A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic.

BACKGROUND: This study investigated the associations between COVID-19 related stigma and post-traumatic stress symptoms (PTSS); and the associations between PTSS and COVID-19 related stigma, HIV status, COVID-19 status and key HIV population status. METHODS: This was a secondary analysis of data of 12,355 study participants generated through an online survey that recruited adults from 152 countries between July and December 2020. The dependent variables were COVID-19-related stigma and PTSS. The independent variables were HIV status (positive/negative), transaction sex (yes/no), use of psychoactive drugs (yes/no), and vulnerability status (transaction sex workers, people who use psychoactive drugs, living with HIV, and COVID-19 status). The confounding variables were age, sex at birth (male/female), level of education, sexual minority individuals (yes/no) and country income level. Multivariable logistic regression analyses were conducted to determine associations between the dependent and independent variables after adjusting for confounders. RESULTS: There were 835 (6.8%) participants who experienced COVID-19 related stigma during the pandemic and 3,824 (31.0%) participants reported PTSS. Respondents who were living with HIV (AOR: 1.979; 95%CI: 1.522-2.573), tested positive for COVID-19 (AOR: 3.369; 95%CI: 2.692-4.217), engaged in transactional sex (AOR: 1.428; 95%CI: 1.060-1.922) and used psychoactive drugs (AOR: 1.364; 95%CI: 1.053-1.767) had significantly higher odds of experiencing COVID-19 related stigma. Individuals with vulnerability status (AOR:4.610; 95%CI: 1.590-13.368) and who experienced COVID-19 related stigma (AOR: 2.218; 95%CI: 1.920-2.561) had significantly higher odds of PTSS. CONCLUSION: Individuals with vulnerability status may be at increased risk for COVID-19 related stigma. Key and vulnerable populations who were living with HIV and who experienced stigma may be at a higher risk of experiencing PTSS. Populations at risk for PTSS should be routinely screened and provided adequate support when they contract COVID-19 to reduce the risk for poor mental health during COVID-19 outbreaks and during future health crisis with similar magnitude as the COVID-19 pandemic.

Associations between Mental Health and COVID-19 Status among 18- and 19-Year-Old Adolescents: A Multi-Country Study

The aim of this study was to describe the mental health status of 18- and 19-year-old adolescents who were infected or affected by COVID-19 during the first wave of the COVID-19 pandemic. This was a secondary analysis of a dataset collected from 152 countries between July and December 2020. Dependent variables were anxiety, depression, and post-traumatic stress symptoms. The independent variable was COVID-19 status (tested positive for COVID-19, had COVID-19 symptoms but did not test, had a close friend who tested positive for COVID-19, knew someone who died from COVID-19). Three multivariable logistic regression analyses were conducted to determine the associations between the dependent and independent variables while adjusting for confounding variables (sex - male, female, and country income level). Data of 547 participants were extracted, and 98 (17.9%) had experienced depression, 130 (23.8%) had experienced anxiety, and 219 (40.0%) had experienced post-traumatic stress symptoms. Knowing someone who died from COVID-19 was associated with significantly lower odds of having post-traumatic stress symptoms (AOR: 0.608). Having COVID-19 symptoms but not getting tested was associated with significantly higher odds of having anxiety symptoms (AOR: 2.473). Results indicate diverse mental health responses among adolescents aged 18-19-years old as a sequela of COVID-19. This needs to be studied further.

Sociodemographic Factors Associated with Emotional Distress, Transactional Sex and Psychoactive Substance Use during the First Wave of the COVID-19 Pandemic

The aim of this study was to identify the sociodemographic factors associated with emotional distress and determine if the quality of family relationships and the perception of social isolation can protect those who transacted sex or used psychoactive substances from emotional distress during the COVID-19 pandemic. Data for 426 people who transacted sex and 630 persons who used psychoactive drugs during the COVID-19 pandemic were extracted from a database of participants recruited from 152 countries. The extracted data were the dependent (emotional distress), independent (age, sex, education status, employment status, HIV status, the perception of social isolation, and the quality of family relationships), and confounding (country income level) variables. Multivariable logistic regression analyses were conducted to determine the associations between the dependent and independent variables after adjusting for confounders. Students who transacted sex (AOR:2.800) and who used psychoactive substances (AOR:2.270) had significantly higher odds of emotional distress. Participants who transacted sex, lived with HIV (AOR:2.582), or had the same/better quality of family relationships (AOR:1.829) had significantly higher odds of emotional distress. The participants who used psychoactive substances, had tertiary education (AOR:1.979), were retired (AOR: 2.772), were unemployed (AOR:2.263), or felt socially isolated (AOR:2.069) had significantly higher odds of emotional distress. Being a student was the only sociodemographic risk indicator common to both populations. The risk indicators and protective factors for emotional distress differed for both populations despite both being at high risk for emotional distress.

