scholarly journals 2499. Perceptions of and Preferences for Oral or Long-Acting Injectable Antiretroviral Treatment Regimens in the United States and Canada

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S866-S867
Author(s):  
Cindy Garris ◽  
Sebastian Heidenreich ◽  
Erin Arthurs ◽  
Frank Spinelli ◽  
Katelyn Cutts ◽  
...  

Abstract Background Antiretroviral treatment (ART) for patients living with HIV (PLHIV) has improved greatly, however, challenges with daily oral dosing remain. New ART options with reduced dosing frequency and innovative delivery methods may help address these challenges. This study assesses patient and physician satisfaction with current treatments and preferences for switching to a monthly or every other month long-acting injectable (LAI) ART. Methods This is a cross-sectional online survey of PLHIV and physicians treating PLHIV in United States and Canada. A literature review, clinical expert input, and qualitative and quantitative pilots informed survey design. Eligible PLHIV were on ART for ≥ 6 months and virally suppressed (self-reported). Survey questions for patients evaluate satisfaction and adherence to current ART. Treatment preferences are assessed using a discrete choice experiment (DCE), where respondents choose between staying on current ART, switching to another oral ART or switching to a LAI ART. DCE treatment attributes include dosing frequency, side effects, forgivability, food/mealtime restrictions, and mode of administration. Pilot data for US patients is included here; the main survey will include approximately 550 patients and 450 physicians. Results Of 51 PLHIV completing the pilot survey, 80% were male, mean age was 54 years, and 63% were on ART for ≥10 years. Switching ART was common, with 55% reporting changing their ART ≥ 3 times. Just under half of patients (47%) were not totally satisfied with their current ART. Most common reasons for dissatisfaction included daily reminder of having HIV (31%) and having to take medicine every day (28%). Just over a quarter of patients (28%) reported forgetting to take their ART in the prior month. Across all DCE choices, patients preferred to remain on their current treatment 47% of the time, while 45% of the time patients preferred switching to the LAI, and for the remaining 8%, patients chose switching to another oral ART regimen. Conclusion Despite advances in ART, treatment challenges remain. Among the treatment-experienced PLHIV in this pilot survey, over half of their choices resulted in switching to an alternative regimen, and when opting to switch, most patients preferred the long-acting injectable treatment regimen. Disclosures All authors: No reported disclosures.

2020 ◽  
Author(s):  
Jeb Jones ◽  
Patrick S Sullivan ◽  
Travis H Sanchez ◽  
Jodie L Guest ◽  
Eric W Hall ◽  
...  

BACKGROUND Existing health disparities based on race and ethnicity in the United States are contributing to disparities in morbidity and mortality during the coronavirus disease (COVID-19) pandemic. We conducted an online survey of American adults to assess similarities and differences by race and ethnicity with respect to COVID-19 symptoms, estimates of the extent of the pandemic, knowledge of control measures, and stigma. OBJECTIVE The aim of this study was to describe similarities and differences in COVID-19 symptoms, knowledge, and beliefs by race and ethnicity among adults in the United States. METHODS We conducted a cross-sectional survey from March 27, 2020 through April 1, 2020. Participants were recruited on social media platforms and completed the survey on a secure web-based survey platform. We used chi-square tests to compare characteristics related to COVID-19 by race and ethnicity. Statistical tests were corrected using the Holm Bonferroni correction to account for multiple comparisons. RESULTS A total of 1435 participants completed the survey; 52 (3.6%) were Asian, 158 (11.0%) were non-Hispanic Black, 548 (38.2%) were Hispanic, 587 (40.9%) were non-Hispanic White, and 90 (6.3%) identified as other or multiple races. Only one symptom (sore throat) was found to be different based on race and ethnicity (<i>P</i>=.003); this symptom was less frequently reported by Asian (3/52, 5.8%), non-Hispanic Black (9/158, 5.7%), and other/multiple race (8/90, 8.9%) participants compared to those who were Hispanic (99/548, 18.1%) or non-Hispanic White (95/587, 16.2%). Non-Hispanic White and Asian participants were more likely to estimate that the number of current cases was at least 100,000 (<i>P</i>=.004) and were more likely to answer all 14 COVID-19 knowledge scale questions correctly (Asian participants, 13/52, 25.0%; non-Hispanic White participants, 180/587, 30.7%) compared to Hispanic (108/548, 19.7%) and non-Hispanic Black (25/158, 15.8%) participants. CONCLUSIONS We observed differences with respect to knowledge of appropriate methods to prevent infection by the novel coronavirus that causes COVID-19. Deficits in knowledge of proper control methods may further exacerbate existing race/ethnicity disparities. Additional research is needed to identify trusted sources of information in Hispanic and non-Hispanic Black communities and create effective messaging to disseminate correct COVID-19 prevention and treatment information.


