The impact of the COVID‐19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review

Abstract

Introduction:The COVID-19 pandemic and associated measures implemented by authorities have created additional stressors and increased the risk of psychological illnesses among people living with HIV (PLWH). Yet, there is no collective evidence on the mental health status of this population during the global pandemic and associated factors. This scoping review aimed to synthesize the evidence in the current literature related to the mental health outcomes and challenges faced by PLWH during the COVID-19 pandemic, identify the associated factors with psychological distress and summarize various coping strategies to ease these psychological distresses used by this population. Methods: We conducted a scoping review following the PRISMA-ScR guideline and a literature search in four electronic databases in August 2022. Three reviewers independently screened all the search records and extracted the data from studies that met the inclusion criteria. Factors associated with worsened mental health outcomes were synthesized according to the socio-ecological framework. Results: Among 1100 research records, 45 articles met the eligibility criteria and were included in the final review and data extraction, most of which were quantitative analyses. PLWH reported high rates of mental health problems during the pandemic. Multi-level factors were associated with increased psychological distress, including substance use, antiretroviral adherence, social support, financial hardship and economic vulnerability during the pandemic. PLWH used social media as a coping strategy to foster social support to deal with growing mental distress. Increased mental health illnesses were associated with increased substance use, it was also found associated with suboptimal medication adherence and antiretroviral therapy (ART) care engagement. Discussion: PLWH experienced high rates of mental health illnesses, such as depression during the global COVID-19 pandemic. There is an urgent need to provide comprehensive HIV treatment and mental health services as the pandemic continues to evolve. Conclusions: The review summarized how the mental health of PLWH was affected during the COVID-19 pandemic. Future work in the implementation of effective interventions to promote mental health in this population is needed, not only to ensure their quality of life but also to help them maintain ART adherence and healthcare during more unprecedented times.

Violence Victimization, Homelessness, and Severe Mental Illness Among People Who Use Opioids in Three U.S. Cities

“…To our knowledge, our study is among the first to examine the association between violence victimization and SMI among PWUOs. These findings add additional evidence to the literature and echo previous studies indicating the impact of violence victimization and mental health outcomes among various populations, including sexual and gender minority and people living with HIV (Brown et al, 2016;Buller et al, 2014;Finneran & Stephenson, 2013;Hong et al, 2023). We also found that having SMI was associated with multilevel factors, including individual factors such as being female, identifying as bisexual, lower income and being unemployed, and structural barriers, such as having resource negotiation history and being incarcerated.…”

Associations between HIV-related knowledge and discriminatory attitudes in Lesotho, Malawi, Tanzania, Zambia, and Zimbabwe: Results from population-based HIV impact assessments.

“…The COVID-19 pandemic brought heightened awareness to infectious diseases, which could humanize the experience of living with infections, such as HIV. However, syndemics of mental health disorders, drug use, and STIs have become exacerbated due to a variety of challenges including lack of access to health care (Hong et al, 2023). This disconnection from healthcare services could have resulted in decreased education about HIV or other conditions aside from COVID-19, which could influence attitudes and perceptions, and amplify existing disparities, as seen in one case study from Canada (Bowles et al, 2023).…”

Strengths and challenges among Black and Latinx people living with HIV during COVID-19: A mixed-methods investigation of the translation of self-management across syndemic health crises.

“…Specifically, the latter group of participants described difficulties accessing providers and canceled/delayed appointments; these participants also reported significantly more depressive symptoms than those reporting care continuity. Although several studies reported increases in depressive and other mental health symptoms during COVID-19, this was largely attributed to social isolation and economic concerns (Hong et al, 2023; Winwood et al, 2021). Our mixed-methods results suggest that lack of care continuity may also be a stressor that in turn, negatively impacts mental health.…”

“…However, the potential translation of individual strategies between the syndemics of HIV and COVID-19 has received less attention. Instead, studies among individual PLWH have focused on challenges they faced in the context of COVID-19, like increasing mental health symptoms, social isolation, food insecurity, and socioeconomic stress (Hong et al, 2023; Meyer et al, 2023; Winwood et al, 2021; Wion & Miller, 2021). Conversely, few studies have examined strengths PLWH could leverage in a new public health crisis, despite evidence that PLWH translated some HIV self-management strategies to the COVID-19 pandemic.…”