Resilience-Focused HIV Care to Promote Psychological Well-Being During COVID-19 and Other Catastrophes.

L Lauren Brown,Erika G Martin,Bryan R Garner,Hannah K Knudsen,Heather J Gotham

doi:10.3389/fpubh.2021.705573

Abstract

The COVID-19 pandemic has adversely affected people with HIV due to disruptions in prevention and care services, economic impacts, and social isolation. These stressors have contributed to worse physical health, HIV treatment outcomes, and psychological wellness. Psychological sequelae associated with COVID-19 threaten the overall well-being of people with HIV and efforts to end the HIV epidemic. Resilience is a known mediator of health disparities and can improve psychological wellness and behavioral health outcomes along the HIV Continuum of Care. Though resilience is often organically developed in individuals as a result of overcoming adversity, it may be fostered through multi-level internal and external resourcing (at psychological, interpersonal, spiritual, and community/neighborhood levels). In this Perspective, resilience-focused HIV care is defined as a model of care in which providers promote optimum health for people with HIV by facilitating multi-level resourcing to buffer the effects of adversity and foster well-being. Adoption of resilience-focused HIV care may help providers better promote well-being among people living with HIV during this time of increased psychological stress and help prepare systems of care for future catastrophes. Informed by the literature, we constructed a set of core principles and considerations for successful adoption and sustainability of resilience-focused HIV care. Our definition of resilience-focused HIV care marks a novel contribution to the knowledge base and responds to the call for a multidimensional definition of resilience as part of HIV research.

Highlights

The COVID-19 pandemic poses a substantial threat to national and jurisdictional efforts to end the HIV epidemic [1]
The adoption and implementation of resilience-focused HIV care may help providers understand the unique adversities faced by people with HIV, the impact of adversity on improving outcomes along the HIV Continuum of Care, and how the psychological strengths of those who have overcome adversity can be leveraged for effective HIV care planning, especially during the COVID-19 pandemic and other catastrophes
In light of the myriad stressors connected to COVID-19, HIV providers have been tasked with modifying standard HIV care to ensure people continue to be retained in care and adherent to medication regimens

Summary

INTRODUCTION

The COVID-19 pandemic poses a substantial threat to national and jurisdictional efforts to end the HIV epidemic [1]. The adoption and implementation of resilience-focused HIV care may help providers understand the unique adversities faced by people with HIV, the impact of adversity on improving outcomes along the HIV Continuum of Care, and how the psychological strengths of those who have overcome adversity can be leveraged for effective HIV care planning, especially during the COVID-19 pandemic and other catastrophes This resilience framework breaks from a traditional medical model, which has been criticized for applying a pathologizing lens that views individuals as ailing and requiring “expert” treatment in order to be healed [29]; it may help providers experientially understand (through increased emotional intelligence) the unique strengths and mastery that people with HIV have developed as a result of major life adversity. Providers who see their patients achieve goals are less likely to experience compassion fatigue and more likely to experience energy-enhancing compassion satisfaction that is associated with better professional quality of life [46]

DISCUSSION

DATA AVAILABILITY STATEMENT