The CROI Foundation is an organization that operates exclusively for the charitable and educational purpose of organizing, promoting, and presenting the Conference on Retroviruses and Opportunistic Infections (CROI). We highlight three presentations from this year’s CROI, which included the contributions of CUNY ISPH Investigators and research staff.
Many early COVID-19 outcome studies were based exclusively on electronic health record (EHR) data from single health systems. However, many people in 2020 who would have ordinarily received care in the same system experienced outcomes at other hospitals or at home – 2 common scenarios when COVID-19 temporarily transformed usual practice. CUNY ISPH contributors to “Completeness of COVID-19 Outcomes Among People With HIV Receiving Care in New York City in 2020,” include Jenny Shen, Denis Nash, McKaylee Robertson, and Heidi Jones.The study team assessed completeness of COVID-19 outcomes among people with HIV (PWH) receiving HIV care in 3 New York City health systems, comparing EHR data alone to the gold standard of public health surveillance data. The team found that in 2020, analyses limited to EHR severely underestimated COVID-19 outcomes and resulted in important biases in outcome estimates and measures of association. Interpretation of estimates from EHR-based studies during public health emergencies should require careful consideration of ascertainment bias.
With colleagues from France, Malawi, Uganda, Côte d’Ivoire, Brazil, India, South Africa, United Republic of Tanzania, Rwanda, Nigeria, and the US, CUNY ISPH Executive Director Denis Nash contributed to “Effect of COVID-19 Pandemic on ART Access and Timely Initiation in Adults With HIV in 31 Countries.” The study group found that in most countries, there was no difference in ART initiations or timeliness after the onset of the pandemic. This suggests that contributing clinics maintained a “test and treat” approach despite strict pandemic measures. Further research should examine the pandemic’s impact on case finding (first 95) and viral suppression (third 95), especially in countries with observed disruptions.
CUNY ISPH Investigator Constantin Yiannoutsos, with colleagues from the (IeDEA) Collaboration – East Africa Region, investigated HIV and TB stigma and reported influences of TB stigma on care access among individuals with pulmonary TB in Eldoret, Kenya, and Mbarara, Uganda, in “HIV and Tuberculosis Stigma Affecting Individuals With Pulmonary Tuberculosis in East Africa.” The findings indicate that individuals with TB in East Africa endorsed substantial felt HIV stigma, particularly among younger individuals, those in rural areas, and those living with HIV. TB stigma was comparatively lower, with little self-reported impact on TB care access. The study team suggests that further work is needed to evaluate stigma impacts on TB care outcomes and wellbeing.
