Impact of the COVID-19 Pandemic on the Medical Follow-up and Psychosocial Well-Being of People Living With HIV: A Cross-Sectional Survey

Abstract

Background: Empirical data on the consequences of the novel coronavirus disease (COVID-19) pandemic on HIV care are lacking. We surveyed people living with HIV (PLWH) in different countries to investigate whether their medical follow-up and psychosocial well-being had been compromised due to COVID-19 and associated restrictions. Methods: In April 2020, a cross-sectional survey among PLWH was conducted using a web-based multilingual questionnaire. The research tool assessed HIV follow-up, psychosocial well-being, COVID-19 (flu-like) symptoms and prevention measures. Consenting respondents provided answers anonymously. Results: Three hundred seventeen PLWH were included (mean age 43.4 ± 11.7; 71.6% men); 60.3% of participants resided in Belgium and Brazil. One hundred forty (44.2%) reported experiencing a cold with at least one flu-like symptom since January 2020. Of the 18 who reported COVID-19 test results, 4 (22.2%) were positive. Seventy-four (23.3%) respondents screened positive for major depressive disorders, whereas 72 (22.7%) had generalized anxiety disorders. Fifty-six (17.7%) respondents reported difficulties in obtaining antiretroviral medications because of COVID-19–related measures. Adaptations of HIV care during the COVID-19 outbreak included greater quantities of antiretroviral refill in 67 (21.1%), phone consultations in 25 (7.9%), and new refill sites in 12 (3.9%). Factors associated with a reduced risk of experiencing flu-like symptoms included flu vaccination during the past 12 months (P = 0.005) and adaptations of HIV care during the COVID-19 pandemic (P = 0.010). Conclusion: COVID-19 and associated restrictive measures seem detrimental to the well-being and follow-up of PLWH. We recommend that health systems devise innovative approaches for antiretroviral provision and psychosocial support to PLWH during such outbreaks.

Follow-Up Survey of the Impact of COVID-19 on People Living with HIV during the Second Semester of the Pandemic

“…Our study throws more light on the well-being of PLWH as well as the state of HIV care in the context of a persisting pandemic that has greatly impacted health systems. A little over one quarter of respondents screened positive for either anxiety or depression, representing a fairly stable prevalence compared to the 22% in a first survey among PLWH earlier during the pandemic [ 10 ]. Compared to anxiety and depression rates among PLWH prior to the COVID-19 outbreak [ 21 , 22 ], our findings show a slightly lower prevalence of both conditions.…”

“…Besides causing disease and death in infected individuals, the COVID-19 outbreak has also disrupted healthcare provision for several non-COVID-19 conditions, including the routine follow-up of PLWH [ 10 ]. Moreover, the COVID-19 pandemic has resulted in a shrinking of funding for the global HIV response [ 11 ], and several countries reported high risks of stock-outs of antiretroviral treatment (ART) as a direct consequence of restrictions implemented to contain the COVID-19 outbreak [ 12 ].…”

“…Moreover, widespread inertia to visiting hospitals for non-COVID-19 health issues has been reported earlier during the pandemic [ 13 ], and it is unclear whether these tendencies still persist after several months. During an initial multi-country online survey in April 2020 [ 10 ], we found that 17.7% of respondents had difficulties in obtaining ART because of COVID-19–related measures. In addition, one quarter of participants were screened positive for either anxiety or depression.…”

“…At the time, the global COVID-19 incidence was evolving exponentially, and most health systems were overwhelmed with COVID-19 cases. HIV clinics had to devise innovative ways to cater for PLWH amidst the challenges [ 10 ]. The purpose of this follow-up survey is to assess the psychosocial well-being of PLWH and the quality of HIV care offered to PLWH during the weeks and months following the first wave of COVID-19 infections.…”

Sexual health (excluding reproductive health, intimate partner violence and gender-based violence) and COVID-19: a scoping review

“…18 52 People with HIV Nineteen studies assessed PLHIV. [54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72] Three modelling studies predicted a significant increase in HIV-related deaths in African countries due to treatment disruption with the pandemic. [61][62][63] A US retrospective observational quantitative study found that shelter-inplace orders had a negative impact on antiretroviral therapy adherence, especially among homeless PLHIV.…”