Knowledge and Impact of COVID-19 on Middle-Aged and Older People living with HIV in Lima, Peru

  1. Monica M. Diaz
  2. Diego M. Cabrera
  3. Marcela Gil-Zacarías
  4. Valeria Ramírez
  5. Manuel Saavedra
  6. Cesar Cárcamo
  7. Evelyn Hsieh
  8. Patricia J. García

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Abstract

COVID-19 has had an unprecedented worldwide impact, and Peru has had one of the highest COVID-19 case rates despite implementation of an early strict nationwide quarantine. Repercussions on Peru’s healthcare system may impact vulnerable populations, particularly people with HIV (PWH). We explored the knowledge of COVID-19 and the socioeconomic and health impact of the pandemic among middle-aged and older PWH. A cross-sectional telephone survey was administered to 156 PWH age ≥40 years receiving care in one of two large HIV clinics in Lima, Peru. The majority of PWH (age 52±7.7 years, 41% female, 65% completed secondary school or less) were knowledgeable regarding COVID-19 symptoms and prevention methods. Nearly half of those employed prior to the pandemic reported job loss. Female sex (unadjusted prevalence ratio [PR] 1.85 [95%CI 1.27-2.69]), low educational level (PR 1.62 [1.06-2.48]) and informal work (PR 1.58 [1.06-2.36]) were risk factors for unemployment but not in adjusted models. Increased anxiety was reported in 64% and stress in 77%. COVID-19 has had a substantial socioeconomic and mental health impact on PWH living in Lima, Peru, particularly those with lower educational levels and informal workers. Efforts are needed to ensure continued medical care and socioeconomic support of PWH in Peru.

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  1. ScreenIT

    SciScore for 10.1101/2021.04.23.21255998: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: Ethics: This study was reviewed and approved by the ethics committees of the Yale School of Medicine and Universidad Peruana Cayetano Heredia.
    Consent: All participants provided verbal informed consent after a comprehensive explanation of the procedures by phone prior to study enrollment.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were performed using STATA (College Station, TX, USA) and JMP Pro version 14.2.0 (Cary, NC, USA).
    STATA
    suggested: (Stata, RRID:SCR_012763)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our study has limitations. First, this study was a cross-sectional telephone survey and did not have an HIV-negative control group for comparison. However, national surveys of the general Peruvian population allowed us to make comparisons to the findings of PWH in our study.23,25,32 Second, this was a convenience sample of middle-aged to older PWH attending two large multidisciplinary HIV clinics in an urban capital city, thus, may not be representative of the all Peruvian PWH. Third, our sample was largely educated with the majority of participants having completed secondary school, exceeding the proportion of Peruvians with at least some secondary schooling (64% female, 75.4% male),40. Next, most women were recruited from one of the study sites, but despite these recruitment differences, PWH did not differ greatly between study sites. On the other hand, although there have been some surveys exploring knowledge and socioeconomic, physical and mental health impacts of the pandemic in general population,23,25 this is the first one exploring these areas in PWH in Peru. Our data has shown that the COVID-19 pandemic and measures taken to reduce its transmission have posed a significant mental health and socioeconomic burden on Peruvian PWH and may pose a considerable burden upon PWH in other low-to-middle income countries. As Peru enacted policies to slow the spread of COVID-19 through quarantines and shut-down of most non-essential establishments early on in the beginning of the...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.04.23.21255998v1 on medRxiv
  3. Version published to 10.1177/23259582211056760