Intersecting Pandemics: Impact of SARS-CoV-2 (COVID-19) Protective Behaviors on People Living With HIV, Atlanta, Georgia

Abstract

Background: COVID-19 and its social responses threaten the health of people living with HIV. We conducted a rapid-response interview to assess COVID-19 protective behaviors of people living with HIV and the impact of their responses on HIV-related health care. Method: Men and women living with HIV (N = 162) aged 20–37 years participating in a longitudinal study of HIV treatment and care completed routine study measures and an assessment of COVID-19–related experiences. Results: At baseline, most participants demonstrated HIV viremia, markers indicative of renal disorders, and biologically confirmed substance use. At follow-up, in the first month of responding to COVID-19, engaging in more social distancing behaviors was related to difficulty accessing food and medications and increased cancelation of health care appointments, both by self and providers. We observed antiretroviral therapy adherence had improved during the initial month of COVID-19 response. Conclusions: Factors that may pose added risk for COVID-19 severity were prevalent among people living with HIV, and those with greater risk factors did not practice more COVID-19 protective behaviors. Social distancing and other practices intended to mitigate the spread of COVID-19 interfered with HIV care, and impeded access to food and medications, although an immediate adverse impact on medication adherence was not evident. These results suggest social responses to COVID-19 adversely impacted the health care of people living with HIV, supporting continued monitoring to determine the long-term effects of co-occurring HIV and COVID-19 pandemics.

COVID-19 Outcomes Among Persons Living With or Without Diagnosed HIV Infection in New York State

“…The association between the management of HIV infection and COVID-19 diagnosis was not straightforward because persons living with diagnosed HIV with viral suppression were significantly more likely to have received a diagnosis of COVID-19, as were persons living with diagnosed HIV with CD4 counts less than 200 cells/mm 3 . 3 The increased diagnosis probability among persons with viral suppression may reflect a difference in test-seeking behavior or more interaction with the health care system among persons living with diagnosed HIV with viral suppression rather than a difference in underlying COVID-19 prevalence. Alternatively, healthier persons living with diagnosed HIV may be acquiring COVID-19 at higher rates, although this interpretation is inconsistent with 1 study.…”

“…Alternatively, healthier persons living with diagnosed HIV may be acquiring COVID-19 at higher rates, although this interpretation is inconsistent with 1 study. 3 …”

“…1 In addition to having an older, more male demographic distribution, persons living with diagnosed HIV infection have a higher prevalence of many underlying medical conditions associated with more severe COVID-19 illness. 2 , 3 , 4 …”

Challenges to HIV service delivery and the impacts on patient care during COVID-19: perspective of HIV care providers in Guangxi, China

“…In 11 countries (∼58%), health providers had dual duties for HIV and COVID-19 care (Kowalska et al, 2020). One study conducted among people living with HIV (PLWH) in Atlanta, the United States suggested that responses to COVID-19 such as social distancing were associated with increased cancelations of HIV care appointment (Kalichman et al, 2020). Routine healthcare visits and non-urgent care have been delayed.…”

In the shadow of COVID‐19: HIV‐infected individuals need more attention

“…5 In addition, the COVID-19 pandemic may also have an impact on the access to medical services for acquired immunodeficiency syndrome (AIDS) patients. Due to the personal protection protocols and lockdowns, HIV-related medical and social services could be disrupted, 6 including routine HIV testing, allocation of resources for HIV care in healthcare institutions, and antiretroviral therapy continuation. 7 In Africa, the weak and overburdened public health sectors in low-income countries may be unable to establish relatively safe environments for HIVinfected individuals or unable to respond to high disease rates of AIDS and COVID-19 simultaneously.…”