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

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Abstract

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 sub-groups 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 socio-economically disadvantaged groups. These findings highlight the urgent need to mitigate the negative impacts of COVID-19 among gay men and other MSM.

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The online version of this article (10.1007/s10461-020-02969-0) contains supplementary material, which is available to authorized users.

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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An interactive web-based dashboard to track COVID-19 in real time

Ensheng Dong, Hongru Du, Lauren Gardner (2020)

In December, 2019, a local outbreak of pneumonia of initially unknown cause was detected in Wuhan (Hubei, China), and was quickly determined to be caused by a novel coronavirus, 1 namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak has since spread to every province of mainland China as well as 27 other countries and regions, with more than 70 000 confirmed cases as of Feb 17, 2020. 2 In response to this ongoing public health emergency, we developed an online interactive dashboard, hosted by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University, Baltimore, MD, USA, to visualise and track reported cases of coronavirus disease 2019 (COVID-19) in real time. The dashboard, first shared publicly on Jan 22, illustrates the location and number of confirmed COVID-19 cases, deaths, and recoveries for all affected countries. It was developed to provide researchers, public health authorities, and the general public with a user-friendly tool to track the outbreak as it unfolds. All data collected and displayed are made freely available, initially through Google Sheets and now through a GitHub repository, along with the feature layers of the dashboard, which are now included in the Esri Living Atlas. The dashboard reports cases at the province level in China; at the city level in the USA, Australia, and Canada; and at the country level otherwise. During Jan 22–31, all data collection and processing were done manually, and updates were typically done twice a day, morning and night (US Eastern Time). As the outbreak evolved, the manual reporting process became unsustainable; therefore, on Feb 1, we adopted a semi-automated living data stream strategy. Our primary data source is DXY, an online platform run by members of the Chinese medical community, which aggregates local media and government reports to provide cumulative totals of COVID-19 cases in near real time at the province level in China and at the country level otherwise. Every 15 min, the cumulative case counts are updated from DXY for all provinces in China and for other affected countries and regions. For countries and regions outside mainland China (including Hong Kong, Macau, and Taiwan), we found DXY cumulative case counts to frequently lag behind other sources; we therefore manually update these case numbers throughout the day when new cases are identified. To identify new cases, we monitor various Twitter feeds, online news services, and direct communication sent through the dashboard. Before manually updating the dashboard, we confirm the case numbers with regional and local health departments, including the respective centres for disease control and prevention (CDC) of China, Taiwan, and Europe, the Hong Kong Department of Health, the Macau Government, and WHO, as well as city-level and state-level health authorities. For city-level case reports in the USA, Australia, and Canada, which we began reporting on Feb 1, we rely on the US CDC, the government of Canada, the Australian Government Department of Health, and various state or territory health authorities. All manual updates (for countries and regions outside mainland China) are coordinated by a team at Johns Hopkins University. The case data reported on the dashboard aligns with the daily Chinese CDC 3 and WHO situation reports 2 for within and outside of mainland China, respectively (figure ). Furthermore, the dashboard is particularly effective at capturing the timing of the first reported case of COVID-19 in new countries or regions (appendix). With the exception of Australia, Hong Kong, and Italy, the CSSE at Johns Hopkins University has reported newly infected countries ahead of WHO, with Hong Kong and Italy reported within hours of the corresponding WHO situation report. Figure Comparison of COVID-19 case reporting from different sources Daily cumulative case numbers (starting Jan 22, 2020) reported by the Johns Hopkins University Center for Systems Science and Engineering (CSSE), WHO situation reports, and the Chinese Center for Disease Control and Prevention (Chinese CDC) for within (A) and outside (B) mainland China. Given the popularity and impact of the dashboard to date, we plan to continue hosting and managing the tool throughout the entirety of the COVID-19 outbreak and to build out its capabilities to establish a standing tool to monitor and report on future outbreaks. We believe our efforts are crucial to help inform modelling efforts and control measures during the earliest stages of the outbreak.

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Antiretroviral Therapy for the Prevention of HIV-1 Transmission.

Myron S Cohen, Ying Q Chen, Marybeth McCauley … (2016)

An interim analysis of data from the HIV Prevention Trials Network (HPTN) 052 trial showed that antiretroviral therapy (ART) prevented more than 96% of genetically linked infections caused by human immunodeficiency virus type 1 (HIV-1) in serodiscordant couples. ART was then offered to all patients with HIV-1 infection (index participants). The study included more than 5 years of follow-up to assess the durability of such therapy for the prevention of HIV-1 transmission.

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COVID-19, unemployment, and suicide

Wolfram Kawohl, Carlos Nordt (2020)

