The effects of the COVID-19 pandemic on people living with HIV

Intro: Public health restrictions were introduced in the UK in March 2021 in response to the COVID-19 pandemic. The aim of our study was to understand the impact of the disruptions to routine healthcare services among people with HIV during this time and the effect on their engagement with healthcare, social, employment, and relationship networks and mental and physical well-being, to inform advanced planning in the event of future healthcare service disruptions.

Methods: An online survey was conducted, with participants recruited from one HIV clinic and one community organization in England. It included questions on demographics, HIV infection, treatment and status, the effect of the HIV pandemic on aspects of HIV care, and other social factors. Descriptive and limited statistical analysis was carried out to describe and look for associations within the data.

Results: Our sample of 100 respondents were significantly older, and had more White, male participants than the UK population of people with HIV. In total, 65% had experienced COVID-19 infection. Over one-quarter (29%) of our respondents had missed HIV appointments during the pandemic; 38% reported that access to HIV treatment had worsened, and 25% reported that their HIV-related health had worsened. Women, those diagnosed with depression, those living further from the clinic, and Black respondents were significantly more likely to also report missed appointments. HIV-related health deterioration was significantly associated with missed appointments and with welfare receipt.

Discussion and conclusion: Our findings highlight the unequal effects of the COVID-19 pandemic and disruption to HIV services on people living with HIV. Our sample under-represented women and over-represented older, White men, which needs to be addressed in the recruitment strategies of a future nationwide sample. In preparation for future service disruption, HIV services should identify vulnerable populations, including those at greater risk of missing appointments or struggling to access services, drug treatment, and information. Clear targeted mitigations should be developed and put in place. Steps to allow remote provision of services to those living at distance from the clinic should be considered.