August 21, 2020 | Erin Bluvas, bluvase@sc.edu
Monique Brown (Arnold School of Public Health, Department of Epidemiology and Biostatistics) and Sharon Weissman (School of Medicine, Internal Medicine/Infectious Diseases) have published a paper on the impact of COVID-19 on older adults living with HIV. In their letter to the editor of the Journal of Gerontological Social Work, they describe HIV care and psychosocial effects for this group during the coronavirus pandemic.
“COVID-19 continues to have a detrimental impact worldwide, and older adults living with HIV are a vulnerable group,” Brown says. “This virus may have an effect on HIV treatment outcomes and psychosocial health among older adults living with HIV, and social workers and healthcare providers should be aware of the potential long-term impact of COVID-19 on this vulnerable population.”
Previous research has already demonstrated that older adults and adults with underlying health conditions (e.g., diabetes, heart disease, lung disease, cancer, high blood pressure) and compromised immune systems are at a higher risk for death from COVID-19. Individuals who are co-infected with both HIV and COVID-19 are particularly vulnerable and face additional challenges.
The authors note that COVID-19 may have adverse cascading impacts on HIV treatment outcomes, affecting testing, diagnosis, linkage to care and patient engagement. Loneliness, depression, stigma and social isolation, which are already challenges for individuals living with HIV, are exacerbated by the pandemic as well.
Long-term HIV survivors (i.e., individuals who have lived with HIV for several years or more) are particularly susceptible to these challenges, with some of them facing additional barriers and hardships such as PTSD, housing and financial insecurity, comorbidities and premature aging. Other vulnerable populations include groups who are disproportionately affected by HIV and mortality due to COVID-19. For example, Black populations comprise 27 percent of South Carolinians but account for 68 percent of the people living with HIV and 45 percent of COVID-19 cases in the state. LGBTQ populations, who are less likely to have access to healthcare and more likely to live in poverty, are also at an increased risk for complications due to COVID-19.
Brown and Weissman call for continuous study and monitoring of co-infected populations until scientists can amass long-term outcome data related to how COVID-19 impacts HIV prevention efforts, diagnosis, treatment outcomes and viral loads. This is particularly true for especially vulnerable groups, such as long-term HIV survivors, Black populations and those who identify as LGBTQ.
“In spite of the challenges faced, older adults living with HIV are a resilient group,” Weissman says. “Social workers and healthcare providers should not forget about this vulnerable population as older adults living with HIV navigate uncertainty with regards to HIV treatment and care, and their overall well-being in the midst of the COVID-19 pandemic.”
This work was supported by the National Institute of Mental Health [K01MH115794].
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