Deborah L Jones1, Yuehan Zhang2, Violeta J Rodriguez1,3, Sabina Haberlen2, Catalina Ramirez4, Adaora A Adimora4, Daniel Merenstein5, Bradley Aouizerat6, Anjali Sharma7, Tracey Wilson8, Matthew J Mimiaga9, Anandi N Sheth10, Michael Plankey11, Mardge H Cohen12, Valentina Stosor13, Mirjam-Colette Kempf14, M Reuel Friedman15. 1. Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 3. Department of Psychology, University of Georgia, Athens, GA. 4. Department of Medicine, School of Medicine, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. 5. Family Medicine, Georgetown University Medical Center, Washington, DC. 6. Bluestone Center for Clinical Research, Department of Oral and Maxillofacial Surgery, College of Dentistry, New York University, New York City, New York. 7. Department of Medicine, Albert Einstein College of Medicine. 8. Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, New York. 9. Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA. 10. Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA. 11. Department of Medicine, Georgetown University Medical Center, Washington, DC. 12. Department of Medicine, Stroger Hospital of Cook County, Chicago IL. 13. Divisions of Infectious Diseases and Organ Transplantation, Northwestern University Feinberg School of Medicine, Evanston, IL. 14. Department of Family, Community & Health Systems, Schools of Nursing, Medicine and Public Health, University of Alabama at Birmingham, Birmingham, AL; and. 15. Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Abstract
OBJECTIVES: This study of people with HIV (PWH) and those without HIV conducted during the COVID-19 pandemic in the United States in 2020 examines the impact of posttraumatic stress disorder (PTSD) on COVID-19 burden, defined as pandemic-related disruptions. METHODS: Data consisted of survey responses on PTSD among participants (N = 2434) enrolled in the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV (WIHS) cohorts. Unadjusted and adjusted regression models were used to examine the association of PTSD with COVID-19 burden (overall and domain-specific burdens). Quasi-Poisson regression models were used to assess associations with the COVID-19 burden score and 2 domain-specific burdens: (1) changes in resources and (2) interruptions in health care. Analyses was adjusted for age, race/ethnicity, HIV serostatus, current smoking status, number of comorbidities, education, and study regions. RESULTS: Study participants were a median age of 58 (interquartile range, 52-65) years. In both bivariate and multivariable models, PTSD severity was associated with greater overall COVID-19 burden. PTSD severity was associated with the number of resource changes and number of interruptions in medical care. These findings were also consistent across cohorts (MACS/WIHS) and across HIV serostatus, suggesting a greater risk for COVID-19 burden with greater PTSD severity, which remained significant after controlling for covariates. CONCLUSIONS: This study builds on emerging literature demonstrating the impact of mental health on the burden and disruption associated with the COVID-19 pandemic, providing context specific to PWH. The ongoing pandemic requires structural and social interventions to decrease disruption to resources and health resource needs among these vulnerable populations.
OBJECTIVES: This study of people with HIV (PWH) and those without HIV conducted during the COVID-19 pandemic in the United States in 2020 examines the impact of posttraumatic stress disorder (PTSD) on COVID-19 burden, defined as pandemic-related disruptions. METHODS: Data consisted of survey responses on PTSD among participants (N = 2434) enrolled in the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV (WIHS) cohorts. Unadjusted and adjusted regression models were used to examine the association of PTSD with COVID-19 burden (overall and domain-specific burdens). Quasi-Poisson regression models were used to assess associations with the COVID-19 burden score and 2 domain-specific burdens: (1) changes in resources and (2) interruptions in health care. Analyses was adjusted for age, race/ethnicity, HIV serostatus, current smoking status, number of comorbidities, education, and study regions. RESULTS: Study participants were a median age of 58 (interquartile range, 52-65) years. In both bivariate and multivariable models, PTSD severity was associated with greater overall COVID-19 burden. PTSD severity was associated with the number of resource changes and number of interruptions in medical care. These findings were also consistent across cohorts (MACS/WIHS) and across HIV serostatus, suggesting a greater risk for COVID-19 burden with greater PTSD severity, which remained significant after controlling for covariates. CONCLUSIONS: This study builds on emerging literature demonstrating the impact of mental health on the burden and disruption associated with the COVID-19 pandemic, providing context specific to PWH. The ongoing pandemic requires structural and social interventions to decrease disruption to resources and health resource needs among these vulnerable populations.
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