Knowledge, Attitude, Behavior, and Socioeconomic Conditions of People Living with HIV in Indonesia During the COVID-19 Pandemic: A Cross-Sectional Study

Figures & data

Table 1 Demographics of the Study Subjects

Characteristics	N = 545
Age (mean; SD)	39 (9.2)
Age groups	N (%)
18–35	165 (30.3)
36–55	362 (66.4)
>55	18 (3.3)
Sex, male	397 (72.8)
Marital status
Single	175 (32.1)
Married	270 (49.5)
Widowed	100 (18.3)
Education
Low level (primary school or did not finish)	51 (9.4)
High school	270 (49.5)
Undergraduate	83 (15.2)
Graduate	128 (23.5)
Post-graduate	13 (2.4)
Comorbidities
Diabetes mellitus	19 (3.5)
Hypertension	52 (9.5)
Tuberculosis	39 (7.2)
Coronary heart disease	5 (0.9)
Bronchitis	8 (1.5)
Cancer	4 (0.7)
Kidney disease	9 (1.7)
Other comorbidities (hepatitis B, hepatitis C, SLE)	8 (1.5)
Current CD4 count
(mean; SD)	508 (297.8)
<200	84 (15.4)
200–500	204 (37.4)
>500	257 (47.1)
HIV viral load
<50	195 (35.7)
50–1000	48 (8.8)
> 1000	21 (3.9)
No data	281 (51.6)
ARV combination
NRTI-
AZT	218 (40)
TDF	290 (53.2)
Other	2 (0.4)
NNRTI
NVP	164 (30.1)
EFV	258 (47.3)
RPV	10 (1.8)
PI
LPV/r	75 (13.8)
DRV/r	1 (0.2)
INSTI
DTG	1 (0.2)
No data	33 (6.1)
Not on ART yet	2 (0.4)
ART adherence
Always regular	435 (79.8)
Irregular	110 (20.2)
Smoking status (current vs past)
Never smoked	232 (42.6)
Smoked in the past	195 (35.7)
Currently smoke	118 (21.6)
Monthly income before COVID-19 pandemic (IDR)
≤2 million (≤ 140 USD)	104 (19.1)
2–4 million (140–280 USD)	159 (29.2)
4–10 million (280–701 USD)	112 (20.6)
>10 million (>701 USD)	26 (4.8)
Not willing to answer	144 (26.4)
Change of income during the pandemic
No change	151 (27.7)
Increase	4 (0.7)
Reduced by up to 10%	53 (9.7)
Reduced by 10% to 50%	112 (20.6)
Reduced by more than 50%	103 (18.9)
Loss of income	122 (22.4)
Change in job during the pandemic
Unchanged	212 (38.9)
Work from home	132 (24.2)
Sometimes work in office or business location	116 (21.3)
Lost job during the pandemic	85 (15.6)

Abbreviation: NRTI, nucleoside reverse transcriptase inhibitors; AZT, zidovudine; TDF, tenofovir disoproxil fumarate; NNRTI, non-nucleoside reverse transcriptase inhibitors; NVP, nevirapine; EFV, efavirenz; RPV, rilpivirine; PI, protease inhibitors; LPV/r, lopinavir/ritonavir; DRV/r, darunavir/ritonavir; INSTI, Integrase strand transfer inhibitors; DTG, Dolutegravir.

Table 2 Knowledge of COVID-19 and Impact of HIV Infection on COVID-19

Knowledge Questions About COVID-19 Answered Correctly	N (%)
Medium of COVID-19 transmission	494 (90.6)
COVID-19 symptoms	439 (80.6)
How to protect oneself and family from COVID-19	300 (55)
What to do in the event of flu symptoms	243 (44.6)
Treatment for COVID-19	167 (30.6)
Knowledge About Impact of HIV Infection on COVID-19	N (%)
ART can prevent COVID-19 infection
Yes	247 (45.3)
No	298 (54.7)
Current condition increases susceptibility to COVID-19 infection
Yes	278 (51)
No	112 (20.6)
Not sure	155 (28.4)
If infected with COVID-19, symptoms will be worse
Yes	244 (44.8)
No	56 (10.3)
Not sure	245 (45)

