Post-Traumatic Stress Symptoms Related to the COVID-19 Pandemic in Persons Living and Aging with HIV

The COVID-19 pandemic was an event involving an actual threat of death, serious injury, or harm to the integrity of self or others, which could have served as a precipitant for unmasking symptoms of post-traumatic stress disorder (PTSD). Persons living with HIV and those with hepatitis C (HCV) coinfection could be at increased risk of PTSD symptoms after a traumatic event, given their lifetime experiences of trauma, stigma, poverty, mental health conditions, and substance use. We measured PTSD symptoms at three time points during the COVID-19 pandemic using a 17-item questionnaire in two established cohorts of persons living with HIV in Canada-those with HCV coinfection and those aging with HIV-groups at risk for having symptoms. We found that twice as many persons in the HCV coinfection cohort had moderate to severe PTSD symptoms at baseline relative to the aging cohort (49% vs. 25%) and that these percentages remained high in the coinfection cohort but declined in the aging cohort with time. Notably, those who self-reported depression had increased rates of PTSD symptoms over time. Our data points to the potential long-lasting impact that the COVID-19 pandemic or other traumatic events could have on the mental health of persons living with HIV and those with coinfection, especially among those with underlying depression. We stress the need for increased awareness and management strategies of vulnerable groups during times of trauma.