Attitudes toward COVID-19 among people living with HIV attending a multiethnic outpatient centre in Houston, Texas

ABSTRACT

Objectives: The evolving outbreak of coronavirus 2019 (COVID-19) may impact people with HIV (PWH) in unique ways, beyond the increased risk of medical complications. Social distancing measures resulting in social isolation and interruptions in medical care may disproportionately affect PWH. The purpose of this study is to capture and understand how COVID-19 is affecting PWH in a low-income, multiethnic urban health centre in Houston, Texas. Methods: Cross-sectional survey of adult PWH who attend Thomas Street Health Center for outpatient care and volunteered to complete a short telephone questionnaire. Descriptive statistics were calculated for all patient characteristics and survey responses. Results: Of the 188 participants, 26% were women, 3.9% were transgender women, 33% were non-Hispanic Black and 57.4% Hispanic. The median (interquartile range) age was 49 (40-56) years;73% had 1 or more comorbidities. Overall, most (82%) people had not experienced difficulty accessing HIV medicines;25% of patients reported difficulty accessing medical care and failing to attend clinic due to fear of exposure to COVID-19. Most (82.8%) reported being affected by COVID-19 in their daily life;14% reported being extremely affected. 64% feared getting COVID-19, though a minority feared they were at increased risk of becoming sick, a finding especially true among Black (22.4%) and Hispanic individuals (33.9%) compared with White participants (15.4%). Nearly half (48.4%) reported increased anxiety. More than a third (37.8%) reported feeling depressed, more frequently reported among Black (46.6%) compared with Hispanic individuals (34.8%) and White participants (23%);31% felt more alone;90% reported not seeking behavioural health resources. Only 10% reported increased use in alcohol or illegal substances. One in four did not have access to an electronic device for a telemedicine visit. Of the 14% who had lost their job after the pandemic started, 61% were Hispanic. Conclusions: PWH experienced a wide range of effects from the COVID-19 pandemic. It is important to recognize the socioeconomical and psychological implications that will be seen in disadvantaged communities of PWH as a consequence of COVID-19.