Table 3 Characteristics of PLWH Based on Their Level of Knowledge of COVID-19

Variables	Poor Level of Knowledge (n = 166)	Good Level of Knowledge (n = 379)	P value
Age (years)
Mean, SD	39 (6.5)	41 (8.2)	0.045*
CD4 count
Mean, SD	474 (284.2)	523 (303.2)	0.061
Sex
Male, n (%)	123 (31)	274 (69)	0.741
Female, n (%)	43 (29.1)	105 (70.9)
Marital status
Single, n (%)	59 (33.7)	116 (66.3)	0.398
Married, n (%)	81 (30)	189 (70)
Widowed, n (%)	26 (26)	74 (74)
Education
Low, n (%)	98 (30.6)	222 (69.4)	0.995
High, n (%)	68 (30.2)	157 (69.8)
Income
Below minimum wage, n (%)	88 (33.2)	177 (66.8)	0.141
Equal or above minimum wage, n (%)	44 (31.9)	94 (68.1)
No data, n (%)	34 (23.9)	108 (76.1)
Having comorbidities as risk factors of COVID-19
Yes, n (%)	25 (31.3)	55 (68.8)	0.972
No, n (%)	141 (30.3)	324 (69.7)
Usage of LPV/r
Yes, n (%)	20 (27.4)	53 (72.6)	0.635
No, n (%)	146 (30.9)	326 (69.1)
ART adherence
Always regular, n (%)	139 (32)	296 (68)	0.164
Irregular, n (%)	27 (24.5)	83 (75.5)
Smoking status
Yes, n (%)	100 (31.9)	213 (68.1)	0.433
No, n (%)	66 (28.4)	166 (71.6)

Note: *Statistically significant at p value <0.05.

Table 4 Characteristics of PLWH Based on Level of Worry of COVID-19 Infection

Variables	Not Worried About COVID-19 Infection (n = 342)	Worried About COVID-19 Infection (n = 203)	P value
Age (years)
Mean, SD	39.34 (8.9)	39.27 (9.6)	0.874
CD4 Count
Mean, SD	514.89 (291.8)	496.97 (308.1)	0.303
Sex
Male, n (%)	245 (61.7)	152 (38.3)	0.470
Female, n (%)	97 (65.5)	51 (34.5)
Marital status
Single, n (%)	102 (58.3)	73 (41.7)	0.075
Married, n (%)	168 (62.2)	102 (37.8)
Widowed, n (%)	72 (72)	28 (28)
Education
Low, n (%)	201 (62.8)	119 (37.2)	0.972
High, n (%)	141 (62.7)	84 (37.3)
Income
Below minimum wage, n (%)	163 (61.5)	102 (38.5)	0.842
Equal or above minimum wage, n (%)	88 (63.8)	50 (36.2)
No data, n (%)	91 (64.1)	51 (35.9)
Having comorbidities that are risk factors of COVID-19
Yes, n (%)	56 (70.9)	23 (29.1)	0.136
No, n (%)	286 (61.4)	180 (38.6)
Usage of LPV/r
Yes, n (%)	38 (52.1)	35 (47.9)	0.042*
No, n (%)	304 (64.4)	168 (35.6)
ART adherence
Always regular, n (%)	279 (64.1)	156 (35.9)	0.183
Irregular, n (%)	63 (57.3)	47 (42.7)
Smoking status
Yes, n (%)	200 (63.9)	113 (36.1)	0.521
No, n (%)	142 (61.2)	90 (38.8)

Note: *Statistically significant at p value <0.05.

Figure 1 Actions that are taken during the COVID-19 pandemic.

Figure 2 Behaviors regarding HIV treatment.

Figure 3 Efforts to prevent stop taking ART interruption.