2021 ◽  
Vol 102 (1) ◽  
pp. 78-90
Author(s):  
Donna Wang ◽  
Jill M. Chonody ◽  
Kathryn Krase ◽  
Leina Luzuriaga

Guidelines aimed at slowing the spread of COVID-19 resulted in major changes in people’s lives. A cross-sectional online survey, completed by 1,405 adults in Canada and the United States in June 2020, found respondents from rural areas/small towns reported better coping and adjustment (i.e., less use of substances for support), less personal impact, less life disruption, and fewer challenges with transportation and health care, than urban and suburban respondents. Those in rural areas were less likely to use the newspaper, but more likely to use social media, for information. Finally, rural respondents reported higher levels of support for their national leadership’s response to the pandemic. The needs and strengths of rural areas, as well as approaches to serve rural areas are discussed.


2022 ◽  
Vol 8 ◽  
pp. 233372142110573
Author(s):  
Mary L. Greaney ◽  
Zachary J. Kunicki ◽  
Meghan M. Drohan ◽  
Caitlin C. Nash ◽  
Steven A. Cohen

Sleep is an integral component of health. The impact of the COVID-19 pandemic on sleep quality among informal caregivers, individuals who provide unpaid care or assistance to family members or friends, assisting older adults is not well understood. Therefore, informal caregivers in the United States providing care for individuals aged 50+ were recruited via Amazon’s Mechanical Turk, an online platform for enrolling study participants into social and behavioral science research, to complete an online survey. The sample of informal caregivers ( n = 835) was 69% male and 55% non-Hispanic. Multivariable linear regression models were constructed to assess the associations between sleep disturbance scores (SDS) and sleep-related impairment scores (SIS) and caregiving-related measures (hours caregiving/week, length of time spent caregiving, and caregiver burden), demographics, and region of the United States. The analysis determined that Black (β = 2.6, 95% CI [−4.3, −0.9]) and Asian informal caregivers (β = −1.8, 95% CI [−3.4, −0.3]) had lower mean SIS than White caregivers, the referent group. In addition, increasing caregiver burden was associated with increased SDS (β = 0.8, 95% CI [0.6, 1.0]) and SIS (β = 1.3, 95% CI [0.7, 1.6]). In conclusion, higher caregiver burden was associated with higher SIS and SDS, suggesting that informal caregivers' sleep should be assessed, and when needed interventions should be offered.


10.2196/19161 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19161 ◽  
Author(s):  
John M Clements

Background The early days of the coronavirus disease (COVID-19) pandemic in the United States brought uncertainty in the knowledge about COVID-19 and what to do about it. It is necessary to understand public knowledge and behaviors if we are to effectively address the pandemic. Objective The aim of this study is to test the hypothesis that knowledge about COVID-19 influences participation in different behaviors including self-reports of purchasing more goods than usual, attending large gatherings, and using medical masks. Methods This study was funded and approved by the Institutional Review Board on March 17, 2020. The cross-sectional online survey of 1034 US residents aged 18 years or older was conducted on March 17, 2020. Results For every point increase in knowledge, the odds of participation in purchasing more goods (odds ratio [OR] 0.88, 95% CI 0.81-0.95), attending large gatherings (OR 0.87, 95% CI 0.81-0.93), and using medical masks (OR 0.56, 95% CI 0.50-0.62) decreased by 12%, 13%, and 44%, respectively. Gen X and millennial participants had 56% and 76% higher odds, respectively, of increased purchasing behavior compared to baby boomers. The results suggest that there is a politicization of response recommendations. Democrats had 30% lower odds of attending large gatherings (OR 0.70, 95% CI 0.50-0.97) and 48% lower odds of using medical masks (OR 0.52, 95% CI 0.34-0.78) compared to Republicans. Conclusions This survey is one of the first attempts to study determinants of knowledge and behaviors in response to the COVID-19 pandemic in the United States. A national, coordinated effort toward a pandemic response may ensure better compliance with behavioral recommendations to address this public health emergency.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243188
Author(s):  
Theresa E. Gildner ◽  
Elise J. Laugier ◽  
Zaneta M. Thayer

