Examining Associations between COVID-19 Distress, Multilevel Resilience, and HIV Viral Suppression among African American/Black Adults in the Southeastern United States

Abstract: The COVID-19 pandemic may have exacerbated HIV viral suppression disparities between African American/Black and White people living with HIV in the United States. Although COVID-19 disrupted HIV care and caused distress, multilevel resilience resources may have mitigated the impact of COVID-19 distress on HIV viral suppression. We used prospective observational data on 124 African American/Black adults from two clinical cohorts in the Southeastern United States and modified Poisson regression to examine whether an intervention that reduced COVID-19 distress and enhanced multilevel resilience resources would have more effectively improved HIV viral suppression had such a dual intervention been implemented in the real-world during the COVID-19 pandemic. This examination did not yield strong evidence that a real-world dual intervention would have more effectively improved HIV viral suppression on the additive scale during the pandemic among study participants. Larger future studies that minimize systematic sources of bias are needed.