The impact of the COVID-19 pandemic on HIV-positive men who have sex with men: (dis)connection to social, sexual, and health networks

ABSTRACT

The COVID-19 pandemic has disproportionately affected HIV-positive cisgender men who have sex with men (MSM). Between May and June in 2020, we conducted one-on-one semi-structured qualitative interviews with 20 HIV-positive MSM aiming to describe their (dis)connection to social, sexual, and health networks during the COVID-19 pandemic. All participants relied on social support networks to manage pandemic-based distress, using computer-mediated communication as well as physical proximity. To connect to sexual networks, this sample described adaptations to their partner selection strategies, such as enumerating harm reduction approaches. To connect to health networks, participants depended on reassuring providers, resourceful case managers, telehealth, and streamlined access to their antiretroviral therapy (ART) medications. Nonetheless, stay-at-home recommendations reduced community connection, sexual activity, and healthcare access for many participants, and perceptions of these losses were shaped by psychosocial burdens (e.g. loneliness), structural burdens (e.g. environmental barriers, financial difficulties), and health-protective factors (e.g. hopeful outlook, adherence to a regular routine). The COVID-19 pandemic appears to have exacerbated health-related issues for HIV-positive MSM. Given the ongoing COVID-19 mutations, community-based organisations, clinicians, and researchers might use these findings to modify HIV prevention and intervention efforts.

KEYWORDS:

• HIV
• men who have sex with men
• COVID-19
• healthcare
• syndemic theory

Acknowledgments

The authors would like to thank Gamille Gallus and Sabrina Rios for their assistance during the quality assurance phase of transcription. Special thanks to additional members of the T5K study team: David Pantalone, Denis Nash, Sarit A. Golub, Viraj V. Patel, Gregorio Millett, Don Hoover, Sarah Kulkarni, Matthew Stief, Chloe Mirzayi, Javier Lopez-Rios, Fatima Zohra, & Pedro Carneiro. Thank you to the program staff at NIH: Gerald Sharp, Sonia Lee, and Michael Stirratt. And thank you to the members of our Scientific Advisory Board: Michael Camacho, Demetre Daskalakis, Sabina Hirshfield, Jeremiah Johnson, Claude Mellins, and Milo Santos. While the NIH financially supported this research, the content is the responsibility of the authors and does not necessarily reflect official views of the NIH.

Disclosure statement

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

Data availability

Data available upon request.

Additional information

Funding

This work was supported by the National Institutes for Health under Grant UH3 AI 133675—PI Grov—Together 5000. Other forms of support include the CUNY Institute for Implementation Science in Population Health, the Einstein, Rockefeller, CUNY Center for AIDS Research (ERC CFAR, P30 AI124414). Cory Cascalheira is supported as a RISE Fellow by the National Institutes of Health under grant R25GM061222.

Notes on contributors

Cory J. Cascalheira

Cory J. Cascalheira is a doctoral candidate in the Department of Counseling & Educational Psychology at New Mexico State University and a lab manager at Syracuse University.

Corey Morrison

Cory Morrison now works at the New York State Psychiatric Institute HIV Center for Clinical and Behavioral Studies.

Alexa B. D’Angelo

Alexa D'Angelo is a doctoral student at the City University of New York.

Oziel Garcia Villanueva

Oziel Garcia Villanueva recently received a master’s in public health from New Mexico State University.

Christian Grov

Christian Grov is a tenured Professor and Chair in the Department of Community Health and Social Sciences at CUNY Graduate School of Public Health and Health Policy.