COVID-19 Incidence, Risk Factors, Impact, and Related Stigma among a Cohort of Persons with HIV in Washington, DC

Background: Studies on the incidence of COVID-19 among persons with HIV (PWH) present varied results. Few studies have investigated the impact of COVID-19 infection on health and socioeconomic factors or COVID-19 stigma. We sought to measure the incidence and severity of COVID-19 infection among a cohort of PWH, characterize associated risk factors and impact, and document perceptions of COVID-19-related stigma. Methods: Data for this cross-sectional study come from the COVID-19 survey of participants in the DC Cohort longitudinal study from October 30, 2020 through December 31, 2022. Survey results were linked to electronic health records, including HIV labs and COVID test results. We conducted analyses comparing demographic, socioeconomic, HIV measures, and stigma among those with and without self-reported COVID-19. Results: Out of 1,972 survey respondents, 17% self-reported COVID-19 infection, with greatest incidence in the Omicron wave of the pandemic. We found statistically significant differences by age, employment status, essential worker status, education, and household income. Longer duration of HIV diagnosis was associated with greater incidence of COVID-19. PWH who were overweight or obese had greater incidence of COVID-19 compared to those who were not. Over 40% of PWH with COVID-19 reported experiencing at least one form of COVID-19-related stigma. Conclusion: We observed a high incidence of COVID-19 infection among PWH in DC. Further, a substantial proportion of PWH with COVID-19 reported experiencing COVID-19 related stigma. These findings add to the existing literature on COVID-19 co-infection among PWH and highlight the need for awareness and support for those experiencing COVID-19 stigma.