COVID-19 health information trust and prejudicial attitudes predict healthcare disruptions in the first year of COVID-19 among people living with HIV.

Cross-sectional studies have reported that people living with HIV experienced disruptions to social relationships and healthcare during the first year of the COVID-19 pandemic. Furthermore, individuals with less trust in public health sources of COVID-19 information as well as those who held greater COVID-19 prejudicial attitudes experienced greater healthcare disruptions in the early months of COVID-19. To examine changes in trust and prejudicial attitudes in relation to healthcare disruptions during the first year of COVID-19, we followed a closed cohort of 115 men and 26 women ages 18 to 36 living with HIV over the first year of the COVID-19 pandemic. Findings confirmed that a majority of individuals continued to experience disruptions to their social relationships and healthcare over the course of the first year of COVID-19. In addition, trust in COVID-19 information from the CDC and state health department diminished over the year as did COVID-19 prejudicial attitudes. Regression models showed that lower trust in the CDC and health department and greater prejudicial attitudes toward COVID-19 early in the pandemic predicted greater healthcare disruptions over the year. In addition, greater trust in the CDC and health department early in COVID-19 predicted better antiretroviral therapy adherence later in the year. Results support an urgent need to regain and sustain trust in public health authorities among vulnerable populations.

Prepandemic Predictors of Medication Adherence and HIV Viral Load During the First Year of COVID-19.

ABSTRACT: Studies have reported significant immediate impacts of the COVID-19 pandemic on the social relationships and health care of people living with HIV. This study followed a closed cohort of young people living with HIV over the first year of the COVID-19 pandemic. Participants were men and women (N = 140) age 36 years and younger who were living with HIV and had demonstrated suboptimal adherence to antiretroviral therapy, unsuppressed HIV viral load, or active substance use in a run-in study. The results confirmed that participants continued to experience significant disruptions to their social relationships and health care over the course of the first year of the COVID-19 pandemic. There was evidence for sustained impacts on transportation, housing stability, and food security during the first year of COVID-19. Multivariable models showed that greater pre-COVID-19 social support predicted greater antiretroviral therapy adherence and greater HIV suppression (lower viral load) over the first year of the COVID-19 pandemic. Efforts to plan and prepare people living with HIV for future social crises, including future pandemics, should emphasize building and sustaining social support.

Intersecting Pandemics: Impact of SARS-CoV-2 (COVID-19) Protective Behaviors on People Living With HIV, Atlanta, Georgia.

BACKGROUND: COVID-19 and its social responses threaten the health of people living with HIV. We conducted a rapid-response interview to assess COVID-19 protective behaviors of people living with HIV and the impact of their responses on HIV-related health care. METHOD: Men and women living with HIV (N = 162) aged 20-37 years participating in a longitudinal study of HIV treatment and care completed routine study measures and an assessment of COVID-19-related experiences. RESULTS: At baseline, most participants demonstrated HIV viremia, markers indicative of renal disorders, and biologically confirmed substance use. At follow-up, in the first month of responding to COVID-19, engaging in more social distancing behaviors was related to difficulty accessing food and medications and increased cancelation of health care appointments, both by self and providers. We observed antiretroviral therapy adherence had improved during the initial month of COVID-19 response. CONCLUSIONS: Factors that may pose added risk for COVID-19 severity were prevalent among people living with HIV, and those with greater risk factors did not practice more COVID-19 protective behaviors. Social distancing and other practices intended to mitigate the spread of COVID-19 interfered with HIV care, and impeded access to food and medications, although an immediate adverse impact on medication adherence was not evident. These results suggest social responses to COVID-19 adversely impacted the health care of people living with HIV, supporting continued monitoring to determine the long-term effects of co-occurring HIV and COVID-19 pandemics.

Prejudicial beliefs and COVID-19 disruptions among sexual minority men living with and not living with HIV in a high SARS-CoV-2 prevalence area.

The COVID-19 pandemic has had profound health and social impacts. COVID-19 also affords opportunities to study the emergence of prejudice as a factor in taking protective actions. This study investigated the association of COVID-19 concerns, prejudicial beliefs, and personal actions that involve life disruptions among people not living with and people living with HIV. 338 Black/African American men not living with HIV who reported male sex partners and 148 Black/African American men living with HIV who reported male sex partners completed a confidential survey that measured COVID-19 concern, COVID-19 prejudice, and personal action and institutionally imposed COVID-19 disruptions. Participants reported having experienced multiple social and healthcare disruptions stemming from COVID-19, including reductions in social contacts, canceling medical appointments, and inability to access medications. Mediation analyses demonstrated that COVID-19 concerns and COVID-19 prejudice were associated with personal action disruptions, indicating that these social processes are important for understanding how individuals modified their lives in response to COVID-19. It is imperative that public health efforts combat COVID-19 prejudice as these beliefs undermine investments in developing healthcare infrastructure to address COVID-19 prevention.

Trust in health information sources and its associations with COVID-19 disruptions to social relationships and health services among people living with HIV.

BACKGROUND: SARS-CoV-2 infection (COVID-19) is potentially severe for individuals with compromised immune systems, including people living with HIV. Along with the direct health threats of COVID-19, there are disruptions to social relationships and health services resulting from mitigation efforts instituted by public health authorities. This study examined the relationship between trust in the government and trust in COVID-19 health information from the US CDC, state health departments, and social media on the experience of COVID-19 social and health services-related disruptions. METHODS: People living with HIV (N = 459) recruited through social media advertisements and chain referrals completed confidential surveys delivered through an online platform. RESULTS: Participants experienced high-levels of disruptions to social relationships and health services attributable to COVID-19 mitigation efforts. We also observed high-rates of inaccurate information and low-levels of trust in government and sources of COVID-19 information. Greater disruptions to social relationships were predicted by more concern about oneself and others contracting COVID-19, whereas disruptions to health services were predicted by greater concern for oneself contracting COVID-19, greater general medical mistrust, and less trust in information from the CDC. CONCLUSIONS: Findings have implications for the necessity of rebuilding public trust in credible sources of health information and stepping up efforts to counter sources of inaccurate information.