The burden of anxiety among people living with HIV during the COVID-19 pandemic in Pune, India

Abstract

Introduction Globally, India has the third largest population of people living with HIV (PLHIV) and the second highest number of COVID-19 cases. Anxiety is associated with antiretroviral therapy (ART) nonadherence. It is crucial to understand the burden of anxiety and its sources among Asian Indian PLHIV during the COVID pandemic, but data are limited. Methods During the first month of government mandated lockdown, we administered an anxiety assessment via telephone among PLHIV registered for care at a publicly funded antiretroviral therapy (ART) center in Pune, India. Generalized anxiety was defined as GAD-7 score ≥ 10. Sociodemographic and clinical variables were compared by anxiety status (GAD-7 score ≥ 10 vs GAD-7 score < 10). Qualitative responses to an open-ended question about causes of concern were evaluated using thematic analysis. Results Among 167 PLHIV, median age was 44 years (IQR 40–50); the majority were cisgender women (60%) and had a monthly family income < 200 USD (81%). Prior history of tuberculosis and other comorbidities were observed in 38 and 27%, respectively. Overall, prevalence of generalized anxiety was 25% (n = 41). PLHIV with GAD-7 score ≥ 10 had fewer remaining doses of ART than those with lower GAD-7 scores (p = 0.05). Thematic analysis indicated that concerns were both health related and unrelated, and stated temporally. Present concerns were often also projected as future concerns. Conclusions The burden of anxiety was high during COVID lockdown in our population of socioeconomically disadvantaged PLHIV in Pune and appeared to be influenced by concerns about ART availability. The burden of anxiety among PLHIV will likely increase with the worsening pandemic in India, as sources of anxiety are expected to persist. We recommend the regular use of short screening tools for anxiety to monitor and triage patients as an extension of current HIV services.

Psychological impact of COVID-19 and contributing factors of students’ preventive behavior based on HBM in Gondar, Ethiopia

“…This finding is in line with a study done in Philippines nurses (37.8%) but lower than studies conducted in Bangladesh (87.7%), united Arab Emirates (46.9%), France(60.2%, and Iran(50.9%) [ 15 , 36 , 37 ]. However, this study is higher than a study done in India (25%) [ 13 ]. The variation could be difference in the study population and use of different measuring tool.…”

“…Evidences suggested that individuals are experiencing high level of anxiety during COVID-19 [ 10 – 12 ].The psychological impact like anxiety, obsession and fear of Covid-19 varies across countries. For example, in India it ranges from 20%to 25% [ 13 , 14 ] a systematic review among health workers revealed that the pooled prevalence was 37% [ 5 ] Studies examined that sociodemographic the factors such as lower age, female sex, household income, and social support were the determinant factors of Anxiety and obsession [ 13 , 15 , 16 ]. Therefore, understanding and identifying the psychological impact and the contributing factors is vital to enhance preventive behavior of Covid-19.…”

O impacto do isolamento social na pandemia de COVID-19 no acesso ao tratamento e aos serviços de prevenção do HIV

“…A importância da geração de dados de saúde mental entre pessoas vivendo com HIV no cenário da pandemia pode ser inferida, visto que a piora da saúde mental foi relatada na população em geral. Na análise temática foram identificados os seguintes quatro temas: a) preocupações relacionadas com o presente imediato; b) preocupações relacionadas ao futuro iminente; c) falta de apoio social e financeiro; d) indiferença às circunstâncias secundárias ao COVID-19 (Marbaniang et al, 2020). Uma saúde mental equilibrada diminui os riscos de pouca adesão e abandono ao tratamento.…”

The impact of COVID-19 pandemic on mental health in gay, bisexual, and other men who have sex with men in China: Difference by HIV status

“…Numerous studies have demonstrated the elevated rates of depression, anxiety, and PTSD among living with HIV around the globe, due to reasons such as lack of social support( Collins et al, 2006 ; Jones et al, 2021 ; Tabler et al, 2021 ). There is also emerging evidence demonstrating the disproportionately high levels of depression and anxiety symptoms experienced by people living with HIV (PLWH) since the pandemic began( Jones et al, 2021 ; Marbaniang et al, 2020 ; Siewe Fodjo et al, 2020 ). In China, Sun et al found that PLWH reported high depressive and anxiety symptoms during the COVID-19( Sun et al, 2020 ).…”