ABSTRACT
Background: Increases in the prevalence of mental health symptoms during global pandemics have been observed. We hypothesized that people with HIV (PWH) and without HIV (HIV-) would experience an increase in mental health symptoms and alcohol use after the onset of the COVID-19 pandemic and that PWH would experience a greater increase than HIV-individuals. Methods: Participants were recruited from two established cohorts of PWH and HIV-adults in Omaha, Nebraska for whom baseline data including mental health and alcohol use assessments had been collected prior to the pandemic. Participants were excluded from the original cohorts if they had any known psychiatric diagnosis or were taking antipsychotics or anticonvulsants. Participants were reassessed utilizing the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Alcohol Use Identification Test (AUDIT), and Pittsburgh Sleep Quality Index (PSQI) between February and April 2021. All outcomes were evaluated using generalized linear mixed models. Results: Of the 95 participants who completed all questionnaires, 50 were PWH and 45 HIV-. Groups did not statistically differ in age, sex, race or ethnicity (mean: 45.67 years;69.5% male;74% non-Hispanic white). Pre-pandemic mean BDI-II, BAI, AUDIT and PSQI scores were higher in PWH versus HIV-. After the onset of the pandemic, mean BDI-II and AUDIT scores increased significantly in both groups (see Table;P<.001 and P=0.003, respectively) and AUDIT scores were significantly higher in males than females (P=.002). Measures of binge drinking and alcohol misuse as well as mean BAI and PSQI scores increased numerically intra-pandemic. Intra-pandemic mean BDI-II and AUDIT scores increased more among HIV-than PWH, but not significantly so. The percentage of PWH and HIV-participants who moved into a more severe category of depression as measured by the BDI-II (eg, from minimal to moderate) after the onset of the pandemic was identical (18%). Conclusion: Measures of depression and alcohol use increased significantly after the onset of the COVID-19 pandemic in people with and without HIV. Although there were no significant differences in the changes between the groups, PWH had higher baseline scores so the increases in this group may have more clinical impacts. Screening for symptoms of mental health and alcohol use is critical, especially in PWH during a pandemic. Future work will explore the longer-term impact of the pandemic on mental health symptoms and alcohol use.