HIV, psychological resilience, and substance misuse during the COVID-19 pandemic: A multi-cohort study

Marianna K. Baum, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA. Electronic address: baumm@fiu.edu.
Javier A. Tamargo, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Janet Diaz-Martinez, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Ivan Delgado-Enciso, School of Medicine, University of Colima, Colima, MX, USA.
Christina S. Meade, Duke University School of Medicine, Duke University, Durham, NC, USA.
Gregory D. Kirk, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Shruti H. Mehta, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Richard Moore, Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Michele D. Kipke, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Steven J. Shoptaw, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
Brian Mustanski, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Raul N. Mandler, National Institute on Drug Abuse, Rockville, MD, USA.
Jag H. Khalsa, George Washington University, Washington, DC, USA.
Suzanne Siminski, Frontier Science Foundation, Brookline, MA, USA.
Marjan Javanbakht, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
Pamina M. Gorbach, Fielding School of Public Health, University of California, Los Angeles, CA, USA.

Document Type

Journal Article

Publication Date

2-1-2022

Journal

Drug and alcohol dependence

Volume

231

DOI

10.1016/j.drugalcdep.2021.109230

Keywords

COVID-19; HIV; Mental health; Psychological adaptation; Substance Use

Abstract

OBJECTIVE: The COVID-19 pandemic has dramatically impacted mental health, increasing rates of substance misuse. Resilience is a positive adaptation to stress that may act as a buffer against adverse mental health outcomes. Based on prior knowledge, we hypothesized that PLWH would display higher resilience than HIV-uninfected peers, and that high resilience would be associated with lower risk of substance misuse. METHODS: This analysis of the Collaborating Consortium of Cohorts Producing NIDA Opportunities (C3PNO) included data from six USA cohorts that administered a COVID-19-related survey with a 3-month follow-up during May 2020 and March 2021. All data was self-reported. The Brief Resilience Scale and General Anxiety Disorder-7 were utilized. Primary analyses consisted of multivariate generalized linear mixed models with random intercepts using binary logistic regression. RESULTS: A total of 1430 participants completed both surveys, of whom 670 (46.9%) were PLWH. PLWH had lower odds of anxiety (OR=0.67, 95% CI: 0.51-0.89) and higher odds of high resilience (OR=1.21, 95% CI: 1.02-1.44) than HIV-uninfected participants, adjusted for covariates. The presence of anxiety was associated with higher risk of misuse of all substances. High resilience was associated with lower risk of anxiety and misuse of substances, adjusted for covariates. CONCLUSIONS: Psychological resilience was associated with lower risk of anxiety and substance misuse, potentially serving as a buffer against poor mental and behavioral health during the COVID-19 pandemic. Further research is needed to identify pathways of resilience in the context of substance misuse and comprehensive resilience-focused interventions.

Department

Microbiology, Immunology, and Tropical Medicine

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