“I have the strength to get through this using my past experiences with HIV”: findings from a mixed-method survey of health outcomes, service accessibility, and psychosocial wellbeing among people living with HIV during the Covid-19 pandemic

Figures & data

Table 1. Socio-demographic characteristics of survey participants.

Characteristics	n (%)
Age
20–39	93 (14.4)
40–59	381 (59.1)
>60	171 (26.5)
Gender
Man, including trans man	522 (80.6)
Woman, including trans woman	117 (18.1)
Non-binary	8 (1.2)
Other	1 (0.1)
Ethnicity
White (white British, Irish, or any other white background)	534 (82.8)
BAME (Asian/Asian British/Black/Black British/Mixed/Other Ethnic Groups)	109 (16.9)
Asian or Asian British	9 (1.4)
Black or Black British	83 (12.9)
Other ethnic groups	9 (1.4)
Mixed (White and Black, White and Asian or any other mixed background)	10 (1.5)
Sexual orientation
Gay	451 (69.8)
Heterosexual/Straight	161 (24.9)
Bisexual	21 (3.3)
Other	4 (0.6)
Prefer not to say	9 (1.4)
Cohabitation arrangements
Live with sexual partner	273 (42.3)
Live alone	209 (32.4)
Live in shared house or flat with friends and flatmates	75 (11.6)
Live with children	43 (6.7)
Live with relatives	40 (6.2)
Other	5 (0.8)
Homeless/insecurely housed/sofa surfing	1 (0.2)
HIV service centeres
Brighton and Hove
Lawson Unit	488 (75.5)
East Sussex
Avenue House Clinic, Eastbourne	44 (6.8)
Station Plaza Clinic, Hastings	2 (0.3)
West Sussex
Sexual Health, Chichester	36 (5.6)
Sexual Health, Crawley	40 (6.2)
Sexual Health, Worthing	36 (5.6)
Covid antigen testing
No	562 (87.5)
Yes – tested negative	74 (11.5)
Yes – tested positive	6 (0.9%)
Covid antibody testing
No	617 (95.5%)
Yes – tested negative	20 (3.1%)
Yes – tested positive	4 (0.6%)
Unsure	5 (0.8%)

Table 2. Self-reported changes in physical and mental health among PLWH during the C19 pandemic.

Variable		n (%)
Poor health and wellbeing since the start of the Covid-19 pandemic	No	563 (86.9)
	Yes	85 (13.1)
Physical health has worsened since the start of the pandemic	No	464 (71.7)
	Yes	183 (28.3)
Display of symptoms of Covid-19 (fever and persistent cough, or loss of taste or smell) since the start of the pandemic	No	499 (77.1)
	Yes	148 (22.9)
Feeling more anxious or more worried than usual since the start of the pandemic	No	145 (22.5)
	Yes	501 (77.6)
Feeling depressed or low in mood more than usual since the start of the pandemic	No	182 (28.2)
	Yes	464 (71.8)
Suicidal thoughts since the start of the pandemic	No	520 (80.3)
	Yes	128 (19.8)
Difficulty sleeping since the start of the pandemic	No	174 (26.9)
	Yes	472 (73.1)
Excessive alcohol or drug consumption since the start of the pandemic	No	485 (75.1)
	Yes	161 (24.9)

Table 3. Accessibility of essential health services and information.

Variable		n (%)
Accessibility of health services
Encountered problems accessing medical treatment, advice, or medicine during the pandemic	No	438 (67.8)
	Yes	208 (32.2)
Avoided accessing medical treatment, advice, or medicine during the pandemic	No	427 (66.1)
	Yes	219 (33.9)
Worried about running out of HIV medicine during the pandemic	No	384 (59.3)
	Yes	264 (40.7)
Worried about accessing HIV services during the pandemic	No	402 (62.0)
	Yes	246 (38.0)
Worried about accessing other health services during the pandemic	No	240 (37.0)
	Yes	408 (63.0)
Worried about sexual health and sexually transmitted infections during the pandemic	No	527 (81.6)
	Yes	119 (18.4)
Feels that enough support has been available for PLWH	No	324 (50.4)
	Yes	319 (49.6)
Accessibility of health information
Accessed enough information on how Covid-19 affects PLWH	No	397 (61.7)
	Yes	246 (38.3)
Received information on the support available for PLWH during the lockdown	No	453 (70.1)
	Yes	193 (29.9)
Unable to access information and support for PLWH because of lack of access to technology during the pandemic	No	558 (86.1)
	Yes	90 (13.9)
Unable to access information and support for PLWH because of insufficient technological literacy during the pandemic	No	572 (88.4)
	Yes	75 (11.6)
Worried about HIV status increases the risk of Covid-related complications	No	180 (27.8)
	Yes	468 (72.2)
Technological resources and barriers
Most helpful resources for accessing information and support during the pandemic	SMART phone	464 (71.3)
	Good internet connection/wi-fi	307 (47.2)
	Computer/PC/Laptop	296 (45.5)
	TV, radio	225 (34.6)
	Tablet/iPad	200 (30.7)
	Video software	98 (15.1)
	Telephone	74 (11.4)
	None of these	32 (4.9)
Barriers to accessing information and support during the pandemic	Poor internet connection	40 (6.1)
	No computer access	21 (3.2)
	No video software	20 (3.1)
	No internet connection	13 (2.0)
	No telephone	9 (1.4)
	No SMART phone	8 (1.2)
	Internet illiteracy	6 (0.9)
	None of these	563 (86.5)
Main sources of information from health providers during the pandemic	Texts from clinic	395 (60.7)
	Phone call with clinic	268 (41.2)
	Emails from clinic	163 (25.0)
	EmERGE mobile app*	132 (20.3)
	Clinic website	47 (7.2)

^a The EmERGE app is used in Brighton to facilitate linkage to services and provide PLWH with access to their results as part of a digital health pathway of care.

Table 4. Socio-economic wellbeing of PLWH during Covid-19.

Variable		Total, n (%)
Stigma, discrimination, and safety concerns
More worried than usual about people finding out about HIV status	No	375 (57.9)
	Yes	273 (42.1)
Treated unfairly because of HIV status since the start of the pandemic	No	604 (93.2)
	Yes	44 (6.8)
Worse feelings of shame about HIV status since the start of the pandemic	No	437 (67.4)
	Yes	211 (32.6)
Worried about data security issues since the start of the pandemic	No	363 (56.0)
	Yes	285 (44.0)
Worried about safety in relationships since the start of the pandemic	No	413 (63.7)
	Yes	235 (36.3)
Resilience and support
Living with HIV has equipped me with the strength and personal resources to adapt to the Covid-19 pandemic	No	108 (16.7)
	Yes	537 (83.3)
Able to cope with the situation since the start of the pandemic	No	22 (3.4)
	Yes	623 (96.6)
Enough support from people around you since the start of the pandemic	No	42 (6.5)
	Yes	606 (93.5)
Community support from peers living with HIV was helpful during the Covid-19 pandemic	No	398 (63.3)
	Yes	231 (36.7)
Economic concerns
Worried about money since the start of the pandemic	No	257 (39.7)
	Yes	391 (60.3)
Expected to work in unsafe conditions where there was a risk of contracting coronavirus	No	478 (73.8)
	Yes	170 (26.2)