“When you have an immune disease like HIV and there is a pandemic, you still have to pay your bills”: COVID-19-related challenges among people living with HIV and lessons for care delivery

ABSTRACT

COVID-19 has disrupted routine medical care and increased psychosocial and economic stressors on a global scale, yet the full impact on people living with HIV (PLWH) and the HIV continuum of care remains unknown. As the pandemic continues to pose a significant threat to PLWH and their care, this research qualitatively aimed to elicit COVID-19-related challenges and perspectives of PLWH during the early phase of the pandemic and to identify lessons learned and impactful strategies for facilitating HIV care. We recruited 32 PLWH who receive care at a large academic medical center for semi-structured remote interviews to assess psychological/structural stressors experienced during the pandemic and to discern strategies for improving care. Most participants identified as Black (91%) and heterosexual (56%). Overall, PLWH reported exacerbated mental health stressors (e.g., anxiety, depression, substance use). Most participants cited no issues with antiretroviral therapy (ART) adherence or retention in care, yet five participants reported appointment cancellations or physician inaccessibility. Participants provided specific feedback for facilitating continued engagement in care during the pandemic, including telemedicine and education/patient empowerment. By seeking participant-provided solutions, this study centered on PLWH’s experiences and emphasized proactive HIV care strategies for prioritizing patient empowerment and healthcare adaptability during a rapidly evolving pandemic.

KEYWORDS:

• PLWH
• COVID-19
• psychosocial stressors
• ART adherence

Acknowledgements

The authors thank the study participants for their invaluable insights into the impact of the COVID-19 pandemic on people living with HIV.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the National Institutes of Health (NIH) under K23MH121190-01 (PI: Jessica Ridgway) and the Pritzker School of Medicine. Moira McNulty was supported by the National Institute of Mental Health (K23MH118969).