Social and Behavioral Impacts of COVID-19 on People Living with HIV: Review of the First Year of Research

Abstract

Purpose of the ReviewThe SARS-CoV-2 (COVID-19) pandemic brought unprecedented social change with the most severe impacts on the most vulnerable populations, including people living with HIV (PLWH). This review examined findings from empirical studies of social and behavioral impacts of COVID-19 on PLWH in the first year of the pandemic. Recent Findings Impacts of COVID-19 on PLWH fit within an HIV syndemics framework, with overlapping COVID-19 and HIV comorbid conditions concerning mental health and structural inequality. Early impacts of COVID-19 on social isolation, emotional distress, stigma, and substance use varied across studies with few consistent patterns. Structural inequalities, particularly impacts on food security and housing stability, were observed more consistently and globally. Summary COVID-19 intersects with HIV infection along with multiple interlocking comorbidities that are best characterized and understood within a syndemics framework. Keywords HIV-COVID-19 co-infection • Social impacts • Behavioral impacts • People living with HIV This article is part of the Topical Collection on Co-infections and Comorbidity * Seth C. Kalichman

Socio-Structural Factors and HIV Care Engagement among People Living with HIV during the COVID-19 Pandemic: A Qualitative Study in the United States

“…Despite current research illustrating the effects of COVID-19 on social isolation among PLH [ 16 , 22 , 40 ], participants in our study described how the pandemic had little influence on their ability to receive support from friends, family, clinicians, and social service providers. Our results highlighted the importance of social support for successful care engagement during the pandemic.…”

“…While previous work has illustrated the impact of COVID-19 on housing instability among PLH [ 20 , 30 ], our study is among the first to qualitatively examine the ways in which COVID-19, housing status, and medication adherence operate. Current literature has illustrated increased stress and anxiety among PLH during the pandemic [ 16 ]. As stress is correlated with medication adherence among PLH [ 31 ], it is likely that pandemic-related housing instability impacts medication adherence via stress pathways.…”

“…The effects of the COVID-19 pandemic have exacerbated these concerns [ 16 , 17 , 18 ] and have resulted in healthcare disruptions for PLH [ 19 ]. Research during the first twelve months of the pandemic identified impacts on finances [ 20 , 21 , 22 ], food insecurity [ 21 , 23 ], and access to healthcare services [ 20 , 22 , 23 ] among PLH.…”

“…The influence of the COVID-19 pandemic on pre-existing health inequities among PLH has the potential to have long-lasting effects on individual and public health [ 24 ]. While there is a growing body of research examining the effects of the COVID-19 pandemic on HIV care [ 16 , 17 , 18 ], the majority of work was performed during the early months of the pandemic. To date, there is a lack of research capturing the continued influence of the pandemic on various socio-structural factors that have historically hindered care engagement for PLH.…”

Willingness to receive COVID-19 vaccination in people living with HIV/AIDS from Latin America

“…People living with HIV/AIDS are becoming increasingly concerned that the immunosuppressive nature of HIV (abnormal humoral and T-cell–mediated immune responses) may make them more vulnerable to SARS-CoV-2 infection and more likely to experience a severe presentation. 13 – 16 According to this logic, PLWHA with a low CD4 cell count, advanced disease, a high viral load, or not on ART should be treated with extreme caution. A recent report found poorer COVID-related outcomes (higher rates of severe disease requiring hospitalization) in HIV patients than those without an HIV diagnosis, especially those with multimorbidity and older age 17 .…”