■黑人和拉丁裔社区在健康的社会决定因素(SDOH)和慢性疾病的高发病率方面存在不平等[例如,心血管疾病(CVD),艾滋病毒]。COVID-19大流行放大了这些长期存在的SDOH差异。然而,人们很少关注与大流行有关的经历,这些经历与结构性不平等有关。
■使用半结构化面试指南,对黑人和拉丁裔艾滋病毒感染者(PLWH)和心血管疾病风险进行了60次深入电话采访,以评估:(1)对COVID-19的个人和社区风险;(2)对COVID-19公共卫生信息的了解和获取;(3)对COVID-19公共卫生建议和疫苗接种的障碍;(4)对艾滋病毒的认知,CVD,和COVID-19。面试被专业地转录成英语或西班牙语。西班牙语成绩单被翻译成英文。快速定性分析用于将每个成绩单汇总为与采访指南领域相对应的结构化模板。摘要被组合成矩阵,用于识别和比较不同领域的主题。
■参与者报告了由于免疫功能受损和SDOH而导致的COVID-19风险,包括交通,暴露于他人赋予的风险,生活在资源不足的社区,住房不安全。参与者通过遵守公共卫生任务从事保护性对策。与供应商的关系,参加社区支持小组,在COVID-19信息的传播和疫苗接种方面,数字包容和识字是显著的。管理慢性病的经验促进了疫苗的接受。参与者描述了语言障碍,歧视的经验,以及历史上对医疗系统和疫苗缺乏信任。
■这项研究提供了在COVID-19大流行期间易感的PLWH和CVD风险的实时叙述。影响包括需要与提供者和已建立的社区网络保持连续性,增加互联网接入和数字健康素养,并解决医疗环境中遭受的历史创伤。至关重要的是要了解传统的SDOH对慢性病患者的影响以及其他社会决定因素,这些因素有助于获取公共卫生信息,遵守公共卫生建议,以及暴露于结构性不平等的人群的疫苗摄取。
UNASSIGNED: Black and Latinx communities experience inequities in the social determinants of health (
SDOH) and high rates of chronic illnesses [e.g., cardiovascular disease (CVD), HIV]. The COVID-19 pandemic amplified these long-standing
SDOH disparities. However, scant attention has been paid to the pandemic-related experiences of populations exposed to structural inequities.
UNASSIGNED: Using a semi-structured interview guide, 60 in-depth telephone interviews were conducted with Black and Latinx people living with HIV (PLWH) and CVD risks to assess: (1) perceived personal and community risk for COVID-19; (2) knowledge of and access to COVID-19 public health information; (3) barriers to COVID-19 public health recommendations and vaccine uptake; and (4) perceptions of HIV, CVD, and COVID-19. Interviews were professionally transcribed into either English or Spanish. Spanish transcripts were translated into English. Rapid qualitative analysis was used to summarize each transcript into a structured templaicte corresponding to interview guide domains. Summaries were combined into matrices for identification and comparison of themes across domains.
UNASSIGNED: Participants reported risks for COVID-19 due to being immunocompromised and
SDOH, including transportation, exposure to risks conferred by others, living in under-resourced neighborhoods, and housing insecurity. Participants engaged in protective countermeasures by adhering to public health mandates. Relationships with providers, participating in community support groups, and digital inclusion and literacy were salient with respect to dissemination of COVID-19 information and vaccine uptake. Experiences with managing a chronic illness facilitated vaccine acceptance. Participants described language barriers, experiences of discrimination, and a historical lack of trust in medical systems and vaccines.
UNASSIGNED: This study provides a real-time narrative from PLWH and CVD risks who were vulnerable during the height of the COVID-19 pandemic. Implications include the need for continuity with providers and established community networks, increasing internet access and digital health literacy, and addressing historical trauma incurred in medical settings. It is critical to understand the impact of traditional
SDOH on those living with chronic illness as well as other social determinants that shed light on access to public health information, adherence to public health recommendations, and vaccine uptake among populations exposed to structural inequities.