COVID-19 Stay-At-Home Orders and Older Adults’ Cognitive Health — United States, June 2018–February 2022

What is already known about this topic?Lack of social activities is known to negatively impact cognitive functioning and increase risk of cognitive impairment,including dementia,among older adults.What is added by this report?Coronavirus disease 2019(COVID-19)stay-at-home orders implemented in the U.S.early during the pandemic were not found to negatively affect cognitive functioning of older adults.What are the implications for public health practice?There may have been no severe,unintended consequences of the COVID-19 stay-at-home orders in terms of their impact on cognitive functioning and risk of dementia among older adults,lending further support to use of such orders.

Projected effectiveness of HIV detection during early infection and rapid ART initiation among MSM and transgender women in Peru: A modeling study

Background:The Sabes study,a treatment as prevention intervention in Peru,tested the hypothesis that initiating antiretroviral therapy(ART)early in HIV infection when viral load is high,would markedly reduce onward HIV transmission among high-risk men who have sex with men(MSM)and transgender women(TW).We investigated the potential population-level benefits of detection of HIV early after acquisition and rapid initiation of ART.Methods:We designed a transmission dynamic model to simulate the HIV epidemic among MSM and TW in Peru,calibrated to data on HIV prevalence and ART coverage from 2004 to 2011.We assessed the impact of an intervention starting in 2018 in which up to 50%of the new infections were diagnosed within three months of acquisition and initiated on ART within 1 month of diagnosis.We estimated the impact of the intervention over 20 years using the cumulative prevented fraction of new HIV infections compared to scenarios without intervention.Findings:Our model suggests that only 19%of the infected MSM and TW are virally suppressed in 2018 and 35%e40%of the new HIV infections are transmitted from contacts with acutely-infected partners.An intervention reaching 10%of all acutely infected MSM and TW is projected to prevent 13.3%[Uncertainty interval:11.9%e14.3%]of the new infections over 20 years and reduce HIV incidence in 2038 by 24%.Reaching 50%of all acutely infected MSM and TWwill increase the prevalence of viral suppression in 2038 to 59%and prevent 41%of expected infections over 20 years.Reaching 50%of the high-risk MSM and TW in acute phase would reduce HIV incidence in 2038 by 60%and prevent 36%of new infections between 2018 and 2038.Conclusions:Early detection of HIV infections and rapid initiation of ART among MSM is desirable as it would increase the effectiveness of the HIV prevention program in Peru.Targeting high-risk MSM and TW will be highly efficient.