The impacts of HIV-related service interruptions during COVID-19 pandemic in South Carolina

南卡罗来纳州 COVID-19 大流行期间与 HIV 相关的服务中断的影响

基本信息

批准号：
10700518
负责人：
Shan Qiao
金额：
$ 69.9万
依托单位：
UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-05-04 至 2028-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10700518
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Adherence Affect Buffers CD4 Lymphocyte Count COVID-19 COVID-19 outbreak COVID-19 pandemic COVID-19 pandemic effects Caring Cellular Phone Censuses Clinic Clinical Collaborations Communities Data Data Reporting Data Science Data Set Deep South Diagnostic Reagent Kits Disasters Disease Progression Electronic Health Record Epidemic Equipment Focus Groups Funding Future HIV HIV diagnosis HIV/AIDS HIV/STD Health Health Personnel Health Policy Health Services Accessibility Health care facility Health system Hospitals Human immunodeficiency virus test Infrastructure Institution Interruption Intervention Interview Investigation Knowledge Literature Measures Medical Medicine Modeling Monitor Monkeypox Nature Outcome Outcome Measure Patients Persons Pharmaceutical Preparations Policy Making Prevention Provider Public Health Readiness Recommendation Research Resource Allocation Resources Risk Series Services Social Sciences Solid Source South Carolina State Government Strategic Planning Surveys Time Travel United States National Institutes of Health Viral Viral Load result antiretroviral therapy care systems climate change cohort coronavirus disease data infrastructure experience health care availability mortality multiple data types pandemic disease pre-exposure prophylaxis pressure promote resilience public health emergency resilience resilience factor response service organization service utilization social capital social culture stay-at-home order supply chain surveillance data telehealth transmission process uptake

项目摘要

Abstract The global COVID-19 pandemic has imposed unprecedented pressure on health systems and has interrupted public health efforts for other major health conditions, including HIV. HIV service interruptions in the forms of redeployment of staff, reallocation of resources, lack of equipment and medicine (e.g., shortages of HIV/STI testing kits, strained drug supply chain), and reduced access to care (e.g., travel restrictions, lock downs) may have a profound and long-term impact on HIV treatment cascade outcomes, especially given the evolving nature of the pandemic. There are several gaps in the existing literature in addressing HIV service interruptions and their consequences. These gaps include a lack of using large-scale, real-world, multi-type data with theoretical guidance; the focus on single or limited HIV treatment cascade outcomes; and limited efforts to identify factors that can mitigate the negative impacts of such interruptions to inform potential interventions and capacity building at state or local levels. In response to NOT-AI-21-057, we propose to comprehensively investigate HIV service interruptions during the COVID-19 pandemic following a socioecological model, assess their impacts on various outcomes of the HIV prevention and treatment cascade, and identify resilience resources for buffering impacts of interruptions on HIV treatment cascade outcomes. Specifically, we will assess HIV service interruptions in South Carolina (SC) since 2020 using operational report data of Ryan White HIV clinics, in-depth interview data with clinic leaders and providers, and HIV service utilization data based on both electronic health records (EHR) and publicly available cellphone-based HIV clinics visitation data. We will further explore how HIV service interruptions affects HIV prevention and treatment cascade outcomes at appropriate geospatial units based on the integration of multi-type datasets (e.g., EHR, geospatial data) from multiple sources. Finally, we will identify institutional-, community-, and structural-level factors (e.g., resilience resources) that may mitigate the adverse impacts of HIV service interruptions based on the triangulation of quantitative (EHR data, online survey data) and qualitative (in- depth interviews, focus group discussion) data regarding health infrastructure, social capital, and organizational preparedness. Our proposed research can lead to a better understanding of complicated HIV service interruptions in SC and resilience factors that can mitigate the negative effects of such interruptions on various HIV treatment cascade outcomes. The multi-level resilience resources identified through data triangulation will assist SC health departments and communities in developing strategic plans in response to this evolving pandemic and other future public health emergencies (e.g., monkeypox, disasters caused by climate change). The research findings can also inform public health policymaking and the practices of other Deep South states with similar sociocultural contexts and experiences of HIV service interruptions during the pandemic.

抽象的全球 COVID-19 大流行给卫生系统带来了前所未有的压力，并中断了针对其他主要健康状况（包括艾滋病毒）的公共卫生努力。表格中的艾滋病毒服务中断人员的重新部署、资源的重新分配、设备和药品的缺乏（例如艾滋病毒/性传播感染的短缺）检测试剂盒、紧张的药品供应链）以及获得护理的机会减少（例如旅行限制、封锁）可能会对艾滋病毒治疗级联结果产生深远而长期的影响，特别是考虑到不断发展的情况大流行的性质。现有文献在解决艾滋病毒服务方面存在一些空白中断及其后果。这些差距包括缺乏使用大规模、真实世界、多类型的有理论指导的数据；关注单一或有限的艾滋病毒治疗级联结果；且有限努力确定可以减轻此类中断负面影响的因素，以告知潜在的影响州或地方层面的干预和能力建设。针对 NOT-AI-21-057，我们建议全面调查 COVID-19 大流行期间艾滋病毒服务中断情况社会生态模型，评估其对艾滋病毒预防和治疗级联的各种结果的影响，并确定弹性资源，以缓冲中断对艾滋病毒治疗级联结果的影响。具体而言，我们将使用运营数据来评估 2020 年以来南卡罗来纳州 (SC) 的艾滋病毒服务中断情况 Ryan White HIV 诊所的报告数据、诊所领导者和提供者的深入访谈数据以及 HIV 基于电子健康记录 (EHR) 和基于公开手机的服务利用数据 HIV 诊所就诊数据。我们将进一步探讨艾滋病毒服务中断如何影响艾滋病毒预防和基于多类型数据集整合的适当地理空间单元的治疗级联结果（例如，电子病历、地理空间数据）来自多个来源。最后，我们将确定机构、社区和可以减轻艾滋病毒服务不利影响的结构层面因素（例如复原力资源）基于定量（EHR 数据、在线调查数据）和定性（in- 深度访谈、焦点小组讨论）有关卫生基础设施、社会资本和组织准备。我们提出的研究可以帮助人们更好地了解复杂的艾滋病毒 SC 的服务中断以及可以减轻此类中断对系统的负面影响的弹性因素各种艾滋病毒治疗级联结果。通过数据识别的多层次弹性资源三角测量将协助南卡罗来纳州卫生部门和社区制定战略计划，以应对这种不断演变的流行病和其他未来的突发公共卫生事件（例如猴痘、由气候变化）。研究结果还可以为公共卫生政策制定和其他实践提供信息具有相似社会文化背景和艾滋病毒服务中断经历的南方腹地各州大流行。