EVALUATION OF MENTAL HEALTH WELLNESS AMONGST HIV PATIENTS EXPOSED TO COVID-19 IN NEW YORK

Abstract

The prevalence of HIV in New York is a significant public health concern, with the state consistently having one of the highest numbers of HIV cases in the United States. As of 2021, approximately 124,630 people were living with HIV in New York State and 2,116 diagnoses of HIV were made in the same year (AIDSVu, 2023). According to New York City Department, of Health and Mental Hygiene (2023), 1,624 HIV-positive diagnoses were made in 2022, a 1.3% increase from the previous year. The state is particularly affected by HIV due to its diverse population, urban density, and robust healthcare infrastructure. For instance, between 2018 and 2019, there was a 7.5% decrease due to a lack of as much testing as compared to other years. The COVID-19 pandemic has disproportionately affected vulnerable populations, including those living with HIV. The pandemic introduced new layers of stress and anxiety. Fear of contracting COVID-19, especially for individuals with compromised immune systems, added to the existing worries about managing HIV (Waterfield et al., 2021). Lockdowns and social distancing measures further isolated vulnerable populations, exacerbating feelings of loneliness and depression. Hong et al. (2023) note that the disruption of healthcare services also created uncertainties about accessing essential HIV care and medications, heightening anxiety among patients. Marginalized communities, which already face disparities in healthcare access and social determinants of health, bore a heavier burden during the pandemic. The aim of the study: to generate nuanced insights that can guide evidence-based interventions, enhance healthcare delivery, and ultimately improve the quality of life for HIV patients facing the dual burden of HIV and other health risks such as COVID-19 in New York. Objectives of the study: 1. To assess the prevalence and severity of mental health disorders, such as depression and anxiety, among HIV patients in New York during the COVID-19 pandemic, and identify the socio-demographic and clinical factors associated with these outcomes. 2. To explore the experiences, perceptions, and challenges faced by HIV patients in New York regarding mental healthcare access and utilization during the COVID-19 pandemic, and examine the impact of COVID-19-related stressors, such as social isolation and healthcare disruptions, on their mental well-being. 3. To elucidate the coping strategies and resilience factors employed by HIV patients in New York to manage mental health challenges amidst the COVID-19 pandemic, and assess their effectiveness in promoting mental health wellness and overall quality of life. Object of study: the course of COVID-19 disease in patients with HIV. Subject of study: patients with HIV and (or without) COVID-19. Methods of study: In this study, methods of general clinical examination of patients were used, such as collecting anamnesis of HIV/COVID-19 disease, general health history and family history, analysis of the patient's medical record, physical examination of the patient, and statistical research methods. Our study underscores the critical importance of addressing the mental health needs of PLWH, particularly during public health emergencies such as the COVID-19 pandemic. Despite advancements in HIV treatment and care, PLWH continues to experience disproportionately high rates of psychiatric disorders and psychosocial challenges, necessitating integrated approaches to HIV care that prioritize mental health screening, prevention, and treatment. 1. Before COVID-19 pandemic mood and anxiety disorders were most prevalent among Black participants (29.8% and 24.1%), followed by Hispanic individuals and White individuals. Substance use disorders and stress-related disorders were compared among racial/ethnic groups. Asian individuals exhibited lower prevalence rates across all disorder categories compared to other racial/ethnic groups. 2. Mental diseases statistics exacerbated for the respective ethnic groups during the pandemic. Black individuals showed the highest mean prevalence rates for most mental health disorders, followed by Hispanic individuals, White individuals, Asian individuals and Other groups. 3. Analysis of the protective factors and their connection to different psychiatric disorders, providing important insights into the mental health outcomes in PLWH. Higher levels of resilience are associated with lower prevalence rates of mood disorders (0.35), substance use disorders (0.28), schizophrenia (0.21), and personality disorders (0.15). Higher levels of social support are associated with lower prevalence rates of substance use disorders (-0.07), schizophrenia (-0.10), and personality disorders (-0.20). Physical activity demonstrates a modest protective effect against mood disorders (-0.05), anxiety disorders (-0.08), stress-related disorders (-0.12), and schizophrenia (-0.09).