WEDNESDAY, June 8, 2022 (HealthDay News) -- Even after vaccination, living with HIV ups the odds for COVID infection, new research shows. Recommended Videos Powered by AnyClip Pfizer’s 3-Dose Vaccine 80% Effective Against Omicron Infection for Youngest Children 1.4K Play Video Pfizer’s 3-Dose Vaccine 80% Effective Against Omicron Infection for Youngest ChildrenNOW PLAYING This Is How a COVID-19 Infection Could Damage Your Brain Top 5 Symptoms of ‘Breakthrough’ COVID-19 White House Warns COVID-19 Cases Could Double Late This Year Are Boosted Americans More Likely To Catch COVID-19? The study found that vaccinated people living with HIV have a 28% higher risk of developing a "breakthrough" COVID infection compared to those who don't have the AIDS-causing virus. That’s the bad news. But there's good news, too: The overall risk for COVID infection among people vaccinated with at least the two primary doses remains low, regardless of their HIV status. “We thought we might see an increase in the risk of breakthrough in people with HIV because of the impact of HIV on the immune system and the role of the immune system in responding to vaccination and infection from a virus like SARS-Cov-2," reasoned study author Keri Althoff. So, the researchers weren't surprised to find "that about 4 in 100 people with HIV experience a breakthrough, compared to 3 in 100 people without HIV," said Althoff, an associate professor in the Johns Hopkins School of Public Health epidemiology department. But it was a relief, she said, to see that nine months after vaccination, "the rate and risk of breakthrough is low among vaccinated people with and without HIV" -- around 4% in each group. Her team analyzed data on nearly 114,000 COVID-vaccinated men and women, of whom 33,000 had HIV. Most were 55 years and up, 70% were white, and more than 9 in 10 were men. The authors focused on COVID risk during the latter half of 2021, when the more contagious Omicron variant emerged. Althoff noted that breakthrough infections were higher across the board -- regardless of HIV status -- in December, when Omicron became the dominant strain. Beyond identifying the 28% higher risk for a breakthrough infection among those with HIV, the researchers noted that certain individuals with HIV faced a higher infection risk than others. They included people under age 45, compared with those between 45 and 54. Risk was also higher among those who had not received a third (or booster) dose, and those with a prior infection. Risk of breakthrough infection in folks with HIV also increased as their T-cell counts dropped. According to the U.S. National Library of Medicine, T-cells are critical infection-fighting white blood cells which are typically attacked by HIV. (When an HIV patient's T-cell count falls to an extremely low level, it is often a sign of transition to full-blown AIDS.) Althoff said she and her colleagues "hypothesize that HIV-induced immune dysfunction may be playing a role in vulnerability to breakthrough COVID-19 illness." For that reason, boosters may be critical for such patients, she said. Currently, Althoff pointed out, third-dose boosters are recommended for those whose HIV is either untreated or advanced. "To increase protection against breakthrough infections, all people with HIV may need an additional dose in their primary series," she noted. That thought was echoed by Dr. Joel Blankson, a professor of medicine at Johns Hopkins Medicine, who was not part of the study. Because the study showed a decrease in breakthrough infections in patients who had received a third vaccine dose, "it is important that people living with HIV get a booster dose when they are eligible," Blankson said. The U.S. Centers for Disease Control and Prevention has COVID vaccine guidelines here. Additional research by Althoff's team suggests that hospitalization risk for breakthrough cases is higher among HIV-positive people compared to those without HIV. (Those findings are still under peer review and are not yet published.) Her advice to those with HIV: "Get vaccinated. Get boosted. Keep living your life and scale up and down your mitigation strategies -- mask-wearing, attending indoor gatherings, etc. -- based on the amount of COVID-19 transmitting in your community, and your personal health status." Dr. Thomas Gut is associate chair of medicine at the Zucker School of Medicine at Hofstra/Northwell in New York City. "The HIV-linked risk of reinfection is somewhat expected," said Gut, who had no role in the study. "In many other infectious diseases besides COVID, it's been known that patients with HIV do tend to have higher risk of both getting sick and having poorer outcomes." But patients with HIV "that have strong immune cell counts have traditionally been known to be better protected from infections compared to those with low immune system counts," he added. "It appears that COVID reinfection risk follows this same pattern." Therefore, Gut said, it is important to keep HIV infection under control as best as possible. The findings are in the June 7 issue of JAMA Network Open. More information There's more on HIV status and COVID-19 at HIV.gov. SOURCES: Keri N. Althoff, PhD, MPH, associate professor, epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore; Joel N. Blankson, MD, PhD, professor, medicine, Johns Hopkins Medicine, Baltimore; Thomas Gut, DO, associate chair, medicine, and director, ambulatory care services, Zucker School of Medicine at Hofstra/Northwell, Staten Island, N.Y.; JAMA Network Open, June 7, 2022 Copyright © 2022 HealthDay. All rights reserved.

