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Introduction: The COVID‐19 pandemic has changed healthcare service delivery. We examined the overall impact of COVID‐19 on people living with HIV in British Columbia (BC), Canada, with a special focus on the potential impact of COVID‐19 on antiretroviral treatment interruptions (TIs). Methods: Purposive sampling was used to enrol people living with HIV aged ≥19 years across BC into the STOP HIV/AIDS Program Evaluation study between January 2016 and September 2018. Participants completed surveys at baseline enrolment and 18 and 36 months later. Additional COVID‐19 questions were added to the survey in October 2020. TIs were defined as >60 days late for antiretroviral therapy (ART) refill using data from the BC HIV Drug Treatment Program. Generalized linear mixed models were used to examine trends in TIs over time and associations with reported health service access. Results: Of 581 participants, 6.1%–7.7% experienced a TI during each 6‐month period between March 2019 and August 2021. The frequency of TIs did not statistically increase during the COVID‐19 epidemic. Among the 188 participants who completed the COVID‐19 questionnaire, 32.8% reported difficulty accessing healthcare during COVID‐19, 9.7% reported avoiding continuing a healthcare service due to COVID‐19‐related concerns, and 74.6% reported using virtual healthcare services since March 2020. In multivariable analysis, the odds of a TI in any 6‐month period were not significantly different from March to August 2019. None of the reported challenges to healthcare services were associated with TIs. Conclusions: Although some participants reported challenges to accessing services or avoidance of services due to COVID‐19, TIs were not more likely during COVID‐19 than before. [ABSTRACT FROM AUTHOR]

There is mixed evidence on whether experiences of HIV-related stigma are mitigated with lived experience. We sought to examine whether people living with HIV (PLWH) with longer living experience reported varying levels of HIV-related stigma. Between January 2016-September 2018, we used purposive sampling to enrol PLWH aged ≥19 across British Columbia, Canada, where participants completed the 10-item Berger HIV Stigma Scale. We conducted bivariate analyzes examining key sociodemographic characteristics and HIV-related stigma scores. Multivariable linear regression modelled the association between year of HIV diagnosis by treatment era and HIV-related stigma scores. We enrolled 644 participants; median age at enrolment was 50 years (Q1–Q3: 42–56), with 37.4% (n = 241) diagnosed before the year 2000. The median HIV-stigma scores of all participants (19.0, Q1–Q3: 13–25, range 0–40) stratified by treatment era were: 17.0 (pre-1996), 20.0 (1996–1999), 20.0 (2000–2009), 19.0 (2010–2018) (p = 0.03). While there was a significant association at the univariate level, year of HIV diagnosis by treatment era was not associated with stigma scores after controlling for age, gender, HIV key populations, ethnicity, relationship status, social support, and ever having a mental health disorder diagnosis. This suggests that PLWH still experience HIV-related stigma today, compared to those diagnosed in earlier time periods. [ABSTRACT FROM AUTHOR]

Depressive symptoms among people living with HIV (PLWH) are associated with poorer overall health outcomes. We characterized depressive symptoms and improvements in symptomology among PLWH (≥ 19 years old) in British Columbia (BC), Canada. We also examined associations between depressive symptomology and antiretroviral therapy (ART) treatment interruptions. Depressive symptoms were measured using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), within a longitudinal cohort study with three surveys administered 18-months apart. We used multivariable logistic regression to model factors associated with improvements in depressive symptoms (CES-D-10 scores from ≥ 10 to < 10). Of the 566 participants eligible for analysis 273 (48.2%) had CES-D scores indicating significant depressive symptoms (score ≥ 10) at enrollment. Improvements in symptoms at first follow-up were associated with greater HIV self-care on the Continuity of Care Scale (adjusted odds ratio: 1.17; 95% CI 1.03–1.32), and not having a previously reported mental health disorder diagnosis (aOR 2.86; 95% CI 1.01–8.13). Those reporting current cocaine use (aOR 0.33; 95% CI 0.12–0.91) and having a high school education, vs. less than, (aOR 0.25; 95% CI 0.08–0.82) had lower odds of improvement in depressive symptomatology. CES-D scores ≥ 10 were not significantly associated with ART treatment interruptions during follow-up (aOR: 1.08; 95% CI:0.65–1.8). Supporting greater self-care and consideration of mental health management strategies in relation to HIV may be useful in promoting the wellbeing of PLWH who experience depressive symptoms. [ABSTRACT FROM AUTHOR]