Anxiety and Worry About COVID-19 Infection are Associated with Less Confidence in Ability to Engage in Treatment: Results from a South India Cohort of People Living with HIV (PLWH)

Following its initial outbreak in Wuhan in December 2019, SARS-CoV-2 spread rapidly around the world and was characterized byWHO as a global pandemic onMarch 12, 2020. Given its global impact, it led to a great deal of concern among the approximately 38 million people living with HIV (PWH). Although many governments worked hard to sustain HIV services, often in collaboration with community partners, it soon became clear that PWH faced multiple barriers and challenges to remain engaged in the HIV care continuum. Containment of the global COVID-19 pandemic required that governments implemented multiple strategies, including requirements to shelter-in-place, distancing, and placing restrictions on travel, which may serve as barriers to accessing non-COVID-related healthcare. OnMarch 25, 2020, the government of India announced an initial “lockdown,” due to the global COVID-19 pandemic, which restricted movement, social gatherings and economic activity until May 31. This resulted in many citizens returning to their native homes to shelter with their extended families. It is unknown what impact the lockdowns may have had on the ability of PWH to visit ART clinics, obtain prescription refills or adhere to their regimens. Since successfulmanagement of HIV requires excellent adherence and timely prescription refills to avoid treatment interruptions, real or perceived challenges, including HIV stigma and worries about coronavirus infection may have interfered with this effort.