Longitudinal Survey Examining Impact of COVID19 on AA with HIV

Date

2022

Authors

Patel, Yesha
Oranu, Chukwuezugo
Cooper, Jennifer
Borgmann, Kathleen
Afrasiabian, Soma
Fleming, Marc
Lee, Deidra

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Abstract

The impact of COVID-19 has been devastating. It increases the risk for individuals with chronic health conditions type 2 diabetes, obesity, and HIV. In addition, research has shown among individuals with comorbidities, African Americans have a higher prevalence and poorer prognosis of COVID-19. Non-medical factors (e.g., social determinants of health) are key drivers of health outcomes and inequities. Patient-reported health outcomes expounded by social determinants of health depict how vulnerable populations are faring over a year into the pandemic. Therefore, our goal was to assess the impact of the pandemic on African Americans living with HIV as it relates to social determinants of health. A longitudinal survey employing face-to-face interview questions was used to address the study objective at three-time points. Participants were part of an ongoing study to examine the impact of medication therapy management visits on patients' health. The inclusion criteria for the study were adults ≥18 years, the presence of hypertension or diabetes, and a positive HIV diagnosis being managed by anti-retroviral therapy. Participants selected for the presented study met the original inclusion criteria and had study visits within the time points defined as pre-COVID, during COVID, and post-COVID. Participants were excluded if they didn't have study visits within three-time points or inclusion criteria. Ten questions that examined social determinants of health and overall well-being were extracted from the survey used at each study visit. Participants met with pharmacists approximately every three months per the study protocol. Descriptive statistics and inferential statistics were used to analyze survey responses. A proportional odds mixed-effects logistic regression model assessed differences between time points. The last six questions were dichotomized due to data skewness. This study was approved by the University of North Texas Health Science Center's Institutional Review Board (IRB). A total of 27 participants were included. The average age of participants was 53. Participants' responses to the survey questions were fairly consistent across all three time points. The mean response to the questions increased (more favorable) from time point 1 to time point 2. The means were higher between time point 2 and time point 3. There was a significant difference between time point 3 and time 1 (odds ratio [OR] = 16.39, 95% CI [1.08-37.73], p= 0.04), regarding the statement "In the last month, I felt like my safety was threatened because of the place I sleep or live." A greater proportion of participants reported a score of 5 on this question, indicating they strongly disagreed with the statement. The results showed a statistically significant difference in participants feeling safer where they resided or slept post-COVID than pre-COVID. This perhaps can be explained by the rent and mortgage moratoriums, and housing protections provided by the Coronavirus Aid, Relief, and Economic Security (CARES) Act. Future research priorities should include the benefits of pharmacist-driven MTM in evaluating social determinants of health, and medication needs to inform public health goals and policy implementation better.

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