Evidence map›Paper›PMID 37194051›Full record

Trial reportBMC health services research2023

Mental health and substance use screening in HIV primary care before and during the early COVID-19 pandemic.

Alexandra N Lea, Tory M Levine, Thibaut Davy-Mendez, Amy Leibowitz, Andrea Altschuler, Jason Flamm, C Bradley Hare, Mitchell N Luu, Michael J Silverberg, Derek D Satre

Registry-linked trialOpen access · goldAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03217058 (Implementing Computerized Substance Use and Depression Screening and Evidence-based Treatments in an HIV Primary Care Population), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03217058 nacompletednot on this map

Implementing Computerized Substance Use and Depression Screening and Evidence-based Treatments in an HIV Primary Care Population

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2020Enrolled10,821ConditionsSubstance Use Disorders, HIV, Depression, AnxietyArmsClinic-based screening and behavioral interventions
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 1 country.

Alexandra N LeaDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA. alexandra.n.lea@kp.org.
Tory M LevineDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Thibaut Davy-MendezUniversity of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
Amy LeibowitzDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Andrea AltschulerDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Jason FlammSacramento Medical Center, Kaiser Permanente Northern California, Sacramento, CA, USA.
C Bradley HareSan Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA.
Mitchell N LuuOakland Medical Center, Kaiser Permanente Northern California, Oakland, CA, USA.
Michael J SilverbergDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Derek D SatreDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Kaiser Permanente · USKaiser Permanente Oakland Medical Center · USKaiser Permanente Sacramento Medical Center · USKaiser Permanente San Francisco Medical Center · USUniversity of California, San Francisco · USUniversity of North Carolina at Chapel Hill · US

Funding

Implementing computerized substance use and depression screening and evidence-based treatments in an HIV primary care populationR01DA043139 · NIDA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SATRE, DEREK D, SILVERBERG, MICHAEL J · 2016 to 2020
$3.2M
Mentoring alcohol use intervention research in HIV health care settingsK24AA025703 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Derek D Satre · 2018 to 2026
$1.8M
NIAAA NIH HHS K24 AA025703NIDA NIH HHS R01 DA043139NIDA NIH HHS R01DA043139
6 · The paper itself

Abstract

backgroundMental health and substance use disorders disproportionately affect people with HIV (PWH), and may have been exacerbated during COVID-19. The Promoting Access to Care Engagement (PACE) trial was designed to assess the effectiveness of electronic screening for mental health and substance use in HIV primary care and enrolled PWH from October 2018 to July 2020. Our objective here was to compare screening rates and results for PWH before (October 2018 - February 2020) and early in the COVID-19 pandemic (March-July 2020).

methodsAdult (≥ 18 years) PWH from 3 large HIV primary care clinics in a US-based integrated healthcare system were offered electronic screening online or via in-clinic tablet computer every 6 months. Screening completion and results (for depression, suicidal ideation, anxiety, and substance use) were analyzed using logistic regression with generalized estimating equations to estimate prevalence ratios (PR) before and after the start of the regional COVID-19 shelter-in-place orders on March 17, 2020. Models adjusted for demographics (age, sex, race/ethnicity), HIV risk factors (men who have sex with men, injection drug use, heterosexual, other), medical center, and modality of screening completion (online or tablet). We conducted qualitative interviews with providers participating in the intervention to evaluate how the pandemic impacted patient care.

resultsOf 8,954 eligible visits, 3,904 completed screenings (420 during COVID, 3,484 pre-COVID), with lower overall completion rates during COVID (38% vs. 44%). Patients completing screening during COVID were more likely to be White (63% vs. 55%), male (94% vs. 90%), and MSM (80% vs., 75%). Adjusted PRs comparing COVID and pre-COVID (reference) were 0.70 (95% CI), 0.92 (95% CI), and 0.54 (95% CI) for tobacco use, any substance use, and suicidal ideation, respectively. No significant differences were found by era for depression, anxiety, alcohol, or cannabis use. These results were in contrast to provider-reported impressions of increases in substance use and mental health symptoms.

conclusionFindings suggest PWH had modest declines in screening rates early in the COVID-19 pandemic which may have been affected by the shift to telemedicine. There was no evidence that mental health problems and substance use increased for PWH in primary care.

trial registrationNCT03217058 (First registration date: 7/13/2017); https://clinicaltrials.gov/ct2/show/NCT03217058.

Indexed as

COVID-19HIV InfectionsSexual and Gender MinoritiesSubstance-Related DisordersAdultHomosexuality, MaleHumansMaleMental HealthPandemicsPrimary Health CareCOVID-19HIVMental HealthScreeningSubstance use

Identifiers

PMID37194051
PMCPMC10186313
OpenAlexW4376872860

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.