IAS 2021

Digital Opportunities to Support Mental Health among Sexual and Gender Diverse Adults Living with HIV During COVID-19: A Multi-National Cross-Sectional Survey

Background: Digital tools offer opportunities to reach and support sexual and gender diverse (SGD) communities, especially those living with HIV (PLHIV). We sought to understand sources of digital support among SGD PLHIV during COVID-19 and if decreased support was associated with depressive and anxiety symptoms.

 Methods: We analyzed self-reported data from 9,893 transgender or non-heterosexual cisgender adults in the COVID-19 Global Disparities Survey, which was deployed in 11 languages from October 25 to November 26, 2020 via Hornet, an SGD social app. We compared digital social support by HIV status. Among PLHIV, we used crude and adjusted Poisson regression to measure the association between decreased digital social support and a positive screen for depression or anxiety (≥3 on PHQ-4 depressive or anxiety sub-scales).

 Results: Participants’ median age was 35 years (IQR: 28–43), with most residing in Russia (24%), Turkey (17%), or Brazil (16%). The majority were cisgender men (93.8%) with the remainder being nonbinary (4.2%), transfeminine (1.5%), or transmasculine (0.5%). About a third (37.5%) screened positive for depression or anxiety. Since COVID-19, digital social support remained stable or increased for the majority (76.7%). Use of tele- or virtual therapy was more common among PLHIV who reported an undetectable viral load (n=75/901, 8.3%) than PLHIV who reported a detectable viral load (n=28/704, 4.0%) or those not living with HIV (n=337/8288, 4.1%). Suicide hotlines (1.1%), crisis text lines (0.93%), chatbots (0.81%), and the Hornet app (8.1%) usage for support was low and similar across groups. In crude and adjusted models among PLHIV (Table 2), participants were significantly more likely to screen positive for depression or anxiety if their digital social support had decreased during COVID-19 (vs. increased or remained stable).

 Conclusions: Strategies for increasing digital programming, outreach, and accessibility are needed to support the mental health of the SGD community, especially PLHIV.