Sustained mental health impacts of COVID-19 among people living with and without HIV in the Dominican Republic.

introductionMental health impacts of the COVID-19 pandemic are clearly documented, particularly in marginalized populations, but longer-term impacts are unknown. This study explored the sustained mental health of the COVID-19 pandemic among people living with HIV (PLHIV) and people without HIV receiving care at a primary care center in La Romana, Dominican Republic from November 2021 to February 2022. METHODOLOGY: Using stratified random sampling, we recruited PLHIV and people without HIV for a one-time telephone survey, employing validated tools to measure COVID-19 impact, anxiety, depression and perceived stress. We examined the association between COVID-19 impact and mental health symptoms using multivariate regression, controlling for HIV status and demographics factors.

resultsA total of 318 clients were recruited (155, 48.7% PLHIV). Higher COVID-19 impact significantly predicted increased anxiety, depression and perceived stress, where unemployed individuals and younger adults remained more vulnerable. PLHIV reported higher rates of anxiety than people without HIV (21.3% vs. 12.1%, p=0.05). People without HIV identified COVID-related factors as their biggest source of worry in the last six months (57.7%), compared to 31.6% of PLHIV (p<0.01).

conclusionThe impact of the COVID-19 pandemic continued to disproportionately affect Dominican PLWH even after impacts became less for people without HIV in the same setting. Nonetheless, the prevalence of mental health symptoms among PLWH was smaller in our clinical population compared to other populations, likely due to the clinic’s efforts to support the mental health of PLHIV during the pandemic. This highlights the importance of swift targeted responses to emerging epidemics.