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Prepandemic Predictors of Medication Adherence and HIV Viral Load During the First Year of COVID-19
Seth C Kalichman1, Lisa A Eaton1, Moira O Kalichman1
1Institute for Collaborative Health Intervention and Policy, University of Connecticut, Storrs, CT.
Insights
The COVID-19 pandemic disrupted social relationships and healthcare for young people living with HIV. Stronger social support before the pandemic predicted better adherence to antiretroviral therapy and HIV suppression.
Area of Science:
- Public Health
- Infectious Diseases
- Social Science
Background:
- The COVID-19 pandemic significantly impacted social relationships and healthcare access for individuals with HIV.
- Young people living with HIV (PLWH) with suboptimal adherence, unsuppressed viral load, or substance use were particularly vulnerable.
Purpose of the Study:
- To assess the sustained impacts of the COVID-19 pandemic on social relationships and healthcare for a cohort of young PLWH over the first year.
- To identify factors that predicted adherence and HIV suppression during the pandemic.
Main Methods:
- A closed cohort of 140 young people (≤36 years) living with HIV were followed for one year into the COVID-19 pandemic.
- Data collected included social support, antiretroviral therapy (ART) adherence, HIV viral load, transportation, housing stability, and food security.
- Multivariable models were used to analyze the relationship between pre-pandemic social support and outcomes.
Main Results:
- Participants experienced continued disruptions in social relationships and healthcare access throughout the first year of the pandemic.
- Sustained negative impacts were observed in transportation, housing stability, and food security.
- Higher pre-pandemic social support was significantly associated with better ART adherence and greater HIV viral suppression.
Conclusions:
- The COVID-19 pandemic had lasting adverse effects on the social and healthcare landscape for young PLWH.
- Pre-existing social support is a critical protective factor for maintaining HIV treatment adherence and viral suppression.
- Future crisis preparedness for PLWH must prioritize building and reinforcing social support networks.
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.
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