Impact of the COVID-19 Pandemic on the Medical Follow-up and Psychosocial Well-Being of People Living With HIV

A Cross-Sectional Survey

Joseph Nelson Siewe Fodjo, MD; Edlaine Faria de Moura Villela, MD, PhD; Stijn Van Hees, PharmD; Thalia Tibério dos Santos; Pieter Vanholder, MA; Patrick Reyntiens; Rafael Van den Bergh, PhD; Robert Colebunders, MD, PhD

Disclosures

J Acquir Immune Defic Syndr. 2020;85(3):257-262. 

In This Article

Methods

Study Design

This was a cross-sectional study conducted among PLWH between April 9, 2020, and May 17, 2020. An online questionnaire was designed to assess the impact of the current COVID-19 pandemic on the life of PLWH. Respondents were invited to participate by filling the questionnaire through a web link that was disseminated through the networks of various associations that support PLWH, including the European AIDS Treatment Group, Sensoa (Flemish center of expertise for sexual health), and RNP+Brasil (National Network of PLWH in Brazil). The questionnaire consisted of 4 parts as follows: inquiring on sociodemographic data, HIV-related information, COVID-related data, and questions on personal health as well as screening tests for psychosocial disorders (anxiety and depression). The screening tests used were the Population Health Questionnaire (PHQ-2) for depression[20] and the Generalized Anxiety Disorder (GAD-2) tool for anxiety.[21] The questionnaire was available in English, Dutch, French, Russian, and Portuguese; it was hosted on the secure website of the International Citizen Project COVID-19.[22] Only respondents who were at least 18 years old and who self-confirmed being PLWH were included. There were no exclusion criteria. An e-consent was required before submitting the responses. Participants were not promised nor given any form of compensation for their participation. A duplicate of the survey template can be found in the supplementary material of this article (see Appendix 6, Supplemental Digital Content, https://links.lww.com/QAI/B524). The study protocol was approved by the Ethics Committee of the University of Antwerp (Belgium), Ref: 20/14/179.

Definitions

Generalized anxiety disorders were defined as having a GAD-2 score of at least 3. Similarly, all respondents who scored 3 or more on the PHQ-2 screening tool were considered as having major depressive disorders. Based on self-reported flu-like symptoms, the World Health Organization (WHO) clinical case definition for COVID-19 was applied on our data; any respondent who had experienced fever associated with at least one respiratory symptom (cough, shortness of breath, sore throat, and coryza) was considered as a suspected case of COVID-19.[23]

Statistical Analyses

Continuous variables were reported as mean with SD (mean ± SD) and compared across groups using nonparametric tests. Categorical variables were summarized into numbers with percentages; proportions were compared using the Yates-corrected χ2 test. A multiple logistic regression analysis was performed to investigate factors associated with the development of flu-like illness since January 2020, when the COVID-19 started spreading to other countries and continents beyond the initial focus in China. Covariates for the final model were purposefully selected and included: sociodemographic variables (age, sex, and country classification as lower-income and middle-income countries [LMIC] vs high-income countries [HIC] based on the World Bank data[24]), COVID-19 prevention (observance of physical distancing and mask use), and other health-related information (CD4 count, flu vaccination received during the past 12 months, treatment with tenofovir-containing ART regimens, and adaptation of HIV care during the lockdown). The rationale for choosing these covariates is summarized in the supplementary material (see Appendix 5, Supplemental Digital Content, https://links.lww.com/QAI/B524). All statistical tests were two-sided; P < 0.05 was considered statistically significant, and 95% CIs were computed. Statistical analyses were performed in R version 3.6.2.

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