Psychosocial Factors Associated with Memory Complaints during the First Wave of the COVID-19 Pandemic: A Multi-Country Survey.

This study assessed the associations between psychosocial factors (social isolation, social support, financial support and emotional distress) and memory complaints during the COVID-19 pandemic. This was a secondary analysis of data extracted from the dataset of participants recruited from 151 countries for a COVID-19 related mental health and wellness study between June and December 2020. The dependent variable was memory complaint, measured using the Memory Complaint Questionnaire. The independent variables were perception of social isolation, social support, financial support, emotional distress and history of SARS-CoV-19 infection. Confounding variables were age, sex at birth, level of education, employment status, HIV status and country-income level. Multivariable logistic regression was used to determine the associations between the dependent and independent variables after adjusting for the confounders. Of the 14825 participants whose data was extracted, 2460 (16.6%) had memory complaints. Participants who felt socially isolated (AOR: 1.422; 95% CI: 1.286-1.571), emotionally distressed (AOR: 2.042; 95% CI: 1.850-2.253) and with history of SARS-CoV-19 infection (AOR: 1.369; 95% CI: 1.139-1.646) had significantly higher odds of memory complaints. Participants who perceived they had social and financial support had significantly lower odds of memory complaints (AOR: 0.655; 95% CI: 0.571-0.751). Future management of pandemics like the COVID-19 should promote access to social and financial support and reduce the risk of social isolation and emotional distress.

Fear of contagion, emotional stress and coping strategies used by adults during the first wave of the COVID-19 pandemic in Nigeria.

BACKGROUND: The COVID-19 pandemic has induced high levels of stress. The aim of the study was to assess the relationship between emotional stress (COVID-19 related fear, anger, frustration, and loneliness) and the use of coping strategies among adults in Nigeria during the COVID-19 pandemic. METHODS: Data from adults aged 18 years and above were collected through an online survey from July to December 2020. The dependent variables were COVID-19 related fear (fear of infection and infecting others with COVID-19), anger, frustration, and loneliness. The independent variables were coping strategies (use of phones to communicate with family and others, video conferencing, indoor exercises, outdoor exercises, meditation/mindfulness practices, engaging in creative activities, learning a new skill, following media coverage related to COVID-19) and alcohol consumption. Five logistic regression models were developed to identify the factors associated with each dependent variables. All models were adjusted for sociodemographic variables (age, sex at birth, and the highest level of education). RESULTS: Respondents who consumed alcohol, followed media coverage for COVID-19 related information, and who spoke with friends or family on the phone had higher odds of having fear of contracting COVID-19 or transmitting infection to others, and of feeling angry, frustrated, or lonely (p < 0.05). Respondents who exercised outdoors (AOR: 0.69) or learned a new skill (AOR: 0.79) had significantly lower odds of having fear of contracting COVID-19. Respondents who practiced meditation or mindfulness (AOR: 1.47) had significantly higher odds of feeling angry. Those who spoke with friends and family on the phone (AOR: 1.32) and exercised indoors (AOR: 1.23) had significantly higher odds of feeling frustrated. Those who did video conferencing (AOR: 1.41), exercised outdoors (AOR: 1.32) and engaged with creative activities (AOR: 1.25) had higher odds of feeling lonely. CONCLUSION: Despite the significant association between emotional stress and use of coping strategies among adults in Nigeria during the COVID-19 pandemic, it appears that coping strategies were used to ameliorate rather than prevent emotional stress. Learning new skills and exercising outdoors were used to ameliorate the fear of contracting COVID-19 in older respondents.

Associations between Emotional Distress, Sleep Changes, Decreased Tooth Brushing Frequency, Self-Reported Oral Ulcers and SARS-Cov-2 Infection during the First Wave of the COVID-19 Pandemic: A Global Survey.

