A Scoping Review of Employment and HIV

Maulsby, Cathy; Ratnayake, Aneeka; Hesson, Donna; Mugavero, Michael J.; Latkin, Carl A.

doi:10.1007/s10461-020-02845-x

“…As mentioned above, men living with HIV reported greater anticipated reductions in income as a result of the slowing of the economy and job loss due to the COVID-19 pandemic. The combination of the interruptions to care and reductions in income for gay men and other MSM living with HIV may also lead to subsequent barriers to HIV care, and in turn lead to treatment failure and increased HIV transmission [41][42][43][44]. Although currently, there is no evidence indicating that people living with HIV who are virologically suppressed are more vulnerable to acquiring COVID-19 or having greater severity of this illness than those not living with HIV, experts generally believe that those with high HIV viral load and low CD4 counts may be more susceptible to negative COVID-19 outcomes [45][46][47].…”

Section: Discussionmentioning

confidence: 99%

Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men

Santos

¹

,

Ackerman

²

,

Rao

³

et al. 2020

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There is an urgent need to measure the impacts of COVID-19 among gay men and other men who have sex with men (MSM). We conducted a cross-sectional survey with a global sample of gay men and other MSM (n = 2732) from April 16, 2020 to May 4, 2020, through a social networking app. We characterized the economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response, and examined whether subgroups of our study population are disproportionately impacted by COVID-19. Many gay men and other MSM not only reported economic and mental health consequences, but also interruptions to HIV prevention and testing, and HIV care and treatment services. These consequences were significantly greater among people living with HIV, racial/ethnic minorities, immigrants, sex workers, and socioeconomically disadvantaged groups. These findings highlight the urgent need to mitigate the negative impacts of COVID-19 among gay men and other MSM. Keywords COVID-19 • Economic impact • Mental health • HIV • AIDS • Gay • Men who have sex with men Resumen Existe una necesidad urgente para medir los impactos de COVID-19 entre hombres gay y otros hombres que tienen sexo con hombres (HSH). Hemos conducido una encuesta multifuncional con una prueba mundial de hombres gay y otros HSH (n = 2732) desde el 16 de Abril hasta el 4 de Mayo del 2020, a través de una aplicación de red social. Nosotros caracterizamos los impactos económicos, de salud mental, prevención del VIH y tratamiento del VIH e impactos a COVID-19 y la respuesta de COVID-19, y examinamos si subgrupos de nuestra población de estudio fueron impactados desproporcionadamente por COVID-19. Muchos hombres no tan solo reportaron consecuencias económicas y de salud mental, sino también interrupciones de prevención y de pruebas de VIH, y cuidado del VIH y servicios de tratamiento. Encontramos consecuencias más significantes entre personas viviendo con VIH, grupos raciales/etnicos, migrantes, sexo servidores, y groupos socioeconomicamente disfavorecidos. Los resultados subrayan la necesidad crucial de mitigar los impactos multifacéticos de COVID-19 entre los hombres homosexuales y otros HSH, especialmente para aquellos con vulnerabilidades entrelazadas.

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“…As mentioned above, men living with HIV reported greater anticipated reductions in income as a result of the slowing of the economy and job loss due to the COVID-19 pandemic. The combination of the interruptions to care and reductions in income for gay men and other MSM living with HIV may also lead to subsequent barriers to HIV care, and in turn lead to treatment failure and increased HIV transmission (48)(49)(50)(51). Although currently, there is no evidence indicating that people living with HIV who are virologically suppressed are more vulnerable to acquiring COVID-19 or having greater severity of this illness than those not living with HIV, experts generally believe that those with high HIV viral load and low CD4 counts may be more susceptible to negative COVID-19 outcomes (52-54).…”

Section: Discussionmentioning

confidence: 99%

Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 response on a Global Sample of Cisgender Gay Men and Other Men who have sex with Men

Santos

¹

,

Ackerman

²

,

Rao

³

et al. 2020

Preprint

View full text Add to dashboard Cite

There is an urgent need to measure the impacts of COVID-19 among gay men and other men who have sex with men (MSM). We conducted a cross-sectional survey with a global sample of gay men and other MSM (n= 2732) from April 16, 2020 to May 4, 2020, through a social networking app. We characterized the economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response, and examined whether subgroups of our study population are disproportionately impacted by COVID-19. Many men not only reported economic and mental health consequences, but also interruptions to HIV prevention and testing, and HIV care and treatment services. Consequences were significantly greater among people living with HIV, racial/ethnic minorities, immigrants, sex workers, and socio-economically disadvantaged groups. Findings underscore the crucial need to mitigate the multifaceted impacts of COVID-19 among gay men and other MSM, especially for those with intersecting vulnerabilities.

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“…Rather, those with employment-based private insurance and Medicare had lower rates of engagement in care. In general, employment is thought to be positively associated with progression along the continuum of HIV care [ 36 ]. However, there is not much known about how work environments and culture may impact a PWH’s ability to engage in care.…”

Section: Discussionmentioning

confidence: 99%

Medicaid Expansion’s Impact on Human Immunodeficiency Virus Outcomes in a Nonurban Southeastern Ryan White HIV/AIDS Program Clinic

McManus

¹

,

Srikanth

²

,

Powers

³

et al. 2020

Open Forum Infectious Diseases

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Background While the Ryan White HIV/AIDS Program (RWHAP) supports high-quality HIV care, Medicaid enrollment provides access to non-HIV care. People living with HIV (PLWH) with Medicaid historically have low viral suppression (VS) rates. In a state with previously high Qualified Health Plan coverage of PLWH, we examined HIV outcomes by insurance status during the first year of Medicaid expansion (ME). Methods Participants were PLWH ages 18-63 who attended ≥1 HIV medical visit/year in 2018 and 2019. We estimated associations of sociodemographic characteristics with ME enrollment prevalence and associations between insurance status and engagement in care and VS. Results Among 577 patients, 151 (33%) were newly eligible for Medicaid, and 77 (51%) enrolled. Medicaid enrollment was higher for those with incomes <100% Federal Poverty Level (adjusted prevalence ratio [aPR] 1.67; 95% confidence interval [CI] 1.00-1.86) compared to others. Controlling for age, income, and 2018 engagement, those with employment-based private insurance (adjusted risk difference [aRD] -8.5%, 95% CI -16.9-0.1) and Medicare (aRD -12.5%, 95% CI -21.2- -3.0) had lower 2019 engagement than others. For those with VS data (n=548), after controlling for age and baseline VS, those with Medicaid (aRD -4.0%, 95% CI -10.3-0.3) and with Medicaid due to ME (aRD -6.2%, 95% CI -14.1- -0.8) were less likely to achieve VS compared with others. Conclusions Given that PLWH who newly enrolled in Medicaid had high engagement in care, the finding of lower VS is notable. The discordance may be due to medication access gaps associated with changes in medication procurement logistics.

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A Scoping Review of Employment and HIV

Cited by 76 publications

References 72 publications

Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men

Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men

Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 response on a Global Sample of Cisgender Gay Men and Other Men who have sex with Men

Medicaid Expansion’s Impact on Human Immunodeficiency Virus Outcomes in a Nonurban Southeastern Ryan White HIV/AIDS Program Clinic

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