Risk of Severe COVID-19 Disease and the Pandemic's Impact on Service Utilization Among a Longitudinal Cohort of Persons with HIV-Washington, DC

Authors

Anne K. Monroe, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC, 20052, USA. amonroe@gwu.edu.
Jiayang Xiao, Department of Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Alan E. Greenberg, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC, 20052, USA.
Matt E. Levy, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC, 20052, USA.
Marinella Temprosa, Department of Biostatistics, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Jenna B. Resnik, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC, 20052, USA.
Amanda D. Castel, Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue, NW, Washington, DC, 20052, USA.

Document Type

Journal Article

Publication Date

4-13-2022

Journal

AIDS and behavior

DOI

10.1007/s10461-022-03662-0

Keywords

COVID-19; Comorbidities; HIV; HIV RNA; Utilization

Abstract

People with HIV (PWH) have a high burden of medical comorbidities, potentially putting them at increased risk for severe COVID-19. Additionally, during the COVID-19 pandemic, HIV care delivery has been restructured and the impact on HIV outcomes is unknown. The objectives of this study were first, to examine the risk of severe COVID-19 among PWH, using a definition incorporating clinical risk factors, and second, to examine the pandemic's impact on HIV care. We used data from the DC Cohort, a large cohort of people receiving HIV care in Washington, DC. We found that a high proportion of participants across all age groups qualified as increased (58%) or high risk (34%) for severe COVID-19. Between 2019 and 2020, encounters increased (17.7%, increasing to 23.5% of active DC Cohort participants had an encounter) while laboratory utilization decreased (14.4%, decreasing to 11.4% of active DC Cohort participants had an HIV RNA test performed). Implications of our work include the importance of protecting vulnerable people with HIV from acquiring COVID-19 and potentially manifesting severe complications through strategies including vaccination. Additionally, acknowledging that HIV service delivery will likely be changed long-term by the pandemic, adaptation is required to ensure continued progress towards 90-90-90 goals.

APA Citation

Monroe, Anne K.; Xiao, Jiayang; Greenberg, Alan E.; Levy, Matt E.; Temprosa, Marinella; Resnik, Jenna B.; and Castel, Amanda D., "Risk of Severe COVID-19 Disease and the Pandemic's Impact on Service Utilization Among a Longitudinal Cohort of Persons with HIV-Washington, DC" (2022). GW Authored Works. Paper 796.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/796

Department

Epidemiology