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

Marianna K Baum¹, Javier A Tamargo², Janet Diaz-Martinez², Ivan Delgado-Enciso³, Christina S Meade⁴, Gregory D Kirk⁵, Shruti H Mehta⁵, Richard Moore⁶, Michele D Kipke⁷, Steven J Shoptaw⁸, Brian Mustanski⁹, Raul N Mandler¹⁰, Jag H Khalsa¹¹, Suzanne Siminski¹², Marjan Javanbakht¹³, Pamina M Gorbach¹³

Affiliations

¹ Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA. Electronic address: baumm@fiu.edu.
² Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
³ School of Medicine, University of Colima, Colima, MX, USA.
⁴ Duke University School of Medicine, Duke University, Durham, NC, USA.
⁵ Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
⁶ Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁷ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁸ David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
⁹ Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
¹⁰ National Institute on Drug Abuse, Rockville, MD, USA.
¹¹ George Washington University, Washington, DC, USA.
¹² Frontier Science Foundation, Brookline, MA, USA.
¹³ Fielding School of Public Health, University of California, Los Angeles, CA, USA.

PMID: 34998257
PMCID: PMC8704725
DOI: 10.1016/j.drugalcdep.2021.109230

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

Marianna K Baum et al. Drug Alcohol Depend. 2022.

. 2022 Feb 1:231:109230.

doi: 10.1016/j.drugalcdep.2021.109230. Epub 2021 Dec 24.

Authors

Affiliations

¹ Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA. Electronic address: baumm@fiu.edu.
² Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
³ School of Medicine, University of Colima, Colima, MX, USA.
⁴ Duke University School of Medicine, Duke University, Durham, NC, USA.
⁵ Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
⁶ Johns Hopkins University School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
⁷ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁸ David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
⁹ Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
¹⁰ National Institute on Drug Abuse, Rockville, MD, USA.
¹¹ George Washington University, Washington, DC, USA.
¹² Frontier Science Foundation, Brookline, MA, USA.
¹³ Fielding School of Public Health, University of California, Los Angeles, CA, USA.

PMID: 34998257
PMCID: PMC8704725
DOI: 10.1016/j.drugalcdep.2021.109230

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.

Keywords: COVID-19; HIV; Mental health; Psychological adaptation; Substance Use.

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Figures

**Fig. 1**
Substance use patterns in the C3PNO multi-cohort during the COVID-19 pandemic Fig. 1 displays substance use patterns in the C3PNO multi-cohort during the two waves of surveys: wave 1 occurred between May-Dec 2020 and wave 2 occurred between Oct 2020-Mar 2021. The proportion of users of each substance is compared between study waves and by HIV status (dark shade for HIV-negative and light shade for HIV-positive). Significant differences were noted only for hazardous drinking, which showed a slight decline from 42.5–39.7% between the 1st and 2nd waves (P = 0.027), and was significantly less frequent among HIV-positive participants during both waves (P < 0.05). Abbreviations: Cann, cannabis; Coc, cocaine; Eth, ethanol (hazardous drinking); Her/Fen, heroin/fentanyl; Meth, methamphetamines; Rx Opi, prescription opioids; Tob, tobacco (cigarette smoking). *McNemar’s test for Wave 1 vs. Wave 2; P < 0.05.

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

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

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