{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:53:22Z","timestamp":1781628802007,"version":"3.54.5"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T00:00:00Z","timestamp":1766966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Social disruptions (e.g., loss of stable housing, employment, income) during the COVID-19 pandemic have been associated with greater mental healthcare and substance use treatment needs in the general population. People with HIV (PWH) may have experienced greater social disruptions during the COVID-19 pandemic due to pre-existing social vulnerabilities and may have experienced greater interruptions in healthcare during the pandemic due to the co-management of chronic and co-morbid conditions, including mental health and substance use disorder diagnoses, which are prevalent among PWH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between April and September 2020, surveys assessing social disruption and healthcare interruption were conducted among Multicenter AIDS Cohort Study\/Women\u2019s Interagency HIV Study Combined Cohort Study participants. Descriptive statistics and multivariable logistic regression models were used to characterize and examine the relationships between social disruptions and interruptions in general, mental health, and substance use care, adjusting for sociodemographic characteristics (age, race and ethnicity, region, income, and employment) and HIV status. Qualitative interviews were conducted to add depth and context to quantitative analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 3,665 survey participants (2,238 PWH, 1,427 PWoH), 54% (1214 PWH, 733 PWoH) reported social disruptions and 42% reported healthcare interruptions (972 PWH, 578 PWoH). PWH experiencing\u2009\u2265\u20092 social disruptions had higher odds of missed healthcare appointments (aOR\u2009=\u20091.92, 95%CI:1.56, 2.36) and interrupted mental healthcare (aOR\u2009=\u20092.54, 95%CI:1.83, 3.53) compared to those experiencing\u2009&lt;\u20092. PWoH experiencing\u2009\u2265\u20092 social disruptions had higher odds of missed healthcare appointments, (aOR\u2009=\u20091.65, 95%CI:1.26, 2.17), interrupted mental healthcare (aOR\u2009=\u20092.24, 95%CI:1.38, 3.64), and interrupted substance use treatment (aOR\u2009=\u20092.58, 95%CI:1.15, 5.75) compared to those experiencing\u2009&lt;\u20092. Qualitative interviews elucidated the following reasons for healthcare interruptions: Interruptions in medication and supplies, reduced access to quality healthcare services, self-imposed interruptions related to perceived COVID risk, increased interruptions related to comorbid care needs, reduced access to mental healthcare, and delays in HIV-care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Healthcare interruptions during the pandemic inequitably affected vulnerable individuals, especially those experiencing greater social disruptions and those with specialized health care needs. Understanding the impact of pandemic related social disruptions on vulnerable individuals provides an opportunity to address disparities and build a more capable health care system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-025-13690-w","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T22:58:28Z","timestamp":1767049108000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of COVID-19 social disruptions on general-, mental- and substance use healthcare services among people with and without HIV in the United States"],"prefix":"10.1186","volume":"25","author":[{"given":"Jenni M.","family":"Wise","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Y.","family":"Byun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorie","family":"Benning","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corilyn","family":"Ott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenoria Causey","family":"Pruitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Krier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lopez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet M.","family":"Turan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheri D.","family":"Weiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Wingood","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennafer","family":"Kwait","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mardge H.