TY - JOUR
T1 - COVID-19 and the HIV continuum in people living with HIV enrolled in Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO) cohorts
AU - Lesko, Catherine R.
AU - Keruly, Jeanne C.
AU - Moore, Richard D.
AU - Shen, Nicola M.
AU - Pytell, Jarratt D.
AU - Lau, Bryan
AU - Fojo, Anthony T.
AU - Mehta, Shruti H.
AU - Kipke, Michele
AU - Baum, Marianna K.
AU - Shoptaw, Steven
AU - Gorbach, Pamina M.
AU - Mustanski, Brian
AU - Javanbakht, Marjan
AU - Siminski, Suzanne
AU - Chander, Geetanjali
N1 - Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Background: The COVID-19 pandemic disrupted the normal delivery of HIV care, altered social support networks, and caused economic insecurity. People with HIV (PWH) are vulnerable to such disruptions, particularly if they have a history of substance use. We describe engagement in care and adherence to antiretroviral therapy (ART) for PWH during the pandemic. Methods: From May 2020 to February 2021, 773 PWH enrolled in 6 existing cohorts completed 1495 surveys about substance use and engagement in HIV care during the COVID-19 pandemic. We described the prevalence and correlates of having missed a visit with an HIV provider in the past month and having missed a dose of ART in the past week. Results: Thirteen percent of people missed an HIV visit in the past month. Missing a visit was associated with unstable housing, food insecurity, anxiety, low resiliency, disruptions to mental health care, and substance use including cigarette smoking, hazardous alcohol use, cocaine, and cannabis use. Nineteen percent of people reported missing at least one dose of ART in the week prior to their survey. Missing a dose of ART was associated with being a man, low resiliency, disruptions to mental health care, cigarette smoking, hazardous alcohol use, cocaine, and cannabis use, and experiencing disruptions to substance use treatment. Conclusions: Social determinants of health, substance use, and disruptions to mental health and substance use treatment were associated with poorer engagement in HIV care. Close attention to continuity of care during times of social disruption is especially critical for PWH.
AB - Background: The COVID-19 pandemic disrupted the normal delivery of HIV care, altered social support networks, and caused economic insecurity. People with HIV (PWH) are vulnerable to such disruptions, particularly if they have a history of substance use. We describe engagement in care and adherence to antiretroviral therapy (ART) for PWH during the pandemic. Methods: From May 2020 to February 2021, 773 PWH enrolled in 6 existing cohorts completed 1495 surveys about substance use and engagement in HIV care during the COVID-19 pandemic. We described the prevalence and correlates of having missed a visit with an HIV provider in the past month and having missed a dose of ART in the past week. Results: Thirteen percent of people missed an HIV visit in the past month. Missing a visit was associated with unstable housing, food insecurity, anxiety, low resiliency, disruptions to mental health care, and substance use including cigarette smoking, hazardous alcohol use, cocaine, and cannabis use. Nineteen percent of people reported missing at least one dose of ART in the week prior to their survey. Missing a dose of ART was associated with being a man, low resiliency, disruptions to mental health care, cigarette smoking, hazardous alcohol use, cocaine, and cannabis use, and experiencing disruptions to substance use treatment. Conclusions: Social determinants of health, substance use, and disruptions to mental health and substance use treatment were associated with poorer engagement in HIV care. Close attention to continuity of care during times of social disruption is especially critical for PWH.
KW - Antidepressant therapy
KW - Care cascade
KW - Depression
KW - Depressive symptoms
KW - Viral non-suppression
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U2 - 10.1016/j.drugalcdep.2022.109355
DO - 10.1016/j.drugalcdep.2022.109355
M3 - Article
C2 - 35331581
AN - SCOPUS:85126835989
SN - 0376-8716
VL - 241
JO - Drug and alcohol dependence
JF - Drug and alcohol dependence
M1 - 109355
ER -