HIV / STI
Examining the joint effect of multilevel resilience and covid-19 distress on viral suppression among african american/black adults living with hiv in the southeastern united states Tariz D. Viera-Rojas* Tariz Viera-Rojas Jason R. Gantenberg Jee Won Park Marta G. Wilson-Barthes Joseph W. Hogan Michael P. Carey Sannisha K. Dale Valerie A. Earnshaw Sarah Dougherty‐Sheff Deana Agil Akilah J. Dulin Chanelle J. Howe
Background: African American/Black persons living with HIV (AA/B-PLWH) in the southeastern U.S. experience disparities in HIV outcomes, including viral suppression. The COVID-19 pandemic disrupted HIV care and caused distress (e.g., economic, mental) that may have impacted HIV viral suppression among AA/B-PLWH. However, availability of multilevel resilience resources (MRR) may have buffered against COVID-related distress. The potential impacts of a joint intervention on MRR and distress on HIV viral suppression warrants investigation.
Objective: Estimate the joint effect of MRR and COVID-19 distress on HIV viral suppression among AA/B-PLWH.
Methods: Prospective cohort study of 103 AA/B-PLWH aged ≥18 years old enrolled in two parent HIV clinic cohorts in the southeastern U.S, with relevant complete data. MRR and COVID-19 distress were assessed based on self-report using the Multilevel Resilience Resource Measure Long Form and the Modified Stanford Measure, respectively, and considered as binary exposures. The outcome was a binary indicator of viral suppression (≤50 copies/mL) during post-exposure follow up (18-month maximum). We estimated unadjusted and adjusted RDs using modified Poisson models.
Results: Focusing on findings most compatible with the data, compared to those with no distress and greater MRR, patients with no distress but lesser MRR were equally likely to be virally suppressed (adjusted RD: -0.00; 95% CL: -0.20, 0.19). Patients with any distress but greater MRR (adjusted RD: -0.12; 95% CL: -0.36, 0.11) or lesser MRR (adjusted RD: -0.03 95% CL: -0.28, 0.21) were less or slightly less likely to be virally suppressed.
Conclusion: We found weak evidence that a dual intervention to increase MRR and decrease COVID-19 distress could improve HIV viral suppression. Effect estimates were imprecise and did not provide strong evidence for interaction on the additive scale. Studies with a larger sample size are needed to examine this joint effect more robustly.
