Abstract
Demographics, HIV care, and deaths among people with HIV with and without diagnosed COVID-19, Massachusetts 2021
APHA 2022 Annual Meeting and Expo
Background: People with HIV (PWH) may be more susceptible to other infections if exposed. We aim to understand the impact of COVID-19 on PWH.
Methods: Individuals with COVID-19 reported to Massachusetts Department of Public Health through May 2021 were matched against the Massachusetts HIV surveillance registry. Demographics, clinical care indicators, and mortality were assessed for PWH with and without COVID-19.
Results: Of 23,329 known PWH living in Massachusetts on 12/31/2019, 1,999 (8.6%) were diagnosed with COVID-19. PWH with COVID-19 were more likely to be non-US-born (41.1% vs. 27.5%, p<0.001), and black, non-Hispanic or Hispanic/Latino (36.9% vs. 29.2% and 34.4% vs. 26.0%, respectively; p<0.001), than PWH without COVID-19. Among those engaged in HIV care, PWH with COVID-19 were more likely to be retained in care (61.7% vs. 55.1%); however, the proportions virally suppressed were comparable (91.4% vs. 91.0%). The groups had similar distributions of recent viral load and CD4 count. The proportion of PWH with COVID-19 who died between January 2020 and November 2021 was nearly three times that of PWH without COVID-19 (5.6% vs. 2.1%; p<0.001). Just under half of these deaths (43.2%) occurred within one month of COVID-19 diagnosis.
Conclusions: Known racial/ethnic disparities among PWH were more pronounced for those diagnosed with COVID-19. PWH with COVID and engaged in care were more likely to be receiving routine HIV care, possibly reflecting increased access and connection to care generally. The majority of both groups had undetectable viral loads, suggesting that COVID-19 does not solely impact those with unmanaged HIV.