Widespread closure of HIV prevention and care services places youth at higher risk during the COVID-19 pandemic

• Published in: PloS one 2021-09, Vol.16 (9), p.e0249740-e0249740
• Main Authors: Stephenson, Rob, Walsh, Alison R, Chavanduka, Tanaka M D, Sallabank, Gregory, Horvath, Keith J, Castel, Amanda D, Bonar, Erin E, Hightow-Weidman, Lisa, Bauermeister, Jose A, Sullivan, Patrick S
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Behavior; Biology and Life Sciences; Control; Coronaviruses; Correlation; Correlation coefficient; Correlation coefficients; Corridors; COVID-19; COVID-19 - epidemiology; Delivery of Health Care - methods; Disease prevention; Epidemics; Epidemiology; Gays & lesbians; Health aspects; Health disparities; Health services; HIV; HIV infection; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Medical tests; Medicine and Health Sciences; Mens health; Mental health; Nursing schools; Pandemics; Prevalence; Prevention; Public health; Randomized Controlled Trials as Topic; Sexual and Gender Minorities - education; Sexual health; Sexuality; Sexually transmitted diseases; Statistical analysis; STD; Support services; Teenagers; Telemedicine; United States - epidemiology; Young Adult; Youth
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0249740

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. 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. We 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). There 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. As 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.