Sex Differences in the Association Between Stress, Loneliness, and COVID-19 Burden among People with HIV in the US.

BACKGROUND: Little is known about the psychological implications of the COVID-19 pandemic on people with HIV (PWH). The purpose of this study was to assess the impact of COVID-19 among men and women with HIV in Miami FL, USA. We hypothesized that the burden of the COVID-19 pandemic will be higher for women , and psychological factors will increase COVID-19 burden among them. METHODS: People with (n = 231) and without HIV (n = 42) residing in Miami, FL completed a survey assessing psychological outcomes such as loneliness, depression and stress, as well as the burden of COVID-19 on their daily lives. T-tests and Chi-square analyses were used to assess sex differences in study variables. Logistic regression was used to compare the interaction effects predicting stress and loneliness by COVID-19 burden and sex. RESULTS: A total of 273 completed the survey; the outcomes of the study, loneliness and stress, did not differ by HIV status (p = .458 and p = 922). Overall, men and women reported similar prevalence of COVID-19 burden. However, a greater proportion of women reported losing childcare than men (18% vs 9%, p = 0.029, respectively), as well as losing mental health care (15% vs 7%, p = 0.049). There was a significant interaction between COVID-19 burden and sex for loneliness and stress such that the association between COVID-19 burden and loneliness was greater for women (p<0.001) than for men (p =0.353) and the association between COVID-19 burden and stress was greater for women (p = 0.013) than men (p = 0.628). CONCLUSIONS: Both men and women with HIV are impacted by the COVID-19 pandemic, but women may experience higher levels of stress and loneliness than men. Sex differences may require tailored interventions to more effectively mitigate the impact of the pandemic on mental health.