Psychosocial and socioeconomic changes among low-income people with HIV during the COVID-19 pandemic in Miami-Dade County, Florida: racial/ethnic and gender differences

Abstract

Background

COVID-19 profoundly and uniquely impacted people with HIV. People with HIV experienced significant psychosocial and socioeconomic impacts, yet a limited amount of research has explored potential differences across gender and racial/ethnic groups of people with HIV.

Objective

The objective of this study was to examine psychosocial and socioeconomic stressors related to the COVID-19 pandemic among a diverse sample of people with HIV in South Florida and to determine if the types of stressors varied across gender and racial/ethnic groups.

Methods

We analyzed data from a cross-sectional survey with Miami-Dade County, Ryan White Program recipients. Outcomes included mental health, socioeconomic, drug/alcohol, and care responsibility/social support changes. Weighted descriptive analyses provided an overview of stressors by gender and racial/ethnic group and logistic regressions estimated associations between demographics and stressors.

Results

Among 291 participants, 39% were Non-Hispanic Black, 18% were Haitian, and 43% were Hispanic. Adjusting for age, sex, language, and foreign-born status, Hispanics were more likely to report several worsened mental health (i.e. increased loneliness, anxiety) and socioeconomic stressors (i.e. decreased income). Spanish speakers were more likely to report not getting the social support they needed. Women were more likely to report spending more time caring for children.

Conclusions

Findings highlight ways in which cultural and gender expectations impacted experiences across people with HIV and suggest strategies to inform interventions and resources during lingering and future public health emergencies. Results suggest that public health emergencies have different impacts on different communities. Without acknowledging and responding to differences, we risk losing strides towards progress in health equity.

Keywords:

• COVID-19
• racial and ethnic health disparities
• gender disparities
• psychosocial changes
• socioeconomic changes

Acknowledgments

We gratefully acknowledge Carla Valle-Schwenk, Ryan White Administrator, and the entire Ryan White Part A Program in the Miami-Dade County Office of Management and Budget, for their assistance in the study’s implementation as well as the participants themselves, without which this work would not be possible.

Disclosure statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethics Approval

Our study was approved by the Florida International University Social Behavioral Institutional Review Board (approval no. IRB-17-0234). All participants provided verbal informed consent prior to enrollment in the study.

Additional information

Funding

This work was supported by the National Institute on Minority Health and Health Disparities (NIMHD) under award numbers MD012421, R01MD013563, and K01MD013770. The authors gratefully acknowledge the use of the services and facilities supported in part by NIMHD under award number U54MD012393. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIMHD or the National Institutes of Health.