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Aouizerat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjali","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catalina","family":"Ramirez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Mimiaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Goparaju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anandi N.","family":"Sheth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Merenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Stosor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adebola","family":"Adedimeji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Plankey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah L.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gypsyamber","family":"D\u2019Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Reuel","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam-Colette","family":"Kempf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,29]]},"reference":[{"issue":"8","key":"13690_CR1","doi-asserted-by":"publisher","first-page":"2236","DOI":"10.1007\/s10461-020-02869-3","volume":"24","author":"AB Algarin","year":"2020","unstructured":"Algarin AB, Varas-Rodr\u00edguez E, Valdivia C, et al. Symptoms, stress, and HIV-related care among older people living with HIV during the COVID-19 pandemic, Miami, Florida. AIDS Behav. 2020;24(8):2236\u20138. https:\/\/doi.org\/10.1007\/s10461-020-02869-3.","journal-title":"AIDS Behav"},{"issue":"4","key":"13690_CR2","doi-asserted-by":"publisher","first-page":"475","DOI":"10.1097\/qai.0000000000002493","volume":"85","author":"J Ballivian","year":"2020","unstructured":"Ballivian J, Alcaide ML, Cecchini D, Jones DL, Abbamonte JM, Cassetti I. Impact of COVID-19-related stress and lockdown on mental health among people living with HIV in Argentina. J Acquir Immune Defic Syndr. 2020;85(4):475\u201382. https:\/\/doi.org\/10.1097\/qai.0000000000002493.","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"2","key":"13690_CR3","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1097\/00001648-199803000-00004","volume":"9","author":"SE Barkan","year":"1998","unstructured":"Barkan SE, Melnick SL, Preston-Martin S, et al. The women\u2019s interagency HIV study. WIHS collaborative study group. Epidemiology. 1998;9(2):117\u201325.","journal-title":"Epidemiology"},{"issue":"2","key":"13690_CR4","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101. https:\/\/doi.org\/10.1191\/1478088706qp063oa.","journal-title":"Qual Res Psychol"},{"key":"13690_CR5","unstructured":"Centers for Medicare & Medicaid Services. Non-emergent, elective medical services, and treatment recommendations. www.cms.gov\/files\/document\/cms-non-emergent-elective-medical-recommendations.pdf."},{"issue":"4","key":"13690_CR6","doi-asserted-by":"publisher","first-page":"e141","DOI":"10.15190\/d.2021.20","volume":"9","author":"NC Chacon","year":"2021","unstructured":"Chacon NC, Walia N, Allen A, et al. Substance use during COVID-19 pandemic: impact on the underserved communities. Discoveries (Craiova). 2021;9(4):e141. https:\/\/doi.org\/10.15190\/d.2021.20.","journal-title":"Oct-Dec"},{"issue":"8","key":"13690_CR7","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1093\/aje\/kwab050","volume":"190","author":"G D\u2019Souza","year":"2021","unstructured":"D\u2019Souza G, Bhondoekhan F, Benning L, et al. Characteristics of the MACS\/WIHS combined cohort study: opportunities for research on aging with HIV in the longest US observational study of HIV. Am J Epidemiol. 