This study assessed the association between emotional distress, sleep changes, decreased frequency of tooth brushing, and self-reported oral ulcers, and the association between COVID-19 status and decreased frequency of tooth brushing. Using a cross-sectional online survey, data were collected from adults in 152 countries between July and December 2020. Binary logistic regression analyses were conducted to determine the associations between dependent (decreased frequency of tooth brushing, oral ulcers, change in sleep pattern) and independent (tested positive for COVID-19, depression, anxiety, frustration/boredom, loneliness, anger, and grief/feeling of loss) variables after adjusting for confounders (age, sex, level of education, employment status). Of the 14,970 participants data analyzed, 1856 (12.4%) tested positive for COVID-19. Respondents who reported feeling depressed (AoR: 1.375), lonely (AoR: 1.185), angry (AoR: 1.299), and experienced sleep changes (AoR:1.466) had significantly higher odds of decreased tooth brushing frequency. Respondents who felt anxious (AoR: 1.255), angry (AoR: 1.510), grief/sense of loss (AoR: 1.236), and sleep changes (AoR: 1.262) had significantly higher odds of oral ulcers. Respondents who tested positive for COVID-19 had significantly higher odds of decreased tooth brushing frequency (AoR: 1.237) and oral ulcers (AoR: 2.780). These findings highlight that the relationship between emotional distress and oral health may intensify during a pandemic.

Sex differences in the experience of COVID-19 post-traumatic stress symptoms by adults in South Africa

Background: The COVID-19 pandemic has created multiple mental health challenges. Many residents in South Africa face pre-existing elevated levels of stress and the pandemic may have had varying impacts on sub-populations. The aims of this study were to determine: 1) the factors associated with post-traumatic stress symptoms (PTSS) and 2) sex differences in the factors associated with PTSS in adults residing in South Africa during the COVID-19 pandemic. Methods: Study participants aged 18 years and above, were recruited for this cross-sectional study through an online survey implemented from June 29, 2020 to December 31, 2020. The outcome variable was PTSS;explanatory variables were sex at birth, COVID-19 status, social isolation and access to emotional support. Confounders considered were age, education level completed and current work status. Logistic regressions were used to determine the association between the outcome and explanatory variables after adjusting for confounders. Outcomes: There were 489 respondents. Among all respondents, those who were older (AOR: 0.97;95% CI: 0.95 - 0.99) and had access to emotional support from family and relatives (AOR: 0.27;95% CI: 0.14 - 0.53) had significantly lower odds of PTSS. Respondents who felt socially isolated had higher odds of PTSS (AOR: 1.17;95% CI: 1.08 - 1.27). Females had higher PTSS scores and higher odds of PTSS compared to males (AOR: 2.18;95% CI: 1.41-3.39). Females (AOR: 0.27;95% CI: 0.08 - 0.95) and males (AOR: 0.26;95% CI: 0.11, 0.59) who had access to emotional support had significantly lower odds of PTSS than those who had no support. Females (AOR: 1.15;95% CI: 1.04 -1.27) and males (AOR: 1.19;95% CI: 0.11, 0.59) who felt socially isolated had higher odds of PTSS compared to those who did not feel socially isolated. Interpretation: Compared to males, females had higher scores and higher odds of reporting PTSS during the COVID- 19 pandemic. Access to emotional support ameliorated the odds of having PTSS for both sexes, while feeling socially isolated worsened the odds for both sexes. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Factors Associated With Experiences of Fear, Anxiety, Depression, and Changes in Sleep Pattern During the COVID-19 Pandemic Among Adults in Nigeria: A Cross-Sectional Study.

