A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic

Morenike Oluwatoyin Folayan; Roberto Ariel Abeldaño Zuñiga; Jorma I Virtanen; Passent Ellakany; Ala'a B Al-Tammemi; Mir Faeq Ali Quadri; Mohammed Jafer; Eshrat Ara; Martin Amogre Ayanore; Balgis Gaffar; Nourhan M Aly; Ifeoma Idigbe; Joanne Lusher; Oliver C Ezechi; Annie L Nguyen; Maha El Tantawi

doi:10.1186/s12889-023-15933-z

A multi-country study of the associations between HIV vulnerability status, perception of COVID-19 related stigma and post-traumatic stress symptoms during the first wave of the pandemic

BMC Public Health. 2023 May 30;23(1):1025. doi: 10.1186/s12889-023-15933-z.

Authors

Morenike Oluwatoyin Folayan^{1

2}, Roberto Ariel Abeldaño Zuñiga^{3

4

5}, Jorma I Virtanen^{3

6}, Passent Ellakany^{3

7}, Ala'a B Al-Tammemi^{3

8

9}, Mir Faeq Ali Quadri^{3

10}, Mohammed Jafer^{3

11}, Eshrat Ara^{3

12}, Martin Amogre Ayanore^{3

13}, Balgis Gaffar^{3

14}, Nourhan M Aly^{3

15}, Ifeoma Idigbe^{3

16}, Joanne Lusher^{3

17}, Oliver C Ezechi^{3

18}, Annie L Nguyen^{3

19}, Maha El Tantawi^{3

15}

Affiliations

¹ Mental Health and Wellness Study Group, Ile-Ife, Nigeria. toyinukpong@yahoo.co.uk.
² Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria. toyinukpong@yahoo.co.uk.
³ Mental Health and Wellness Study Group, Ile-Ife, Nigeria.
⁴ Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico.
⁵ Faculty of Social Sciences, University of Helsinki, Helsinki, Finland.
⁶ Faculty of Medicine, University of Turku, Turku, Finland.
⁷ Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
⁸ Applied Science Research Center, Applied Science Private University, Amman, Jordan.
⁹ Migration Health Division, International Organization for Migration, Amman, Jordan.
¹⁰ Department of Oral Health Sciences, University of Washington, Washington, USA.
¹¹ Dental Public Health Division, Faculty of Dentistry, Jazan University, Jizan, Saudi Arabia.
¹² Department of Psychology, Government College for Women, MA Road, Jizan, J&K, India.
¹³ Department of Health Policy Planning and Management, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana.
¹⁴ Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia.
¹⁵ Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
¹⁶ Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria.
¹⁷ Provosts Group, Regent's University London, London, UK.
¹⁸ Centre for Reproductive and Population Health Studies, Nigerian Institute of Medical Research Yaba, Lagos, Nigeria.
¹⁹ Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.

Abstract

Background: This study investigated the associations between COVID-19 related stigma and post-traumatic stress symptoms (PTSS); and the associations between PTSS and COVID-19 related stigma, HIV status, COVID-19 status and key HIV population status.

Methods: This was a secondary analysis of data of 12,355 study participants generated through an online survey that recruited adults from 152 countries between July and December 2020. The dependent variables were COVID-19-related stigma and PTSS. The independent variables were HIV status (positive/negative), transaction sex (yes/no), use of psychoactive drugs (yes/no), and vulnerability status (transaction sex workers, people who use psychoactive drugs, living with HIV, and COVID-19 status). The confounding variables were age, sex at birth (male/female), level of education, sexual minority individuals (yes/no) and country income level. Multivariable logistic regression analyses were conducted to determine associations between the dependent and independent variables after adjusting for confounders.

Results: There were 835 (6.8%) participants who experienced COVID-19 related stigma during the pandemic and 3,824 (31.0%) participants reported PTSS. Respondents who were living with HIV (AOR: 1.979; 95%CI: 1.522-2.573), tested positive for COVID-19 (AOR: 3.369; 95%CI: 2.692-4.217), engaged in transactional sex (AOR: 1.428; 95%CI: 1.060-1.922) and used psychoactive drugs (AOR: 1.364; 95%CI: 1.053-1.767) had significantly higher odds of experiencing COVID-19 related stigma. Individuals with vulnerability status (AOR:4.610; 95%CI: 1.590-13.368) and who experienced COVID-19 related stigma (AOR: 2.218; 95%CI: 1.920-2.561) had significantly higher odds of PTSS.

Conclusion: Individuals with vulnerability status may be at increased risk for COVID-19 related stigma. Key and vulnerable populations who were living with HIV and who experienced stigma may be at a higher risk of experiencing PTSS. Populations at risk for PTSS should be routinely screened and provided adequate support when they contract COVID-19 to reduce the risk for poor mental health during COVID-19 outbreaks and during future health crisis with similar magnitude as the COVID-19 pandemic.

Keywords: COVID-19; HIV; Post-traumatic; Social stigma; Stress disorders.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
COVID-19* / epidemiology
Female
HIV Infections* / epidemiology
HIV Infections* / psychology
Homosexuality, Male
Humans
Infant, Newborn
Male
Pandemics
Perception
Stress Disorders, Post-Traumatic* / epidemiology

Grants and funding

K01 AG064986/AG/NIA NIH HHS/United States