- People of color from low income households have been disproportionately affected by the COVID-19 pandemic.
- For people living with HIV, surviving a pandemic is not a completely novel experience.
- A new study explores the strategies of Black and Latinx long-term HIV survivors in the early months of the current pandemic.
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It is now well documented that the COVID-19 pandemic has disproportionately affected people of color.
A recent study describes the experiences of Black and Latinx long-term survivors of HIV during the early stages of the COVID-19 pandemic who come from low income households.
The lead and senior authors are based at the New York University Silver School of Social Work (NYU Silver).
Their goal was to both identify gaps in healthcare services for a critically underserved group and learn about the coping mechanisms of a population with a demonstrated ability to live with a life threatening infection.
Long-term HIV survivors are uniquely equipped for dealing with a pandemic. Dr. Marya Gwadz, lead author of the study, explains:
“We were interested in risks but also in identifying ‘indigenous coping strategies’ and gaps that could be addressed for better future preparedness in times of crisis. We define these as effective ways of managing health and well-being in the time of COVID-19 that emerge from the community but are not necessarily strategies that researchers or experts would have come up with.”
Dr. Gwadz is a professor and associate dean at NYU Silver and an associate director of the Transdisciplinary Research Methods Core of the Center for Drug Use and HIV Research at NYU School of Global Public Health.
Her Intervention Innovations Team Lab conducted the research, which appears in the journal AIDS and Behavior.
The researchers conducted structured assessments of 96 Black and Latinx HIV survivors between April 16 and August 7, 2020. All participants were based in New York City.
The participants had lived with HIV for an average of 17 years. In addition, Dr. Gwadz and her colleagues conducted in-depth interviews with 26 of these individuals.
The assessments revealed that the study participants exhibited behavior that suggested ample experience with healthcare systems.
Individuals in the study were early adopters of behaviors such as social distancing, as recommended by public health authorities.
The participants in the study also exhibited sophistication in their selection of information sources, typically having a preference for information from local healthcare authorities over materials published by federal experts.
Having navigated local resources throughout their time living with HIV, the participants were shown to know how to get the things they needed to survive during the COVID-19 pandemic.
The study reports that the participants knew how to “hustle” for resources, such as food, although doing so did force them out into the world, where they were placed at increased risk of infection.
While the study found that, “overall, engagement in HIV care and antiretroviral therapy use were not seriously disrupted,” the individuals were often forced to cancel HIV care visits due to constraints imposed by lockdowns and quarantine.
Substance use treatment appointments and 12-step meetings were similarly affected.
Where possible, face-to-face care interactions were replaced by virtual appointments, although online access was not available to everyone.
The study found that the participants had either cell phone or internet service through the federal Lifeline assistance program — commonly known as the Obama Phone — but typically not both.
In general, virtual support was at least somewhat lacking due to insufficient equipment or technical know-how.
To address this, the researchers advocate for an expansion of the federal Lifeline assistance program that would offer more effective technical training and support in the event of future health crises.
With COVID-19 affecting communities of color particularly badly, many participants tied the disparity directly to structural racism.
The study concludes with an exploration of the ways in which its findings may help the United States prepare for the next crisis in the hopes that it will not become just “another pandemic of the poor.” The authors cite the success of the National HIV/AIDS Strategy as a model.
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