Background: Multiple facets of the pandemic can be a source of fear, depression, anxiety and can cause changes in sleep patterns. The aim of this study was to identify health profiles and the COVID-19 pandemic related factors associated with fear, depression, anxiety and changes in sleep pattern in adults in Nigeria. Methods: The data for this analysis was extracted from a cross-sectional online survey that collected information about mental health and well-ness from a convenience sample of adults 18 years and above resident in Nigeria from July to December 2020. Study participants were asked to complete an anonymous, closed-ended online questionnaire that solicited information on sociodemographic profile, health profiles (high, moderate and low COVID-19 infection risk profile) including HIV status, COVID-19 status, and self-reported experiences of fear, anxiety, depression and changes in sleep patterns. Results: In total, 4,439 participants with mean age of 38.3 (±11.6) years responded to the survey. Factors associated with higher odds of having COVID-19 related fear were health risk (p < 0.05); living with HIV (AOR: 3.88; 95% CI: 3.22-4.69); having COVID-19 symptoms but not tested (AOR: 1.61; 95% CI: 1.30-1.99); having a friend who tested positive to COVID-19 (AOR: 1.28; 95% CI: 1.07-1.53) and knowing someone who died from COVID-19 (AOR: 1.43; 95% CI: 1.24-1.65). The odds of feeling anxious was significantly higher for those with moderate or low health risk profile (p < 0.05); living with HIV (AOR: 1.64; 95% CI: 1.32-2.04); had a friend who tested positive for COVID-19 (AOR: 1.35; 95% CI: 1.08-1.68) or knew someone who died from COVID-19 (AOR: 1.53; 95% CI: 1.28-1.84). The odds of feeling depressed was significantly higher for those with health risk profile (p < 0.05); living with HIV (AOR: 2.49; 95% CI: 1.89-3.28); and respondents who had COVID-19 symptoms but had not taken a test (AOR: 1.41; 95% CI: 1.02-1.94). Factors associated with higher odds of having sleep pattern changes were having moderate and low health risk profiles (p < 0.05). Conclusion: The study findings suggest that the pandemic may cause fear, anxiety, depression and changes in sleep patterns differently for people with different health profile, HIV status and COVID-19 status.

"Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: A cross-sectional study": Correction

Reports an error in "Factors associated with Covid-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: A cross-sectional study" by Morenike Oluwatoyin Folayan, Olanrewaju Ibigbami, Maha ElTantawi, Giuliana Florencia Abeldano, Eshrat Ara, Martin Amogre Ayanore, Passent Ellakany, Balgis Gaffar, Nuraldeen Maher Al-Khanati, Ifeoma Idigbe, Anthonia Omotola Ishabiyi, Mohammed Jafer, Abeedah Tu-Allah Khan, Zumama Khalid, Folake Barakat Lawal, Joanne Lusher, Ntombifuthi P. Nzimande, Bamidele Emmanuel Osamika, Bamidele Olubukola Popoola, Mir Faeq Ali Quadri, Mark Roque, Anas Shamala, Ala'a B. Al-Tammemi, Muhammad Abrar Yousaf, Jorma I. Virtanen, Roberto Ariel Abeldano Zuniga, Joseph Chukwudi Okeibunor and Annie Lu Nguyen (BMC Psychiatry, 2022[Jan][21], Vol 22[48]). In the original article, affiliation 7 is incorrectly assigned to Eshrat Ara. The correct affiliations are given in erratum. (The following of the original article appeared in record 2022-26374-001). Background: Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV;to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support;and to determine the association between PTSS and use of COVID-19 prevention strategies. Methods: The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables. Results: Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p < 0.001). People living with HIV (AOR = 0.39), those who wore masks (AOR = 0.62) and those who had emotional support (AOR = 0.63), had lower odds of reporting PTSS (p < .05). Conclusion: The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Factors Associated With Experiences of Fear, Anxiety, Depression, and Changes in Sleep Pattern During the COVID-19 Pandemic Among Adults in Nigeria: A Cross-Sectional Study

Background Multiple facets of the pandemic can be a source of fear, depression, anxiety and can cause changes in sleep patterns. The aim of this study was to identify health profiles and the COVID-19 pandemic related factors associated with fear, depression, anxiety and changes in sleep pattern in adults in Nigeria. Methods The data for this analysis was extracted from a cross-sectional online survey that collected information about mental health and well-ness from a convenience sample of adults 18 years and above resident in Nigeria from July to December 2020. Study participants were asked to complete an anonymous, closed-ended online questionnaire that solicited information on sociodemographic profile, health profiles (high, moderate and low COVID-19 infection risk profile) including HIV status, COVID-19 status, and self-reported experiences of fear, anxiety, depression and changes in sleep patterns. Results In total, 4,439 participants with mean age of 38.3 (±11.6) years responded to the survey. Factors associated with higher odds of having COVID-19 related fear were health risk (p < 0.05);living with HIV (AOR: 3.88;95% CI: 3.22–4.69);having COVID-19 symptoms but not tested (AOR: 1.61;95% CI: 1.30–1.99);having a friend who tested positive to COVID-19 (AOR: 1.28;95% CI: 1.07–1.53) and knowing someone who died from COVID-19 (AOR: 1.43;95% CI: 1.24–1.65). The odds of feeling anxious was significantly higher for those with moderate or low health risk profile (p < 0.05);living with HIV (AOR: 1.64;95% CI: 1.32–2.04);had a friend who tested positive for COVID-19 (AOR: 1.35;95% CI: 1.08–1.68) or knew someone who died from COVID-19 (AOR: 1.53;95% CI: 1.28–1.84). The odds of feeling depressed was significantly higher for those with health risk profile (p < 0.05);living with HIV (AOR: 2.49;95% CI: 1.89–3.28);and respondents who had COVID-19 symptoms but had not taken a test (AOR: 1.41;95% CI: 1.02–1.94). Factors associated with higher odds of having sleep pattern changes were having moderate and low health risk profiles (p < 0.05). Conclusion The study findings suggest that the pandemic may cause fear, anxiety, depression and changes in sleep patterns differently for people with different health profile, HIV status and COVID-19 status.