The COVID-19 pandemic has led to the introduction of strong restrictive measures that are having a substantial effect on the global economy, including an increase in the unemployment rate worldwide. 1 In a previous study, 2 we modelled the effect of unemployment on suicide on the basis of global public data from 63 countries, and we observed that suicide risk was elevated by 20–30% when associated with unemployment during 2000–11 (including the 2008 economic crisis). We have now used this model to predict the effects of the currently expected rise in the unemployment rate on suicide rates. Close to 800 000 people die by suicide every year. 3 We used our core model's estimates (intercept, sex, age group, and unemployment) 2 to describe the non-linear connection between unemployment and suicide. We applied the overall estimates to World Bank Open Data (ie, worldwide number in the labour force in 2019, unemployment rate [modelled estimate from the International Labour Organization] for 2019, and male and female populations in 2018 in the four age groups). Because the model predicted only 671 301 suicides with this data, instead of 800 000, we added a correction term of 0·17 to address differences in space (194 vs 63 countries) and time (2020 vs 2000). The expected number of job losses due to COVID-19 were taken from the International Labour Organization's press release from March 18, 2020, 1 reporting a decline of 24·7 million jobs as a high scenario and 5·3 million jobs lost as a low scenario. In the high scenario, the worldwide unemployment rate would increase from 4·936% to 5·644%, which would be associated with an increase in suicides of about 9570 per year. In the low scenario, the unemployment would increase to 5·088%, associated with an increase of about 2135 suicides. According to WHO, each suicide in a population is accompanied by more than 20 suicide attempts. 3 Thus, the number of mentally distressed people who might seek help from mental health services can be expected to increase in the context of the COVID-19 pandemic. Data from the economic crisis of 2008 showed that the increase in suicides preceded the actual rise in the unemployment rate. 2 We therefore expect an extra burden for our mental health system, and the medical community should prepare for this challenge now. Mental health providers should also raise awareness in politics and society that rising unemployment is associated with an increased number of suicides. The downsizing of the economy and the focus of the medical system on the COVID-19 pandemic can lead to unintended long-term problems for a vulnerable group on the fringes of society. It is important that various services, such as hotlines and psychiatric services, remain able to respond appropriately.

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Author and article information

Contributors

Glenn-Milo Santos:

ORCID: http://orcid.org/0000-0003-1009-5317

Glenn-Milo.Santos@ucsf.edu

Journal

Journal ID (nlm-ta): AIDS Behav

Journal ID (iso-abbrev): AIDS Behav

Title: AIDS and Behavior

Publisher: Springer US (New York )

ISSN (Print): 1090-7165

ISSN (Electronic): 1573-3254

Publication date (Electronic): 11 July 2020

Pages: 1-11

Affiliations

[1 ]GRID grid.266102.1, ISNI 0000 0001 2297 6811, Community Health Systems Department, , University of California San Francisco, ; San Francisco, CA USA

[2 ]GRID grid.410359.a, ISNI 0000 0004 0461 9142, Center of Public Health Research, San Francisco Department of Public Health, ; San Francisco, CA USA

[3 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Department of Biostatistics, , Johns Hopkins Bloomberg School of Public Health, ; Baltimore, MD USA

[4 ]GRID grid.21107.35, ISNI 0000 0001 2171 9311, Center for Public Health and Human Rights, , Johns Hopkins Bloomberg School of Public Health, ; Baltimore, MD USA

[5 ]MPact Global Action for Gay Men’s Health and Rights, Oakland, CA USA

[6 ]Joint United Nations Programme On HIV and AIDS, Geneva, Switzerland

[7 ]Hornet, Los Angeles, CA USA

[8 ]GRID grid.19006.3e, ISNI 0000 0000 9632 6718, Luskin School of Public Affairs, , University of California Los Angeles, ; Los Angeles, CA USA

[9 ]GRID grid.430387.b, ISNI 0000 0004 1936 8796, Rutgers School of Public Health, ; Piscataway, NJ USA

[10 ]GRID grid.4714.6, ISNI 0000 0004 1937 0626, Department of Global Public Health, , Karolinska Institutet, ; Stockholm, Sweden

[11 ]GRID grid.256667.6, ISNI 0000 0001 2192 5385, Department of Mathematics, Computer Science, and Statistics, , Gustavus Adolphus College, ; Saint Peter, MN USA

[12 ]GRID grid.64523.36, ISNI 0000 0004 0532 3255, Department of Public Health, , National Cheng Kung University, ; Tainan City, Taiwan

[13 ]GRID grid.214458.e, ISNI 0000000086837370, Department of Biostatistics, School of Public Health, , University of Michigan, ; Ann Arbor, MI USA

[14 ]GRID grid.266100.3, ISNI 0000 0001 2107 4242, Department of Communication, , University of California San Diego, ; San Diego, CA USA

[15 ]GRID grid.411149.8, ISNI 0000 0004 0472 0160, University Hospital of Caen, ; Caen, France

[16 ]OutRight Action International, New York, NY USA

[17 ]GRID grid.418914.1, ISNI 0000 0004 1791 8889, European Centre for Disease Prevention and Control, ; Solna, Sweden

[18 ]GRID grid.420226.0, ISNI 0000 0004 0639 2949, WHO Regional Office for Europe, ; Copenhagen, Denmark

[19 ]LGBT Foundation, San Francisco, CA USA

[20 ]Tech4HIV, San Francisco, CA USA

[21 ]Aix-Marseille University, CNRS, EHESS, Centrale Marseille, AMSE, Chemin du Château Lafarge, 13290 Les Milles, France

[22 ]GRID grid.8993.b, ISNI 0000 0004 1936 9457, Section of Infectious Diseases, Department of Medical Sciences, , Uppsala University, ; Uppsala, Sweden

Author information

Glenn-Milo Santos https://orcid.org/http://orcid.org/0000-0003-1009-5317

Article

Publisher ID: 2969

DOI: 10.1007/s10461-020-02969-0

PMC ID: 7352092

PubMed ID: 32654021

SO-VID: 34181608-80de-4907-baba-5583d8f68bfb

License:

This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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

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Novel Coronavirus Disease COVID-19

Most cited references 30

An interactive web-based dashboard to track COVID-19 in real time

Antiretroviral Therapy for the Prevention of HIV-1 Transmission.

COVID-19, unemployment, and suicide

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