Questioning the "Ease" in disease: Was living with HIV a burden or boost during the first wave of Covid-19 in France? A qualitative study (COVIDHIV)

• Published in: PloS one Vol. 19; no. 3; p. e0295223
• Main Authors: Roucoux, Guillaume, Thonon, Frédérique, Zucman, David, Rey, David, Abgrall, Sophie, Eriksson, Lars E, Préau, Marie, Michels, David, Chéret, Antoine, Duracinsky, Martin
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 07.03.2024; Public Library of Science (PLoS)
• Subjects: Analysis; Antiviral agents; Biology and Life Sciences; Care and treatment; Comorbidity; Coronaviruses; COVID-19 - epidemiology; COVID-19 Drug Treatment; COVID-19 Testing; Diagnosis; Dosage and administration; Highly active antiretroviral therapy; HIV; HIV (Viruses); HIV Infections - complications; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV patients; Humans; Male; Medical research; Medicin och hälsovetenskap; Medicine and Health Sciences; Medicine, Experimental; Middle Aged; SARS-CoV-2; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0295223

Clinical research has focused on risk factors and treatment for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), particularly in people with a comorbidity including the human immunodeficiency virus (HIV), but little attention has been paid to the care pathway. This article aims to show how living with HIV may have been a biopsychosocial burden or boost in care pathways for Covid-19. People living with HIV (PLHIV) from 9 clinical centers were invited to participate in this qualitative study. The sampling was purposive with a maximum variation in their sociodemographic profiles. Semi-structured interviews were conducted until data saturation, then coded for thematic analysis, using an inductive general approach. We interviewed 34 PLHIV of which 20 had SARS-COV-2 once. They were 24 males, 26 born in France; median age: 55. Twenty had a CD4 number above 500, and all were on antiretroviral therapy (ART). HIV appeared as a burden when Covid-19 symptoms reminded HIV seroconversion, fear of contamination, and triggered questions about ART effectiveness. HIV was not considered relevant when diagnosing Covid-19, caused fear of disclosure when participants sought SARS-COV-2 testing, and its care in hospitals was disrupted by the pandemic. ART-pill fatigue caused avoidance for Covid-19 treatment. As a boost, living with HIV led participants to observe symptoms, to get advice from healthcare professionals, and screening access through them. Some participants could accept the result of screening or a clinical diagnosis out of resilience. Some could consider ART or another drug prescribed by their HIV specialist help them to recover from Covid-19. Living with HIV could function as a burden and/or a boost in the care pathways for Covid-19, according to patients' relationship to their HIV history, comorbidities and representation of ART. Covid-19 in PLHIV needs further qualitative study to gain a more comprehensive assessment of the pandemic's consequences on their lives and coping strategies.