886. The Impact of the COVID-19 Pandemic on Clinical Follow-Up, Monitoring and Regimen Discontinuation for People Living with HIV in the US

Background The COVID-19 pandemic has disrupted health care services for people living with HIV (PLWH). This study aimed to compare rates of clinical visits, viral load monitoring and antiretroviral therapy (ART) regimen discontinuation among virally suppressed PLWH in the US before and during the COVID pandemic. Methods The study population consisted of ART-experienced PLWH ≥18 years of age and active in care in the OPERA cohort within 2 years prior to 31OCT2020. Virally suppressed PLWH (i.e., viral load < 200 copies/mL) were included if they switched to either dolutegravir/lamivudine or a dolutegravir- or bictegravir-based 3-drug regimen between 01MAY2019 and 30APR2020. The study periods spanned from 01MAY2019 to 28FEB2020 (pre-COVID) and 01MAR2020 to 31OCT2020 (during COVID). Incidence rates of clinical visits, viral load measurements and regimen discontinuation were estimated using univariate Poisson regression for both study periods. In-person visits comprised any scheduled or walk-in outpatient, inpatient, emergency or laboratory visit. Telehealth visits comprised any phone or video encounters. Results The study included 4806 PLWH in the pre-COVID and 4992 in the COVID period. Rates of in-person visits were reduced almost 2-fold during COVID, while telehealth visits increased almost 9-fold, resulting in an overall reduction in any visits rates from 10.07 visits per person-year (95% CI: 9.93, 10.21) pre-COVID to 7.10 (95% CI: 7.01, 7.19) during COVID [Fig 1]. Rates of viral load measurements dropped from 2.99 viral loads per person-year (95% CI: 2.92, 3.07) pre-COVID to 1.97 (95% CI: 1.92, 2.02) during COVID [Fig 2]. Regimen discontinuation rates were also reduced from 14.3 discontinuations per 100 person-years pre-COVID (95% CI: 12.7, 16.1) to 9.6 (95% CI: 8.6, 10.8) during COVID [Fig 3]. In both study periods, virologic failures were detected in < 1% of PLWH with ≥ 1 viral load. Figure 1. Incidence rates for overall, in-person, and telehealth visits during the pre-COVID (open circle) and the COVID (filled circle) study periods Incidence rates for viral load measurements during the pre-COVID (open circle) and the COVID (filled circle) study periods Incidence rates for regimen discontinuation during the pre-COVID (open circle) and the COVID (filled circle) study periods Conclusion The COVID pandemic has led to an important reduction in the frequency and type of clinical follow-up visits and viral load monitoring among virally suppressed PLWH in the US. A reduction in regimen discontinuation rates was also observed, presumably associated to less frequent follow-up. The long-term impact of the pandemic on HIV care remains uncertain. Disclosures Gerald Pierone, MD, Epividian (Board Member) Jennifer S. Fusco, BS, Epividian, inc (Employee) Laurence Brunet, PhD, Epividian, inc (Employee) Cassidy Henegar, PhD, GSK (Shareholder)ViiV Healthcare (Employee) Jean A. van Wyk, MB,ChB, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Supriya Sarkar, PhD, GSK (Shareholder)ViiV Healthcare (Employee) Vani Vannappagari, MBBS, MPH, PhD, ViiV Healthcare Limited (Employee) Andrew Zolopa, MD, GlaxoSmithKline (Shareholder)ViiV Healthcare (Employee) Michael B. Wohlfeiler, MD, Epividian, inc (Board Member)ViiV Healthcare (Research Grant or Support) Gregory Fusco, MD, MPH, Epividian, inc (Employee)

Introduction

This chapter introduces the importance of a continuing substantive conversation on the identity and mission of Catholic higher education. It reviews some of the debates before and after Vatican II (1962–1965) and explains the metaphor of the “open circle,” the danger of mission slippage, and the profound cultural changes over the past seventy-five years. It also offers a diagnosis of the current state of Catholic higher education and describes the Institute for Advanced Catholic Studies (ifacs.com).

Academic Freedom and the Open Circle

This chapter provides a historical and epistemological analysis of academic freedom as presented by the American Association of University Professors (AAUP) and supports its procedural guidelines but criticizes the way in which it associates reliable knowledge almost exclusively with scientifically based knowledge. It describes three types of universities: the closed circle, the marketplace of ideas, and the open circle, defending the last model as the most valuable for Catholic universities to embrace in the twenty-first century. It argues that even though the open circle model is the most difficult to sustain, it points the best way forward, academically and theologically.

Open Circle: Playing Coexistence in Ten Movements

The central focus of this article is Open Circle, a play written by Esther Uria-Iriarte that follows Arts Based Research (ABR) methods in theatrically interpreting the results of a doctoral research study carried out in four secondary schools in The Basque Country of Spain. The research aims to analyze the implications of theater as a methodological strategy for the improvement of coexistence in secondary students of The Basque Country. Open Circle is accompanied by the relevant theoretical foundations that support the ABR methodology and the aesthetic strategies applied to writing the play. In an intercalated way, we present various fragments of the theatrical work that reflect the researcher’s feelings during the research process, including her difficulties and vulnerability in working with adolescent participants, as well as her frustrations in facing the contradictions in her research results.

Implementation of Interleaved Three Stage Boost Converter Fed Dc Drive With Zero-Voltage Transition

This paper manages reenactment of Voltage Controlled PFC based interleaved support Converter sustained DC engine Drive in open circle . An epic delicate exchanging interleaved coupled-inductor support converter is proposed in this paper. Just a solitary dynamic delicate exchanging module is expected to all the while accomplish the delicate exchanging property of the two switches in the interleaved coupled-inductor support converter. The better productivity is accomplished with the less segments and cost. The two principle switches can accomplish the ZVT turn-on and littler current mood killer at the same time when the single dynamic delicate exchanging module is dynamic. The aftereffects of three phase ILBC are contrasted and those of two phase ILBC.. [1],[ 3],[5]

A theoretical study of new representatives of closed- and open-circle benzofuran and benzocyclopentadienone oligomers

Strain energies for oxa[n]circulene species relative to the unstrained tetraoxa[8]circulene.