2021;190(8):1457\u201375. https:\/\/doi.org\/10.1093\/aje\/kwab050.","journal-title":"Am J Epidemiol"},{"issue":"5","key":"13690_CR8","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1080\/25787489.2020.1844521","volume":"21","author":"G D\u2019Souza","year":"2020","unstructured":"D\u2019Souza G, Springer G, Gustafson D, et al. COVID-19 symptoms and SARS-CoV-2 infection among people living with HIV in the US: the MACS\/WIHS combined cohort study. HIV Res Clin Pract Oct. 2020;21(5):130\u20139. https:\/\/doi.org\/10.1080\/25787489.2020.1844521.","journal-title":"HIV Res Clin Pract Oct"},{"issue":"5","key":"13690_CR9","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.1002\/jmv.27549","volume":"94","author":"E Dragioti","year":"2022","unstructured":"Dragioti E, Li H, Tsitsas G, et al. A large-scale meta-analytic atlas of mental health problems prevalence during the COVID-19 early pandemic. J Med Virol. 2022;94(5):1935\u201349. https:\/\/doi.org\/10.1002\/jmv.27549.","journal-title":"J Med Virol"},{"issue":"5","key":"13690_CR10","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1097\/qai.0000000000002799","volume":"88","author":"MR Friedman","year":"2021","unstructured":"Friedman MR, Kempf MC, Benning L, et al. Prevalence of COVID-19-related social disruptions and effects on psychosocial health in a mixed-serostatus cohort of men and women. J Acquir Immune Defic Syndr. 2021;88(5):426\u201338. https:\/\/doi.org\/10.1097\/qai.0000000000002799.","journal-title":"J Acquir Immune Defic Syndr"},{"key":"13690_CR11","doi-asserted-by":"publisher","first-page":"101882","DOI":"10.1016\/j.pmedr.2022.101882","volume":"28","author":"AH Gertz","year":"2022","unstructured":"Gertz AH, Pollack CC, Schultheiss MD, Brownstein JS. Delayed medical care and underlying health in the united States during the COVID-19 pandemic: A cross-sectional study. Prev Med Rep Aug. 2022;28:101882. https:\/\/doi.org\/10.1016\/j.pmedr.2022.101882.","journal-title":"Prev Med Rep Aug"},{"issue":"6","key":"13690_CR12","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1007\/s40271-023-00645-8","volume":"16","author":"A Grudniewicz","year":"2023","unstructured":"Grudniewicz A, Gray CS, Boeckxstaens P, De Maeseneer J, Mold J. Operationalizing the chronic care model with Goal-Oriented care. Patient Nov. 2023;16(6):569\u201378. https:\/\/doi.org\/10.1007\/s40271-023-00645-8.","journal-title":"Patient Nov"},{"issue":"2","key":"13690_CR13","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1007\/s10461-020-02976-1","volume":"25","author":"KR Hochstatter","year":"2021","unstructured":"Hochstatter KR, Akhtar WZ, Dietz S, et al. Potential influences of the COVID-19 pandemic on drug use and HIV care among people living with HIV and substance use disorders: experience from a pilot mHealth intervention. AIDS Behav. 2021;25(2):354\u20139. https:\/\/doi.org\/10.1007\/s10461-020-02976-1.","journal-title":"AIDS Behav"},{"key":"13690_CR14","doi-asserted-by":"publisher","unstructured":"Jackson SL, Derakhshan S, Blackwood L, et al. Spatial disparities of COVID-19 cases and fatalities in united States counties. Int J Environ Res Public Health. 2021;18(16). https:\/\/doi.org\/10.3390\/ijerph18168259.","DOI":"10.3390\/ijerph18168259"},{"key":"13690_CR15","doi-asserted-by":"publisher","unstructured":"Jamieson MK, Govaart GH, Pownall M. Reflexivity in quantitative research: a rationale and beginner\u2019s guide. Soc Personal Psychol Compass. 2023;17(4). https:\/\/doi.org\/10.1111\/spc3.12735.","DOI":"10.1111\/spc3.12735"},{"issue":"2","key":"13690_CR16","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1093\/aje\/126.2.310","volume":"126","author":"RA Kaslow","year":"1987","unstructured":"Kaslow RA, Ostrow DG, Detels R, Phair JP, Polk BF, Rinaldo CR. Jr. The multicenter AIDS cohort study: Rationale, organization, and selected characteristics of the participants. Am J Epidemiol. 1987;126(2):310\u20138. https:\/\/doi.org\/10.1093\/aje\/126.2.310.","journal-title":"Am J Epidemiol"},{"issue":"8","key":"13690_CR17","doi-asserted-by":"publisher","first-page":"1792","DOI":"10.3906\/sag-2006-140","volume":"50","author":"\u00d6 Kuman Tun\u00e7el","year":"2020","unstructured":"Kuman Tun\u00e7el \u00d6, Pulluk\u00e7u H, Erdem HA, Kurtaran B, Ta\u015fbakan SE, Ta\u015fbakan M. COVID-19-related anxiety in people living with HIV: an online cross-sectional study. Turk J Med Sci. 2020;50(8):1792\u2013800. https:\/\/doi.org\/10.3906\/sag-2006-140.","journal-title":"Turk J Med Sci"},{"issue":"8","key":"13690_CR18","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1001\/jama.2020.26443","volume":"325","author":"L