Knowledge and Impact of COVID-19 on Middle-Aged and Older People living with HIV in Lima, Peru

The impact of the COVID-19 pandemic on people living with HIV: a cross-sectional study in Caracas, Venezuela

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela.

METHODS

We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022.

RESULTS

A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31-55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations.

CONCLUSION

This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.

HIV and COVID-19 in Latin America and the Caribbean

PURPOSE OF REVIEW

Latin America and the Caribbean (LAC) has been hit hard by COVID-19 due to political instability, flawed health systems, and structural inequalities. The repercussion of the pandemic on vulnerable populations, like people living with HIV (PLWH), is complex. This review aims to explore the interactions between the HIV and COVID-19 pandemics in this region.

RECENT FINDINGS

Data regarding the interactions of HIV and COVID-19 in LAC is scarce. Only case reports or small case series have been published regarding the clinical course of COVID-19 in PLWH and regarding the clinical course of COVID-19 in PLWH, which appears to be similar to the general population. The pandemic has disrupted prevention and treatment of PLWH. However, there have been country efforts to counteract those effects. There are some lessons from the HIV response which have been effectively applied in the region to address COVID-19. COVID-19 has had an unprecedented impact on the cascade-of-care among PLWH in LAC. There is a need for longitudinal studies that assess clinic implication of these pandemic interactions in LAC.

Social and Behavioral Impacts of COVID-19 on People Living with HIV: Review of the First Year of Research

Purpose of the Review

The SARS-CoV-2 (COVID-19) pandemic brought unprecedented social change with the most severe impacts on the most vulnerable populations, including people living with HIV (PLWH). This review examined findings from empirical studies of social and behavioral impacts of COVID-19 on PLWH in the first year of the pandemic.

Recent Findings

Impacts of COVID-19 on PLWH fit within an HIV syndemics framework, with overlapping COVID-19 and HIV comorbid conditions concerning mental health and structural inequality. Early impacts of COVID-19 on social isolation, emotional distress, stigma, and substance use varied across studies with few consistent patterns. Structural inequalities, particularly impacts on food security and housing stability, were observed more consistently and globally.

Summary

COVID-19 intersects with HIV infection along with multiple interlocking comorbidities that are best characterized and understood within a syndemics framework.