Disability and self-care living strategies among adults living with HIV during the COVID-19 pandemic

AIDS Research and Therapy

Soo Chan Carusone¹  Jaime H. Vera²  Rachel Aubry³  Aileen M. Davis⁴  Kelly K. O’Brien⁵  Richard Harding⁶  Steven E. Hanna⁷  Ahmed M. Bayoumi⁸  Patricia Solomon⁹  Colm Bergin^1,10  Darren A. Brown^1,11  Lisa Avery^1,12  Kristine M. Erlandson^1,13 

[1] Casey House, 119 Isabella Street, Toronto, Ontario, Canada;McMaster Collaborative for Health and Aging, McMaster University, Hamilton, Ontario, Canada;Department of Global Health and Infection, Brighton and Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, UK;Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, M5G 1V7, Toronto, Ontario, Canada;Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, M5G 1V7, Toronto, Ontario, Canada;Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th Floor, M5T 3M7, Toronto, Ontario, Canada;Department of Physical Therapy, University of Toronto, 500 University Avenue, Room 160, M5G 1V7, Toronto, Ontario, Canada;Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th Floor, M5T 3M7, Toronto, Ontario, Canada;Rehabilitation Sciences Institute (RSI), University of Toronto, 500 University Avenue, Room 160, M5G 1V7, Toronto, Ontario, Canada;Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, Bessemer Road, London, UK;Health Research Methods, Evidence and Impact, McMaster University Medical Centre, McMaster University, 1280 Main Street West, Hamilton, Ontario, Canada;Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, 155 College Street, 4th Floor, M5T 3M7, Toronto, Ontario, Canada;MAP Centre, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario, Canada;Department of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, Ontario, Canada;School of Rehabilitation Science, McMaster University, 1400 Main Street West, Room 403, Hamilton, Ontario, Canada;The GUIDE Clinic, St. James’s Hospital, Hospital 5, James’s Street, Dublin 8, Ireland;School of Medicine, Trinity College Dublin, 152-160 Pearse Street, Dublin, Ireland;Therapies Department, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, SW10 9NH, London, UK;University Health Network, 190 Elisabeth Street, Toronto, Ontario, Canada;Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, Canada;University of Colorado Denver- Anschutz Medical Campus, 13001 East 17th Place, 80045, Aurora, CO, USA;

关键词: HIV/AIDS;    COVID-19 pandemic;    Web-based survey;    Disability;   

DOI  :  10.1186/s12981-021-00413-4

来源: Springer

【 摘 要 】

BackgroundEvents associated with the COVID-19 pandemic, such as physical distancing, closure of community services, postponement of health appointments, and loss of employment can lead to social isolation, financial uncertainty, and interruption of antiretroviral adherence, resulting in additional health-related challenges (disability) experienced among adults living with chronic illness such as HIV. ‘Living strategies’ is a concept derived from the perspectives of people living with HIV, defined as behaviors, attitudes and beliefs adopted by people living with HIV to help deal with disability associated with HIV and multi-morbidity. Our aim was to describe disability among adults living with HIV and self-care living strategies used during the COVID-19 pandemic.MethodsAdults living with HIV in Toronto, Ontario, Canada, including some with pre-pandemic HIV Disability Questionnaire (HDQ) data, completed a cross-sectional web-based survey between June–August 2020. The survey included the HDQ and questions about self-care living strategy use during the pandemic. We compared disability (HDQ) scores prior to versus during the pandemic using paired t-tests. We reported the proportion of participants who engaged in various living strategies at least ‘a few times a week’ or ‘everyday’ during the pandemic.ResultsOf the 63 respondents, 84% were men, median age 57 years, and 62% lived alone. During the pandemic the greatest disability severity was in the uncertainty [median 30; Interquartile range (IQR): 16, 43] and mental-emotional (25; IQR: 14, 41) domains. Among the 51 participants with pre-pandemic data, HDQ severity scores were significantly greater (worse) during the pandemic (vs prior) in all domains. Greatest change from prior to during the pandemic was in the mental-emotional domain for presence (17.7; p < 0.001), severity (11.4; p < 0.001), and episodic nature (9.3; p < 0.05) of disability. Most participants (> 60%) reported engaging a ‘few times a week’ or ‘everyday’ in self-care strategies associated with maintaining sense of control and adopting positive attitudes and beliefs.ConclusionsPeople living with HIV reported high levels of uncertainty and mental-emotional health challenges during the pandemic. Disability increased across all HDQ dimensions, with the greatest worsening in the mental-emotional health domain. Results provide an understanding of disability and self-care strategy use during the COVID-19 pandemic.

【 授权许可】

CC BY