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


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.