Factors associated with COVID-19 pandemic induced post-traumatic stress symptoms among adults living with and without HIV in Nigeria: a cross-sectional study.

BACKGROUND: Nigeria is a country with high risk for traumatic incidences, now aggravated by the COVID-19 pandemic. This study aimed to identify differences in COVID-19 related post-traumatic stress symptoms (PTSS) among people living and not living with HIV; to assess whether PTSS were associated with COVID-19 pandemic-related anger, loneliness, social isolation, and social support; and to determine the association between PTSS and use of COVID-19 prevention strategies. METHODS: The data of the 3761 respondents for this analysis was extracted from a cross-sectional online survey that collected information about mental health and wellness from a convenience sample of adults, 18 years and above, in Nigeria from July to December 2020. Information was collected on the study's dependent variable (PTSS), independent variables (self-reported COVID-19, HIV status, use of COVID-19 prevention strategies, perception of social isolation, access to emotional support, feelings of anger and loneliness), and potential confounder (age, sex at birth, employment status). A binary logistic regression model tested the associations between independent and dependent variables. RESULTS: Nearly half (47.5%) of the respondents had PTSS. People who had symptoms but were not tested (AOR = 2.20), felt socially isolated (AOR = 1.16), angry (AOR = 2.64), or lonely (AOR = 2.19) had significantly greater odds of reporting PTSS (p < 0.001). People living with HIV (AOR = 0.39), those who wore masks (AOR = 0.62) and those who had emotional support (AOR = 0.63), had lower odds of reporting PTSS (p < .05). CONCLUSION: The present study identified some multifaceted relationships between post-traumatic stress, HIV status, facemask use, anger, loneliness, social isolation, and access to emotional support during this protracted COVID-19 pandemic. These findings have implications for the future health of those affected, particularly for individuals living in Nigeria. Public health education should be incorporated in programs targeting prevention and prompt diagnosis and treatment for post-traumatic stress disorder at the community level.

Factors Associated with Financial Security, Food Security and Quality of Daily Lives of Residents in Nigeria during the First Wave of the COVID-19 Pandemic.

An online survey was conducted to identify factors associated with financial insecurity, food insecurity and poor quality of daily lives of adults in Nigeria during the first wave of the COVID-19 pandemic. The associations between the outcome (experience of financial loss, changes in food intake and impact of the pandemic on daily lives) and the explanatory (age, sex, education level, anxiety, depression, HIV status) variables were determined using logistic regression analysis. Of the 4439 respondents, 2487 (56.0%) were financially insecure, 907 (20.4%) decreased food intake and 4029 (90.8%) had their daily life negatively impacted. Males (AOR:0.84), people who felt depressed (AOR:0.62) and people living with HIV -PLHIV- (AOR:0.70) had significantly lower odds of financial insecurity. Older respondents (AOR:1.01) had significantly higher odds of financial insecurity. Those depressed (AOR:0.62) and PLHIV (AOR:0.55) had significantly lower odds of reporting decreased food intake. Respondents who felt anxious (AOR:0.07), depressed (AOR: 0.48) and who were PLHIV (AOR:0.68) had significantly lower odds of reporting a negative impact of the pandemic on their daily lives. We concluded the study findings may reflect a complex relationship between financial insecurity, food insecurity, poor quality of life, mental health, and socioeconomic status of adults living in Nigeria during the COVID-19 pandemic.