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. 2025 Apr;29(4):1118-1131.
doi: 10.1007/s10461-024-04588-5. Epub 2025 Jan 6.

Exposure to COVID-19 Pandemic-Related Stressors and Their Association With Distress, Psychological Growth and Drug Use in People With HIV in Nouvelle Aquitaine, France (ANRS CO3 AQUIVIH-NA Cohort-QuAliV-QuAliCOV Study)

Jihane Ben Farhat  1   2   3 , Mojgan Hessamfar  4   5   6 , Didier Neau  7 , Sophie Farbos  8 , Estibaliz Lazaro  9 , Pierre Duffau  6   10 , Nicolas Rouanes  11 , Charles Cazanave  7 , Thierry Pistone  7 , Patrick Rispal  12 , Marie-Anne Vandenhende  4   13 , Camille Krzyzanowsky  6 , Olivier Leleux  13 , Linda Wittkop  13   14 , Fabrice Bonnet  4   15   5   6 , Diana Barger  4   16
Affiliations

Exposure to COVID-19 Pandemic-Related Stressors and Their Association With Distress, Psychological Growth and Drug Use in People With HIV in Nouvelle Aquitaine, France (ANRS CO3 AQUIVIH-NA Cohort-QuAliV-QuAliCOV Study)

Jihane Ben Farhat et al. AIDS Behav. 2025 Apr.

Abstract

We investigated people living with HIV (PLWH)'s exposure to COVID-19 pandemic stressors and their association with distress, psychological growth, and substance use. PLWH in the ANRS CO3 AQUIVIH-NA cohort's QuAliV study (Nouvelle Aquitaine, France) completed an adapted CAIR Lab Pandemic Impact Questionnaire (C-PIQ) and reported substance use between 9/2021 to 3/2022. We described cumulative stressor exposure (score 0-16) and explored variation by PLWH characteristics (demographic, HIV-related, risk factors, psychosocial). Associations with distress (score 0-23), psychological growth (score 0-20), and substance use were assessed using regression models. Participants reported exposure to a median of 2 (IQR: 1-4) stressors. Stressor exposure was higher in working-age (<60) and psychosocially vulnerable PLWH. Exposure to an additional stressor correlated with a 0.7-point increase in distress scores (95% C.I. 0.5-1.0, p<0.001), a 0.04-point increase (95% C.I. 0.01-0.07, p=0.002) in psychological growth scores in working-age PLWH. In older PLWH, additional stressor correlated with a 0.8-point (95% C.I. 0.4-1.2, p<0.001) increase in distress and a 0.1-point increase (95% C.I. 0.06-0.2, p=0.001) in growth scores. Each additional stressor was associated with 1.2 (95% C.I. 1.0-1.4, p=0.02) higher adjusted odds of cannabis use in working-age PLWH, and 1.2 (95% C.I. 1.0-1.4, p=0.004) higher adjusted odds of drug use. Exposure to stressors was linked to increased distress, cannabis and drug use but also growth. Providers should not only be aware of risk (of severe COVID-19) but also be mindful of the social and psychological challenges PLWH face as these may affect their retention in care, especially during challenging times.

Keywords: COVID-19; Cannabis; Distress; Drugs; HIV; Psychological growth.

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Conflict of interest statement

Declarations. Conflict of interests: The authors declare no conflicts of interest in relation to this manuscript. SF has received financial support from Gilead Sciences, MSD and ViiV Healthcare to attend scientific conferences. Ethical Approval: The ANRS CO3 AQUIVIH-NA Cohort received approval from the Comité de Protection des Personnes (CPP) du Sud-Ouest et d’Outre-Mer III (25 May 2016). Patient consent statement: Informed consent was obtained from all individuals included in the cohort.

Figures

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Flowchart
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Fig. 2
Description of COVID-19-related stressors exposure and median stressor score by individual characteristics (N = 374)
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