Lopez III","year":"2021","unstructured":"Lopez L III, Hart LH III, Katz MH. Racial and ethnic health disparities related to COVID-19. JAMA. 2021;325(8):719\u201320. https:\/\/doi.org\/10.1001\/jama.2020.26443.","journal-title":"JAMA"},{"issue":"1","key":"13690_CR19","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.psc.2021.11.006","volume":"45","author":"OC Melamed","year":"2022","unstructured":"Melamed OC, deRuiter WK, Buckley L, Selby P. Coronavirus disease 2019 and the impact on substance use disorder treatments. Psychiatr Clin North Am Mar. 2022;45(1):95\u2013107. https:\/\/doi.org\/10.1016\/j.psc.2021.11.006.","journal-title":"Psychiatr Clin North Am Mar"},{"key":"13690_CR20","doi-asserted-by":"publisher","first-page":"894370","DOI":"10.3389\/fpsyt.2022.894370","volume":"13","author":"R Mezzina","year":"2022","unstructured":"Mezzina R, Gopikumar V, Jenkins J, Saraceno B, Sashidharan SP. Social vulnerability and mental health inequalities in the syndemic: call for action. Front Psychiatry. 2022;13:894370. https:\/\/doi.org\/10.3389\/fpsyt.2022.894370.","journal-title":"Front Psychiatry"},{"issue":"3","key":"13690_CR21","doi-asserted-by":"publisher","first-page":"e045343","DOI":"10.1136\/bmjopen-2020-045343","volume":"11","author":"R Moynihan","year":"2021","unstructured":"Moynihan R, Sanders S, Michaleff ZA, et al. Impact of COVID-19 pandemic on utilisation of healthcare services: A systematic review. BMJ Open. 2021;11(3):e045343. https:\/\/doi.org\/10.1136\/bmjopen-2020-045343.","journal-title":"BMJ Open"},{"issue":"4","key":"13690_CR22","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1016\/j.apnu.2021.05.002","volume":"35","author":"L Murphy","year":"2021","unstructured":"Murphy L, Markey K, C OD, Moloney M, Doody O. The impact of the COVID-19 pandemic and its related restrictions on people with pre-existent mental health conditions: A scoping review. Arch Psychiatr Nurs. 2021;35(4):375\u201394. https:\/\/doi.org\/10.1016\/j.apnu.2021.05.002.","journal-title":"Arch Psychiatr Nurs"},{"key":"13690_CR23","doi-asserted-by":"publisher","first-page":"160940692312057","DOI":"10.1177\/16094069231205789","volume":"22","author":"M Naeem","year":"2023","unstructured":"Naeem M, Ozuem W, Howell K, Ranfagni S. A step-by-step process of thematic analysis to develop a conceptual model in qualitative research. Int J Qualitative Methods. 2023;22:16094069231205789. https:\/\/doi.org\/10.1177\/16094069231205789.","journal-title":"Int J Qualitative Methods"},{"key":"13690_CR24","unstructured":"National Center for Health Statistics. U.S. Census Bureau, Household Pulse Survey, 2020\u20132024: anxiety and depression. National Center for Health Statistics. https:\/\/www.cdc.gov\/nchs\/covid19\/pulse\/mental-health.htm. Accessed 18 Apr 2024."},{"key":"13690_CR25","unstructured":"Panchal N, Saunders H, Rudowitz R, Cox C. The implications of COVID-19 for mental health and substance use. 2023 Mar 20. https:\/\/www.kff.org\/mental-health\/issue-brief\/the-implications-of-covid-19-for-mental-health-and-substance-use\/. Accessed 16 Mar 2025."},{"key":"13690_CR26","unstructured":"Panchal N, Rae M, Saunders H, Cox C, Rudowitz R. How does use of mental health care vary by demographics and health insurance coverage? Kaiser Family Foundation. https:\/\/www.kff.org\/mental-health\/issue-brief\/how-does-use-of-mental-health-care-vary-by-demographics-and-health-insurance-coverage\/."},{"issue":"4","key":"13690_CR27","doi-asserted-by":"publisher","first-page":"1821","DOI":"10.1017\/s0954579422000499","volume":"35","author":"AM Parenteau","year":"2023","unstructured":"Parenteau AM, Boyer CJ, Campos LJ, et al. A review of mental health disparities during COVID-19: Evidence, mechanisms, and policy recommendations for promoting societal resilience. Dev Psychopathol Oct. 2023;35(4):1821\u201342. https:\/\/doi.org\/10.1017\/s0954579422000499.","journal-title":"Dev Psychopathol Oct"},{"issue":"10","key":"13690_CR28","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.1038\/s41591-022-02028-2","volume":"28","author":"B Penninx","year":"2022","unstructured":"Penninx