Background The COVID-19 pandemic has negatively affected physical and mental health worldwide. Pregnant women already exhibit an elevated risk for depression compared to the general public, a pattern expected to be exacerbated by the pandemic. Certain lifestyle factors, including moderate exercise, may help support mental health during pregnancy, but it is unclear how the pandemic may impact these associations across different locations. Here, we test whether: (i) reported exercise routine alterations during the pandemic are associated with depression scores; and, (ii) the likelihood of reporting pandemic-related exercise changes varies between women living in metro areas and those in non-metro areas. Methods This cross-sectional study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant women in the United States. Participants were recruited April-June 2020 (n = 1,856). Linear regression analyses assessed whether reported COVID-19-related exercise change was associated with depression score as measured by the Edinburgh Postnatal Depression Survey. Logistic regression analyses tested whether a participant’s Rural-Urban Continuum Code classification of “metro” was linked with higher odds of reporting exercise changes compared to a “non-metro” classification. Results Women who reported exercise changes during the pandemic exhibited significantly higher depression scores compared to those reporting no changes. Moreover, individuals living in metro areas of all sizes were significantly more likely to report exercise changes compared to women living in non-metro areas. Conclusions These results suggest that the ability to maintain an exercise routine during the pandemic may help support maternal mental health. It may therefore be prudent for providers to explicitly ask patients how the pandemic has impacted their exercise routines and consider altered exercise routines a potential risk factor for depression. An effort should also be made to recommend exercises that are tailored to individual space restrictions and physical health.


2019 ◽  
Vol 22 (5) ◽  
pp. 713-721 ◽  
Author(s):  
Christopher Russell ◽  
Evangelos Katsampouris ◽  
Neil Mckeganey

Abstract Introduction This study assessed adolescents’ harm and addiction perceptions of the highest-selling brand—JUUL—of the most commonly used tobacco product—electronic cigarettes (e-cigarettes)—among adolescents in the United States. Methods A cross-sectional online survey assessed use and perceptions of the harmfulness and addictiveness of the JUUL e-cigarette and conventional tobacco cigarettes in a nationally representative sample of 9865 adolescents aged 13–17 years in the United States. Associations between adolescents’ harm and addiction perceptions and their use of a JUUL e-cigarette were examined through multinomial logistic regression models. Results Overall, 6.1% and 9.3% of adolescents believed daily use and occasional use of a JUUL e-cigarette, respectively, would cause them no harm. Around 11.3% believed they would either never experience harm from using a JUUL e-cigarette or they could use a JUUL e-cigarette for at least 20 years before experiencing any harm, and 7.3% believed they would be “very unlikely” to become addicted to using a JUUL e-cigarette. Overall, 39.3% and 29.3% of adolescents perceived the JUUL e-cigarette as “less harmful” and “less addictive” than conventional cigarettes, respectively. Compared to never users of the JUUL e-cigarette, current and former users held significantly lower harm and addiction perceptions of the JUUL e-cigarette on all measures. Conclusions The majority of adolescents believed using a JUUL e-cigarette would put them at, at least, some risk for experiencing health problems and addiction. A smaller but significant proportion believed they could use a JUUL e-cigarette without ever being harmed by or becoming addicted to the JUUL e-cigarette. Implications The study reports adolescents’ perceptions of the harmfulness and addictiveness of the highest-selling brand of the most commonly used tobacco product among youth in the United States. Though the majority of adolescents correctly believed that using a JUUL e-cigarette would put them at, at least, some risk for experiencing health problems and addiction, a small proportion believed that using a JUUL e-cigarette would be risk free. Correcting such risk-free perceptions may reduce adolescents’ interest in trying and continuing to use JUUL e-cigarettes.


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