Impact of COVID-19 on People Living with HIV: Data from Five Medical Monitoring Project Sites, 2020-2022.

BACKGROUND: The COVID-19 pandemic disrupted global economic and healthcare systems. People living with HIV (PLWH) represent a marginalized and stigmatized population who may have been particularly impacted. The purpose of this analysis was to describe the impact of the COVID-19 pandemic on PLWH in the United States. SETTING: United States. METHODS: We analyzed surveys of behavioral and clinical characteristics of PLWH residing in five states that participated in the Medical Monitoring Project between 2020 and 2022. We described the impact of COVID-19 illness, testing and diagnoses, receipt of medical care, social service access, employment, and preventive measures by project site and demographic characteristics. RESULTS: Unweighted data from 1715 PLWH were analyzed. A high proportion of PLWH had medical care disrupted by the pandemic; 31% of PLWH missed medical appointments, 26% missed routine labs, and 7% missed antiretroviral therapy doses. 30% of PLWH reported losing wages and 19% reported difficulty in accessing social services. Overall, 88% reported receiving at least one dose of COVID-19 vaccine, but vaccine uptake was low among younger, Black and Hispanic or Latina/o/x PLWH. CONCLUSION: This descriptive analysis reinforces previous findings that show that COVID-19 negatively impacted PLWH and their ability to obtain medical care. Additional efforts will be critical to ameliorating the longer-term impacts of COVID-19 on the health of PLWH and supporting PLWH through future pandemics and healthcare system disruptions.

Maternal androgens and autism spectrum disorder in the MARBLES prospective cohort study.

Background: Maternal hormonal risk factors for autism spectrum disorder (ASD) in offspring could intersect genetic and environmental risk factors. Objectives: This analysis explored ASD risk in association with maternal testosterone, androstenedione, and dehydroepiandrosterone (DHEA) measured in first, second, and third trimesters of pregnancy. Methods: MARBLES is a prospective pregnancy cohort study based at the MIND Institute in Northern California that enrolls mothers who have at least one child previously diagnosed with ASD and are expecting, or planning to have another child. At 36 months the younger sibling is clinically classified as having ASD, or as non-typically developing (Non-TD), or typically developing (TD). Maternal androgens during pregnancy were measured in serum samples from 196 mothers. Multivariable logistic regression models estimated risk of ASD and Non-TD in offspring compared to TD, in relation to the log-transformed maternal androgen concentrations, at each trimester. Results: Non-significant associations were observed, and borderline significant associations were only observed in some stratified unadjusted models. Second trimester maternal testosterone was non-significantly associated with ASD in female offspring, although not after adjustment, aRR 1.54 (95% CI 0.71, 3.33), and second trimester maternal DHEA was non-significantly associated with non-TD in male offspring, again not after adjustment, aRR 0.50 (95% CI 0.21, 1.21). Secondary analysis suggested that third trimester androgen concentrations in mothers with male offspring had significant or near significant associations with their child's Social Responsiveness Scale score. Conclusion: No significant associations were found between maternal androgen concentrations and risk of ASD or Non-TD in the child.

Polychlorinated biphenyls influence on autism spectrum disorder risk in the MARBLES cohort.

BACKGROUND: Autism spectrum disorder (ASD) is suspected to have environmental and genetic contributions. Polychlorinated biphenyls (PCBs) are environmental risk factors of interest due to their potential as neurodevelopmental toxicants and environmental persistence despite a US production ban in the 1970s. METHODS: Participants were mother-child pairs from MARBLES, a high-risk pregnancy cohort that enrolls families who have one child diagnosed with ASD and are planning to have another child. PCB concentrations were measured in maternal blood at each trimester of pregnancy using gas chromatography coupled with triple quadruple mass spectrometry. Concentrations were summed into total PCB and two categories based on function/mechanisms of action: dioxin-like (DL), and ryanodine receptor (RyR)-activating PCBs. Multinomial logistic regression assessed risk of clinical outcome classification of ASD and non-typical development (Non-TD) compared to typically developing (TD) in the children at 3 years old. RESULTS: A total of 104 mother-child pairs were included. There were no significant associations for total PCB; however, there were borderline significant associations between DL-PCBs and decreased risk for Non-TD outcome classification (adjusted OR: 0.41 (95% CI 0.15-1.14)) and between RyR-activating PCBs and increased risk for ASD outcome classification (adjusted OR: 2.63 (95% CI 0.87-7.97)). CONCLUSION: This study does not provide strong supporting evidence that PCBs are risk factors for ASD or Non-TD. However, these analyses suggest the need to explore more deeply into subsets of PCBs as risk factors based on their function and structure in larger cohort studies where non-monotonic dose-response patterns can be better evaluated.

Diabetes Risk Assessment of the UC Irvine Campus Population.

Type 2 diabetes (T2D), historically affecting primarily older individuals, now affects younger people. Few studies have analyzed diabetes risk factors among younger individuals, including college students. We investigated risk in that overlooked population. A 2-part diabetes risk assessment survey was administered to University of California Irvine (UCI) students, faculty, and staff for 2 months. Part I, including 26 questions, assessed participants' nutrition, physical activity, and stress management behaviors. Part II assessed risk according to American Diabetes Association (ADA) Risk Assessment's 8 demographic and lifestyle questions producing a risk score. Scores and behavioral factors analyzed risk on individual and community levels. Recruitment included emails and flyers promoting the UCI Electronic Educational Environment survey link. According to the ADA Risk Assessment scores of the 915 respondents, only 4% are at high risk of developing T2D. Although these scores indicate a small population at risk, our survey revealed a high prevalence of individuals practicing multiple unhealthy lifestyle behaviors associated with diabetes. These multiple behaviors may lead to high percentages of college students developing T2D, despite current low ADA risk status. We conclude the ADA Risk Assessment is geared toward an older demographic and may reflect short-term risk rather than longer-term risks.