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Background: Many clinical and population-based research studies pivoted from in-person assessments to phone-based surveys due to the COVID-19 pandemic. The impact of these transitions on survey response remains understudied, especially for people living with HIV. Given that there are gender-specific trends in alcohol and substance use, it is particularly important to capture these data for women. Objective: Identify factors associated with responding to an alcohol and substance use phone survey administered during the COVID-19 pandemic in the Women's Interagency HIV Study, a multicenter US prospective cohort of women living with and without HIV. Methods: We used multivariable logistic regression to assess for associations of pre-pandemic (April–September 2019) sociodemographic factors, HIV status, housing status, depressive symptoms, alcohol use, and substance use with response to an early-pandemic (August–September 2020) phone survey. Results: Of 1,847 women who attended an in-person visit in 2019, 78% responded to a phone survey during the pandemic. The odds of responding were lower for women of Hispanic ethnicity (aOR 0.47 95% CI 0.33–0.66, ref=Black/African American) and those who reported substance use (aOR 0.63 95% CI 0.41–0.98). By contrast, the odds were higher for White women (aOR 1.64 95% CI 1.02–2.70, ref=Black/African American) and those with stable housing (aOR 1.74 95% CI 1.24–2.43). Conclusions: Pivoting from an in-person to phone-administered alcohol and substance use survey may lead to underrepresentation of key subpopulations of women who are often neglected in substance use and HIV research. As remote survey methods become more common, investigators need to ensure that the study population is representative of the target population. [ABSTRACT FROM AUTHOR]

Background: Methadone is increasingly initiated during hospitalization for the treatment of opioid use disorder (OUD). However, little is known about which factors are associated with linkage to opioid treatment programs (OTP) and retention in methadone maintenance therapy (MMT) following hospital discharge. Materials & Methods: This is a retrospective study of adults with OUD hospitalized in an urban, safety-net hospital referred by inpatient clinicians to an onsite OTP for post-discharge MMT follow-up from October 2017 to July 2019. We used multivariable modified Poisson regression models to generate adjusted risk ratios (aRR) for associations of sociodemographic factors, mental health disorders, alcohol use, stimulant use, and prior care engagement with post-discharge OTP enrollment and MMT retention at 30 and 90-days. Results: Of the 125 patients referred, 40% enrolled in the OTP post-discharge. Among enrollees, 74% were retained at 30-days and 52% were retained at 90-days. Patients with co-occurring stimulant use were less likely to enroll in the OTP post-discharge compared to those without stimulant use (aRR 0.65, 95% CI 0.44–0.97). We found no associations with 30-day MMT retention, but patients who reported stable housing were more likely to be retained in MMT at 90-days compared to those without stable housing (aRR 1.66, 95% CI 1.03–2.66). Conclusion: Our findings suggest that hospitalized patients with co-occurring stimulant use may need additional support to optimize post-discharge OTP linkage. Stable housing may improve retention in MMT. Additional research is needed to identify trends in MMT engagement among those referred from the acute hospital setting. [ABSTRACT FROM AUTHOR]

Traditionally, theories of moral responsibility feature only the minimally sufficient conditions for moral responsibility. While these theories are well-suited to account for the threshold of responsibility, it's less clear how they can address questions about the degree to which agents are responsible. One feature that intuitively affects the degree to which agents are morally responsible is how difficult performing a given action is for them. Recently, philosophers have begun to develop accounts of scalar moral responsibility that make use of this notion of difficulty [Coates and Swenson 2013; Nelkin 2016]. In this paper, I argue that these accounts, although innovative, are incomplete. The degree to which agents are morally responsible is determined not only by the difficulties that agents face but also by the quality of the reasons for which they act. [ABSTRACT FROM AUTHOR]