Changes in high-risk sexual behavior, HIV and other STI testing, and PrEP use during the COVID-19 pandemic in a longitudinal cohort of adolescent men who have sex with men 13 to 18 years old in the United States.

The COVID-19 pandemic has disrupted sexual health services among those most vulnerable to HIV acquisition, such as adolescent men who have sex with men (AMSM). We sought to characterize the changes in sexual-risk behaviors, HIV and other STI testing, and pre-exposure prophylaxis (PrEP) use among a longitudinal cohort of AMSM aged 13 to 18 years before and during the COVID-19 pandemic. We observed a significant decline in HIV testing and a marginal decrease in other STI testing since the pandemic began in March 2020. Outreach efforts and innovative remote delivery of sexual health services are needed to support access to healthcare services among AMSM as the pandemic persists.

RESUMEN: La pandemia de COVID-19 ha afectado la prestación de servicios de salud sexual para los más vulnerables, tales como los hombres adolescentes que tienen relaciones sexuales con hombres (AMSM; por sus siglas en ingles). En una cohorte longitudinal de AMSM de 13 a 18 años, examinamos los cambios en comportamientos sexuales de alto riesgo, la prueba de VIH, las pruebas de otras enfermedades de transmisión sexual, y el uso de Profilaxis Preexposición (PrEP) para el VIH antes y durante la pandemia. Desde el inicio de la pandemia en marzo de 2020, observamos una disminución significativa en la frecuencia de pruebas de VIH y una disminución marginal en la frecuencia de pruebas de otras enfermedades de transmisión sexual. Mientras persista la pandemia, serán necesarios más esfuerzos de divulgación e innovaciones en la prestación remota de servicios de salud sexual para apoyar el acceso a dichos servicios por parte de AMSM.

Burden of Ischemic Heart Diseases among US States from 1990-2019.

BACKGROUND: Ischemic Heart Disease (IHD) is a leading cause of global mortality, including in the United States. Understanding the burden of IHD in the United States is crucial for informed decision-making and targeted interventions aimed at reducing morbidity and mortality associated with this leading cause of death. This study aimed to understand the burden of IHD, identify gender disparities and risk factors, explore the relationship between socioeconomic growth and IHD, and analyze risk factor distribution across the states of the United States. METHODS: This study utilized data from the Global Burden of Diseases Study 2019, which provided comprehensive information on IHD from 1990 to 2019. Data related to IHD from these years were extracted using a query tool from the Institute for Health Metrics and Evaluation (IHME) website. The study assessed the relationship between IHD and socioeconomic development using the Socio-demographic Index (SDI) and measured the overall impact of IHD using Disability-adjusted Life Years (DALYs), considering premature death and disability. Additionally, the study analyzed the burden of IHD attributed to six main risk factors. Data analysis involved comparing prevalence, mortality, SDI, DALYs, attributable burden, and risk estimation among the states. RESULTS: Between 1990 and 2019, there was an improvement in socioeconomic development in all states. Age-standardized rates of disease burden for IHD decreased by 50% [ASDR 3278.3 to 1629.4 (95% UI: 1539.9-1712.3) per 100,000] with the most significant decline observed in Minnesota. Males had higher burden rates than females in all states, and the southeast region had the highest mortality rates. The prevalence of IHD showed a declining trend, with approximately 8.9 million cases (95% UI: 8.0 million to 9.8 million) in 2019, representing a 37.1% decrease in the Age-standardized Prevalence Rate (ASPR) from 1990. Metabolic risks were the leading contributors to the disease burden, accounting for 50% of cases, with Mississippi having the highest attributable risk. Arkansas had the highest attributable risk for high cholesterol and smoking. Conversely, Minnesota had the lowest burden of IHD among all the states. CONCLUSION: This study highlights variations in the burden of IHD across US states and emphasizes the need for tailored prevention programs to address specific risk factors and gender differences. Understanding the trend in IHD may inform policymakers and healthcare professionals in effectively allocating resources to reduce the burden of IHD and improve national health outcomes.

Mental health problems in male young offenders in custodial versus community based-programs: implications for juvenile justice interventions.

BACKGROUND: Young offenders are known to be a population with high prevalence of mental health disorders. In most cases, these disorders are neither identified nor treated properly, with the majority of them being chronic and difficult to treat. In many countries, the prevalence rates of psychopathology in male young offenders are still unknown and no psychotherapeutic interventions are delivered. Therefore, the main goal of the present study was to assess mental health problems in Portuguese male young offenders placed in either custodial or community-based programs and discuss treatment implications within the juvenile justice interventions. METHODS: Participants in this study included 217 male young offenders aged between 14 and 20 years old that were randomly selected using a random number table. From the total sample, 122 (56.3 %) participants were placed in juvenile detention facilities, and 95 (43.7 %) were receiving community-based programs. Participants were interviewed with the Mini-International Neuropsychiatric Interview for Children and Adolescents, a structured interview that assesses DSM-IV Axis I Mental Disorders. Participants aged 18 years or older were also assessed with the antisocial personality disorder section from the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. RESULTS: Results showed a high prevalence of mental health disorders, with a global prevalence of 91.2 % in the total sample. In both groups, global prevalence rates were equally high (93.4 % in youth in custodial versus 88.4 % in youth in community-based programs). Substance-related disorders were more prevalent in youth placed in juvenile facilities, whereas anxiety and mood disorders were more often found in the community-based group. Moreover, oppositional defiant disorder was more prevalent in youth from the community, whereas antisocial personality disorder and conduct disorder were less prevalent than expected in this same group. A high comorbidity rate was also found, with the majority of participants from both groups' fulfilling criteria for two or more disorders. Additionally, participants with conduct disorder were over four times more likely to fulfill criteria for substance abuse. CONCLUSIONS: Our findings inform about specific needs concerning mental health intervention that should be taken into account when deciding and planning rehabilitation programs for male young offenders, either from custodial or community-based programs.

Psychiatric disorders: a global look at facts and figures.

According to data from Western countries, psychiatric disorders are relatively prevalent. For example, in the United States general population, data from the National Comorbidity Survey Replication study indicate that about one-quarter of individuals experience a psychiatric disorder in a given year, with lifetime rates at about 50 percent. For both prevalence designations, anxiety disorders are most common. According to data from the European Study of the Epidemiology of Mental Disorders, the 12-month and lifetime-prevalence rates for psychiatric disorders among European general populations are 11.5 and 25.9 percent, respectively, with mood and anxiety disorders evidencing approximately equal rates. As expected, in primary care settings, the prevalence of psychiatric disorders in the United States and Europe is high, with point-prevalence rates varying, but affecting approximately 25 to 30 percent of patients. In primary care settings, the most common psychiatric diagnoses are mood and anxiety disorders as well as somatoform disorders. While no global summary of cost of care is available, the high prevalence rates of psychiatric disorders correspond with high expenditures for mental healthcare, as evidenced by a number of sources. Given these latter findings, prevention becomes all the more relevant in terms of cost management.