B, Benros ME, Klein RS, Vinkers CH. How COVID-19 shaped mental health: from infection to pandemic effects. Nat Med. 2022;28(10):2027\u201337. https:\/\/doi.org\/10.1038\/s41591-022-02028-2.","journal-title":"Nat Med"},{"issue":"10312","key":"13690_CR29","doi-asserted-by":"publisher","first-page":"1700","DOI":"10.1016\/S0140-6736(21)02143-7","volume":"398","author":"DF Santomauro","year":"2021","unstructured":"Santomauro DF, Mantilla Herrera AM, Shadid J, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet. 2021;398(10312):1700\u201312. https:\/\/doi.org\/10.1016\/S0140-6736(21)02143-7.","journal-title":"Lancet"},{"issue":"2","key":"13690_CR30","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1007\/s10461-020-02969-0","volume":"25","author":"GM Santos","year":"2021","unstructured":"Santos GM, Ackerman B, Rao A, et al. Economic, mental health, HIV prevention and HIV treatment impacts of COVID-19 and the COVID-19 response on a global sample of cisgender gay men and other men who have sex with men. AIDS Behav. 2021;25(2):311\u201321. https:\/\/doi.org\/10.1007\/s10461-020-02969-0.","journal-title":"AIDS Behav"},{"issue":"2","key":"13690_CR31","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1007\/s40615-022-01284-9","volume":"10","author":"MB Thomeer","year":"2023","unstructured":"Thomeer MB, Moody MD, Yahirun J. Racial and ethnic disparities in mental health and mental health care during the COVID-19 pandemic. J Racial Ethn Health Disparities. 2023;10(2):961\u201376. https:\/\/doi.org\/10.1007\/s40615-022-01284-9.","journal-title":"J Racial Ethn Health Disparities"},{"key":"13690_CR32","doi-asserted-by":"publisher","unstructured":"Tran BX, Ho RCM, Ho CSH, et al. Depression among patients with HIV\/AIDS: research development and effective interventions (GAP(RESEARCH)). Int J Environ Res Public Health. 2019;19(10). https:\/\/doi.org\/10.3390\/ijerph16101772.","DOI":"10.3390\/ijerph16101772"},{"key":"13690_CR33","unstructured":"U.S. Department of Defense. Coronavirus: timeline. U.S. Department of Defense; 2024 Apr 28. https:\/\/www.defense.gov\/Spotlights\/Coronavirus-DOD-Response\/Timeline\/."},{"issue":"5","key":"13690_CR34","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1001\/jama.2020.11787","volume":"4","author":"SH Woolf","year":"2020","unstructured":"Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L. Excess deaths from COVID-19 and other Causes, March-April 2020. Jama Aug. 2020;4(5):510\u20133. https:\/\/doi.org\/10.1001\/jama.2020.11787.","journal-title":"Jama Aug"},{"issue":"7","key":"13690_CR35","doi-asserted-by":"publisher","first-page":"e0307656","DOI":"10.1371\/journal.pone.0307656","volume":"19","author":"Q Wu","year":"2024","unstructured":"Wu Q, Tan J, Chen S, Wang J, Liao X, Jiang L. Incidence and influencing factors related to social isolation among HIV\/AIDS patients: protocol for a systematic review and meta-analysis. PLoS ONE. 2024;19(7):e0307656. https:\/\/doi.org\/10.1371\/journal.pone.0307656.","journal-title":"PLoS ONE"},{"key":"13690_CR36","doi-asserted-by":"publisher","unstructured":"Zhong L, Lopez D, Pei S, Gao J. Healthcare system resilience and adaptability to pandemic disruptions in the united States. Nat Med. 2024\/08\/01 2024;30(8):2311\u20139. https:\/\/doi.org\/10.1038\/s41591-024-03103-6","DOI":"10.1038\/s41591-024-03103-6"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-025-13690-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-025-13690-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-025-13690-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:56:58Z","timestamp":1781625418000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12913-025-13690-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["13690"],"URL":"https:\/\/doi.org\/10.1186\/s12913-025-13690-w","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,29]]},"assertion":[{"value":"5 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Johns Hopkins Institutional Review Board approved the research associated with this manuscript. All participants provided informed consent to participate.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1623"}}