The impact of pandemic on people with HIV
The COVID-19 pandemic had substantial psychological impacts on the nation and around the world. Certain segments of populations were particularly tested in their resilience, especially for the mental side.New research shows patients with HIV were particularly susceptible to psychosocial challenges like depression, anxiety, substance abuse, loneliness and more. The study was co-authored by HIV/AIDS expert Dr. Michael Horberg. Researchers analyzed the results from a 2020 survey of nearly 900 Washington DC-based participants diagnosed with HIV.
The survey asked patients to rate the degree to which they experienced challenges with financial stability, mental health, social connections and substance use during the peak of the pandemic. Researchers then evaluated how different demographics experienced psychosocial challenges and which groups were the most vulnerable. Dr Michael Horberg, Associate Medical Director and Head, Mid-Atlantic Permanente Research Institute, pointed out: “D.C. was an important place to conduct this research, as it is both an HIV hotspot and was a COVID-19 hotspot during various points of the pandemic.”
Mental health
Seventy-seven percent of respondents reported struggling with their mental health during the peak of the pandemic. Nearly 50% reported feeling anxious, and 46% reported a decreased quality of life. Over a third of participants reported at least one of the hallmark symptoms of depression, and half of respondents reported decreased social connections.
Financial strain
Fifty-five percent of respondents reported experiencing financial strain during the pandemic, with 34% reporting a decrease in household income. A large number of respondents (27%) reported difficulty getting food, and even more (29%) reported difficulty paying their rent or mortgage. Participants with more education were less likely to report financial impacts but were more likely to report mental health impacts.
Substance use
Researchers found more participants reported an increase in alcohol consumption compared to illicit drug use. Participants whose HIV was well managed were less likely to report an increase of alcohol or drug use. Males were more likely to report increase substance abuse compared to females.
Older age and resiliency
Interestingly, older patients were less likely to experience negative psychosocial challenges. Researchers noted older age is likely protective against these challenges due to having more life experience, being better able to connect with necessary resources, having stronger social connections and being less likely to abuse drugs and alcohol. Dr. Horberg said: “We found older patients were far more resilient compared to younger patients. I think this demonstrates the importance of being socially secure when trying to weather intense stressors like the pandemic.”
Addressing health equity
The authors expressed their concern: “As the pandemic wanes and emergency intervention programs are removed, vulnerable individuals who are already at risk for worse HIV outcomes may suffer more. People with HIV were already at an increased risk of psychosocial challenges, the pandemic only exacerbated these problems. When we remove emergency pandemic relief efforts, we are taking away potential lifelines. It shows we need to do a better job ensuring our vulnerable populations have access to the care they need, regardless of the pandemic.”
Edited by Dr. Gianfrancesco Cormaci, PhD, specialist in CLinical Biochemistry.
Scientific references
Castel AD et al. J Acquir Immune Defic Syndr. 2023 Jun 26.
Monroe AK et al. AIDS Res Therapy 2023; May 9; 20(1):27.
Monroe AK et al. AIDS Behav. 2022 Oct; 26(10):3289-3299.