Abstract
BackgroundCentral to measuring the impact of the COVID-19 pandemic on HIV is understanding the role of loss of access to essential HIV prevention and care services created by clinic and community-based organization closures. In this paper, we use a comprehensive list of HIV prevention services in four corridors of the US heavily impacted by HIV, developed as part of a large RCT, to illustrate the potential impact of service closure on LGBTQ+ youth.MethodsWe identified and mapped LGBTQ+ friendly services offering at least one of the following HIV-related services: HIV testing; STI testing; PrEP/PEP; HIV treatment and care; and other HIV-related services in 109 counties across four major interstate corridors heavily affected by HIV US Census regions: Pacific (San Francisco, CA to San Diego, CA); South-Atlantic (Washington, DC to Atlanta, GA); East-North-Central (Chicago, IL to Detroit, MI); and East-South-Central (Memphis, TN to New Orleans, LA).ResultsThere were a total of 831 LGBTQ+ youth-friendly HIV service providers across the 109 counties. There was a range of LGBTQ+ youth-friendly HIV-service provider availability across counties (range: 0–14.33 per 10,000 youth aged 13–24 (IQR: 2.13), median: 1.09); 9 (8.26%) analyzed counties did not have any LGBTQ+ youth-friendly HIV service providers. The Pearson correlation coefficient for the correlation between county HIV prevalence and LGBTQ+ youth-friendly HIV service provider density was 0.16 (p = 0.09), suggesting only a small, non-statistically significant linear relationship between a county’s available LGBTQ+ youth-friendly HIV service providers and their HIV burden.ConclusionsAs the COVID-19 pandemic continues, we must find novel, affordable ways to continue to provide sexual health, mental health and other support services to LGBTQ+ youth.
Highlights
The COVID-19 pandemic was caused by the 2019 novel coronavirus (SAR-CoV-2) which has experienced rapid global spread since it was first identified in China in late 2019 [1, 2]
By mapping HIV prevalence and service availability data for young GBMSM, this paper aims to take a first step in illustrating areas that, prior to the COVID-19 epidemic, had limited service availability and are likely to experience significant disruptions in HIV prevention and care services during the COVID-19 pandemic
The results demonstrate that prior to the onset of the COVID-19 pandemic there were generally low levels of availability of LGBTQ+ friendly HIV prevention and care services for youth in four corridors of the U.S that are known to be heavily impacted by HIV
Summary
The COVID-19 pandemic was caused by the 2019 novel coronavirus (SAR-CoV-2) which has experienced rapid global spread since it was first identified in China in late 2019 [1, 2]. The closure of clinics and community-based organizations, unemployment, and financial stress have the potential to significantly impact both HIV and COVID-19 outcomes by limiting access to routine HIV care and anti-retroviral therapy (ART) [11, 15, 21]; data have demonstrated the impacts of such closures amongst gay and bisexual men who have sex with men (GBMSM) [22]. People living with HIV have reported high levels of anxiety related to perceived COVID-19 risk and increased social isolation [23, 24] Does this increase the need for mental health services in this population, it could potentially further reduce access and adherence to care, if individuals avoid healthcare facilities and providers out of caution. Central to measuring the impact of the COVID-19 pandemic on HIV is understanding the role of loss of access to essential HIV prevention and care services created by clinic and community-based organization closures. We use a comprehensive list of HIV prevention services in four corridors of the US heavily impacted by HIV, developed as part of a large RCT, to illustrate the potential impact of service closure on LGBTQ+ youth
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