 By Amy Norton HealthDay Reporter

(HEALTHDAY)

WEDNESDAY, June 8, 2022 (HealthDay News) -- The mental health equivalent of 911 is about to launch across the United States, but a new study finds that many communities may not be prepared for it.

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Beginning July 16, a new 988 number will be available 24/7 for Americans dealing with a mental health crisis. It's akin to 911, long used to get help for medical emergencies.

The new code will replace the 10-digit number currently used to reach the National Suicide Prevention Lifeline, which was established in 2005. Health officials expect the easy-to-remember 988 to spur a surge in calls.

The trouble is, few jurisdictions are ready for that, according to the new study, by the nonprofit research organization RAND Corp.

"At the service level, the 988 transition is a simple number change," said Ryan McBain, a RAND policy researcher who co-led the study.

But on the ground, McBain said, it's a different story.

For one, local crisis centers need enough counselors to handle any influx of calls. Beyond that, some callers will need additional in-person help.

Yet, the study found, many jurisdictions lack such resources. It surveyed 180 state, regional and county health officials, and found that only half said their jurisdiction had short-term "crisis stabilization" services to which callers could be directed.

Even fewer -- 28% -- had urgent care units that could be dispatched to people in urgent need. Meanwhile, only 22% had call centers that could schedule mental health appointments on behalf of people who wanted them.

On top of those shortfalls, most local hotlines did not offer text or online chat options. That's a key gap, McBain said, since teenagers and young adults often prefer those modes of communication.

Overall, McBain said, the findings confirm the concerns of many mental health experts: Jurisdictions have not had the time or resources to prepare for the 988 rollout.

The 988 code was authorized by Congress in 2020, with the intent of giving Americans an easier way to reach the National Suicide Prevention Lifeline. The Lifeline is a network of almost 200 crisis centers throughout the United States. When people call the national number, they are connected with the center closest to them to speak with a trained counselor and, if needed, get help finding local resources.

The intent of the Lifeline, and 988, goes beyond suicide prevention, McBain noted. It offers help to people in mental health distress, including problems related to substance abuse.

Studies have shown that the existing Lifeline network helps most people who call.

"For many callers, the issue will be resolved just by having that contact with a counselor," said Dr. Robert Trestman, chair of the American Psychiatric Association's Council on Healthcare Systems and Financing.

"It's when it comes to referral to local services that things will get more complicated," said Trestman, who was not involved in the study.

And that issue is nothing new. The new findings, Trestman said, merely highlight the nation's under-resourced, fragmented mental health care system.

The 988 designation, he noted, came amid a pandemic that has only worsened the situation -- taking a huge toll on Americans' mental health and straining existing mental health services.

Trestman put it bluntly: "We have a mental health care system that was designed to fail."

The looming 988 launch is only the beginning of efforts to shore up that system, said Dr. John Palmieri, acting director of the 988 coordination office at the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA).

"The Biden/Harris Administration has made significant strides in strengthening and expanding the existing Lifeline, and we expect 988 will continue to grow and evolve in the coming months, as more states start to step up," Palmieri said in a statement.

He added that the Lifeline network "has been massively underfunded and under-resourced since it began in 2005."

The Biden Administration has invested $282 million in the 988 transition -- but, Palmieri added, states also need to "rev up investments."

Despite the challenges, all agreed that Americans should use 988 when it becomes available. (According to SAMHSA, if a caller's local crisis center is unable to answer, the caller will be automatically routed to a national "backup" center.)

"Already, the Lifeline is an incredible service," McBain said. "Studies show that."

Trestman agreed, saying that the 988 transition "will go through growing pains," but it is ultimately a "good thing."

It's part of a broad effort, Trestman added, to lift the stigma around mental health care.

Still, McBain said, there is a long way to go before the system is the equivalent of 911 -- where callers know, wherever they live, there will be local services available for their physical health emergency.

"To not have an equivalent for mental health is inexcusable," McBain said.

More information

The Substance Abuse and Mental Health Services Administration has more on 988.

SOURCES: Ryan McBain, PhD, MPH, policy researcher, RAND Corp., Santa Monica, Calif.; John Palmieri, MD, MHA, acting director, 988 and Behavioral Health Crisis Coordination Office, Substance Abuse and Mental Health Services Administration, Rockville, Md.; Robert Trestman, MD, PhD, chair, Council on Healthcare Systems and Financing, American Psychiatric Association, Washington, D.C.; RAND Corp. working paper, June 2022

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