{
  "abstract": "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: IRR=3.49, p<0.001 and 50–64: IRR=2.07, p=0.004) had higher visit numbers compared with the youngest group (18–29 years). Compared with white participants, black or African American (IRR=0.71, p=0.002) and those with employer-sponsored or union-sponsored insurance (IRR=0.54, p<0.001) had fewer visits.Conclusion This study reveals a decrease in mental healthcare utilisation and diverse experiences of mental healthcare among PLWH during the COVID-19 pandemic. Addressing these disparities is crucial, particularly during public health emergencies.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Atena Pasha"
    },
    {
      "affiliations": [
        "Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Shan Qiao"
    },
    {
      "affiliations": [
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Jiajia Zhang"
    },
    {
      "affiliations": [
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Ruilie Cai"
    },
    {
      "affiliations": [
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Buwei He"
    },
    {
      "affiliations": [
        "Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Xueying Yang"
    },
    {
      "affiliations": [
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Chen Liang"
    },
    {
      "affiliations": [
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "Department of Internal Medicine, School of Medicine Columbia, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Sharon Weissman"
    },
    {
      "affiliations": [
        "Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA",
        "South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Xiaoming Li"
    }
  ],
  "title": "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",
  "uid": "4517d9e2-dd53-573d-aadb-255de6ce29a2"
}