Longitudinal changes in anxiety and depression among Ukrainian older people with HIV (OPWH) during the COVID -19 pandemic

Title

Longitudinal changes in anxiety and depression among Ukrainian older people with HIV (OPWH) during the COVID -19 pandemic

Presenter

Katherine Rich

Authors

K. Rich * (1), S. Shenoi (2), I. Zaviryukha (3), O. Zeziulin (3), T. Kiriazova (3), D. Bromberg (2), N. Radich (4), T. Zubenko (5), J. Rozanova (2)

Institutions

(1) Harvard Medical School, Boston, United States, (2) Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, Yale AIDS Program, New Haven, United States, (3) Ukrainian Institute on Public Health Policy, Kyiv, Ukraine, (4) New Way Psychotherapy Rehabilitation Center, Kyiv, Ukraine, (5) Ukrainian Union of Psychotherapists, Kyiv, Ukraine

BACKGROUND: The COVID-19 pandemic amplified mental health challenges especially anxiety and depression. We sought to understand longitudinally how Covid-19 impacted the mental health of older people with HIV (OPWH) living in Ukraine.
METHODS: We surveyed OPWH living in Kyiv, Ukraine by phone first between April-June 2020 (Wave 1) and again from December 2020-February 2021 (Wave 2). The primary outcomes were depressive symptoms and anxiety symptoms, defined as scores on the Patient Health Questionnaire-9 (PHQ-9) >5 and scores on Generalized Anxiety Disorder-7 scale (GAD-7) >5, respectively. Participants PHQ-9 and GAD-7 scores were compared between Wave 1 and 2 to assess for changes in depressive and anxiety symptoms. Other variables of interest were: age, gender, history of a substance use disorder (SUD) and/or alcohol use disorder (AUD), living situation (living alone, not living alone), and employment. Differences were assessed with chi-square and t-tests.
RESULTS: Of the 110 OPWH who completed both Wave 1 and Wave 2 surveys, 55 (50.9%) were women and average age was 55.4y (SD=6.45). Nearly half (47.3%) had a history of a SUD and/or AUD. During Wave 1, 51 participants (46.4%) reported symptoms of depression and 39 (35.5%) reported symptoms of anxiety. During Wave 2, the prevalence of depressive and anxiety symptoms was 40.9% and 22.7%, respectively. At the individual level, 27 (24.5%) participants had decreased depressive symptoms, whereas sixteen (14.5%) had increased symptoms. Twenty-five (22.7%) participants had decreased anxiety and eleven (10.0%) had increased anxiety. Individuals without full time employment were more likely to have increased depressive symptoms than individuals with full time employment (p=0.01). Younger age (p<0.01) and a history of an AUD or SUD (p=0.01) were associated with increased anxiety symptoms between Wave 1 and Wave 2. Gender and living situation were not associated with changes in depressive or anxiety symptoms.
CONCLUSIONS: Among OPWH in Kyiv, prevalence of depressive and anxiety symptoms have remained substantial but have not increased during Covid-19. OPWH with comorbid addiction experienced increased anxiety symptoms. Targeted interventions to address mental health, such as peer-support, are warranted.

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