Changes in mental health care utilisation before and during the COVID-19 pandemic among people living with HIV in the USA: a retrospective cohort study using the All of Us dataset

作者：Atena Pasha, Shan Qiao, Jiajia Zhang, Ruilie Cai, Buwei He, Xueying Yang, Chen Liang, Sharon Weissman, Xiaoming Li · 发表于：BMJ Public Health · 年份：2025 · DOI：10.1136/bmjph-2024-002173 · 被引用次数：3 · 研究领域：COVID-19 and Mental Health、HIV/AIDS Research and Interventions、COVID-19 and healthcare impacts

Introduction: Despite the profound impact of the COVID-19 pandemic on people living with HIV (PLWH) mental health, large-scale, real-world data on mental healthcare utilisation and associated factors among PLWH remain limited. This study explores mental healthcare utilisation and associated factors among PLWH during the COVID-19 pandemic. Methods: Using a retrospective cohort design, we identified and included 4575 PLWH through computational phenotyping based on relevant Observational Medical Outcomes Partnership Common Data Model concept sets from the All of Us programme between March 2018 and March 2022. Mental healthcare utilisation was measured using the yearly count of mental healthcare visits and compared between pre-pandemic (2018-2020) and during the pandemic (2020-2022). Incidence rate ratios (IRRs) from the Poisson generalised linear mixed models were used to examine associations between mental healthcare utilisation, history of COVID-19 infection, demographic factors, pre-existing chronic conditions and socioeconomic status. Results: Annual number of mental healthcare visits among PLWH decreased significantly during the pandemic compared with pre-pandemic (IRR=0.89, p<0.001). COVID-19 infection (IRR=1.35, p<0.001), pre-existing comorbidities (one comorbidity: IRR=5.49; two or more: IRR=10.4, p<0.001) and Medicaid health insurance (IRR=1.29, p=0.007) were associated with a higher number of visits. Middle-aged group participants (aged 30-39: IRR=2.35, p=0.002; 40-49:...