Medication Adherence and Substance Use Among Gay, Bisexual and Other Men Who Have Sex with Men (GBMSM) Living with HIV in New York City During covid-19 Restrictions

COVID-19 shelter-in-place orders were critical in preventing the spread of SARS CoV-2 virus but may have disrupted care for people living with HIV, including access to antiretroviral treatment (ART). Understanding how COVID-19 restrictions affected ART adherence is a public health concern. Neighborhoods, Networks and HIV (NNHIV) is an ongoing longitudinal cohort study evaluating the impact of neighborhoods and networks on HIV care engagement among gay, bisexual, and other men who have sex with men (GBMSM) living in New York City (NYC). During follow-up visits between April 2020 and January 2021, pandemic impact was assessed, including health care/medication access concerns. Using multivariate logistic regression models, correlates of self-reported persistent ART adherence (≥85%) were assessed. 131 participants provided complete data. Over follow-up, half (50%) attended in-person medical appointments, just over a quarter (27.3%) attended in-person HIV-related lab appointments. In multivariable models, homelessness was associated with lower odds of being consistently adherent (aOR = 0.11, 0.10-0.98. Higher levels of HIV treatment self-efficacy (aOR = 1.05, 1.03-1.07), COVID-19 related increases in substance use (aOR = 3.75, 1.02-13.75) and higher levels of medical mistrust (aOR = 1.05, 1.03-1.52) were all associated with increased odds of being persistently adherent. Although COVID-19 public health restrictions did impact the daily lives of GBMSM living with HIV in the NNHIV cohort, ART adherence remained consistently high, even among those who reported difficulty accessing care during the restrictions. This suggests that local healthcare infrastructure adapted in the face of COVID-19 to meet the changing needs of this cohort of men.