective cohort study was conducted in two waves: 2009–2014 (Wave I) and 2014–2019 (Wave II) in the New York City metropolitan area. A total of 600 Millennial SMM ages 18–19 years were recruited for Wave I. A total of 665 SMM ages 22–23 years were recruited for Wave II, of which 41.2% (n = 274) were retained from Wave I. The Timeline Followback assessment was conducted every six months to record event-level drug use in the 30 days prior to the visit.
A total of 5.4% of participants of between the ages of 18–27 reported methamphetamine use throughout the study period. The average number of days of methamphetamine use was significantly higher among racial/ethnic minority men in Wave II (F = 4.34, p = 0.0029). We found methamphetamine use occurred more often on weekend days and same-day use of methamphetamine occurred most often with cannabis and gamma-hydroxybutyrate. Usage of methamphetamine was significantly greater among SMM in Wave II who by design were older than Wave I.
We have identified differences in methamphetamine use by race/ethnicity. Weekend use and poly-drug use were common among methamphetamine-using SMM. Data indicate differential use in the population and that attempts to address this addictive behavior must be linked to other drug use and socialization among young SMM.
Older adults represent the greatest proportion of people living with HIV/AIDS (PLWHA) in the U.S. and sexual minority men continue to be disproportionally impacted. As PLWHA age, they face multiple ...mental and psychosocial health challenges that may impact their overall health and well-being. Resilience may act as a buffer against these challenges.
Associations between HIV-related resilience and mental health endorsements were examined among older HIV-positive gay men in New York City.
Multivariate analyses indicate those with higher levels of HIV-related resilience were more likely to have lower levels of PTSD and substance dependence and were also more likely to feel financially secure.
While further research will help better understand the role resilience has on overall health and well-being of older gay PLWHA, utilizing this perspective can yield important insights that can be used to shift toward strengths-based service and programmatic approaches for this population.
As COVID-19 vaccinations became available in early 2021, we collected data from a US national sample of 496 people living with HIV (PLWH) to assess COVID-19 vaccination uptake and attitudes. The ...study was cross-sectional, and data were collected using an online survey between March and May 2021. At the time, 64% of the participants received at least one dose of a COVID-19 vaccine. Vaccine uptake was associated with older age and more years living with HIV, higher educational attainment, less vaccine hesitancy, and higher perceived COVID-19 vulnerability. Rates of vaccination uptake were highest among sexual and gender minority (SGM) cisgender men and transgender participants as well as those more likely to report undetectable viral load. Among the 166 unvaccinated, intention to receive the vaccine was related to older age and years living with HIV as well as lower vaccine hesitancy. Among the unvaccinated, SGM individuals demonstrated higher intent than non-SGM individuals. Findings indicate relatively high levels of vaccination in PLWH, although uptake and intent are not monolithic in the population. Patterns of vaccination are consistent with the health behavior literature in so much as those with higher levels of perceived heath vulnerability due to age as well as higher levels of proactivity about their HIV health are more likely to be vaccinated or intend to be vaccinated. Ongoing vigilance is required to vaccinate the US population, particularly those with underlying conditions such as HIV, as is the need to tailor health messaging to the highly diverse population of PLWH, with particular emphasis on the intersection of HIV and SGM status.
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