Resilience-Focused HIV Care to Promote Psychological Well-Being During COVID-19 and Other Catastrophes

Abstract

The COVID-19 pandemic has adversely affected people with HIV due to disruptions in prevention and care services, economic impacts, and social isolation. These stressors have contributed to worse physical health, HIV treatment outcomes, and psychological wellness. Psychological sequelae associated with COVID-19 threaten the overall well-being of people with HIV and efforts to end the HIV epidemic. Resilience is a known mediator of health disparities and can improve psychological wellness and behavioral health outcomes along the HIV Continuum of Care. Though resilience is often organically developed in individuals as a result of overcoming adversity, it may be fostered through multi-level internal and external resourcing (at psychological, interpersonal, spiritual, and community/neighborhood levels). In this Perspective, resilience-focused HIV care is defined as a model of care in which providers promote optimum health for people with HIV by facilitating multi-level resourcing to buffer the effects of adversity and foster well-being. Adoption of resilience-focused HIV care may help providers better promote well-being among people living with HIV during this time of increased psychological stress and help prepare systems of care for future catastrophes. Informed by the literature, we constructed a set of core principles and considerations for successful adoption and sustainability of resilience-focused HIV care. Our definition of resilience-focused HIV care marks a novel contribution to the knowledge base and responds to the call for a multidimensional definition of resilience as part of HIV research.

Stress, Support, and Length of Diagnosis Among Women Living with HIV/AIDS in the Southern USA, During the COVID-19 Pandemic

“…[46][47][48] a system-level evaluation of the COVID-19 pandemic on PLWH-specifically, the social, political, and economic influence of the pandemic on the HIV experience, and how inter-connected factors affect the health of racial/ethnic minority WLWH living in the United States. 43 Examining how living with HIV for short-and long-term durations may influence stress and support levels can provide insight to future health needs and help address health disparities among WLWH. As such, the HIV population continues to age and if effective coping strategies, such as relying on support networks helps to maintain healthy outlooks, then support groups should be funded and prioritized.…”

“…The familiarity of living with HIV may provide a buffer during difficult times, even when control of the HIV epidemic is threatened, due to reduced treatment access and prevention services. 15,43 Similarly, the mental health crisis experienced throughout the world, due to the COVID-19 pandemic in addition to loss of routine social support among PLWH, may have contributed to higher rates of chronic stress, regardless of length of diagnosis. 44 It is important to mention that although stress has negative psycho-social consequences, it can also be a facilitator toward mental well-being for WLWH.…”

The Importance of Positive Psychological Factors among People Living with HIV: A Comparative Study

“…This psychological variable is important because, as detailed in other investigations, there is enough published evidence that associates resilience with positive health benefits, favouring viral suppression in subjects with HIV [ 33 ] and positively impacting on their quality of life [ 34 , 35 ].…”

Assessing the Prevalence and Determinants of Exposure-Influenced HIV Testing among a Sample of Pre- and Post-Exposure Prophylaxis-Naïve Young Men Who Have Sex with Men in the United States

“…Last, we found that individualized support across various physical, normative, psychological, and environmental domains to promote resiliency is cited as an essential facilitator to promote HIV testing uptake among YMSM. Future studies should further explore sources across multiple socio-ecological levels to guide the design and implementation of multidimensional social support and resilience-based HIV prevention programs to help address various psychosocial vulnerabilities and promote exposure-influenced HIV testing uptake among YMSM [ 49 ].…”