Association of PTSD With Longitudinal COVID-19 Burden in a Mixed-Serostatus Cohort of Men and Women: Weathering the Storm

Deborah L. Jones*, Yuehan Zhang, Violeta J. Rodriguez, Sabina Haberlen, Catalina Ramirez, Adaora A. Adimora, Daniel Merenstein, Bradley Aouizerat, Anjali Sharma, Tracey Wilson, Matthew J. Mimiaga, Anandi N. Sheth, Michael Plankey, Mardge H. Cohen, Valentina Stosor, Mirjam Colette Kempf, M. Reuel Friedman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives:This study of people with HIV (PWH) and those without HIV conducted during the COVID-19 pandemic in the United States in 2020 examines the impact of posttraumatic stress disorder (PTSD) on COVID-19 burden, defined as pandemic-related disruptions.Methods:Data consisted of survey responses on PTSD among participants (N = 2434) enrolled in the Multicenter AIDS Cohort Study (MACS) and the Women's Interagency HIV (WIHS) cohorts. Unadjusted and adjusted regression models were used to examine the association of PTSD with COVID-19 burden (overall and domain-specific burdens). Quasi-Poisson regression models were used to assess associations with the COVID-19 burden score and 2 domain-specific burdens: (1) changes in resources and (2) interruptions in health care. Analyses was adjusted for age, race/ethnicity, HIV serostatus, current smoking status, number of comorbidities, education, and study regions.Results:Study participants were a median age of 58 (interquartile range, 52-65) years. In both bivariate and multivariable models, PTSD severity was associated with greater overall COVID-19 burden. PTSD severity was associated with the number of resource changes and number of interruptions in medical care. These findings were also consistent across cohorts (MACS/WIHS) and across HIV serostatus, suggesting a greater risk for COVID-19 burden with greater PTSD severity, which remained significant after controlling for covariates.Conclusions:This study builds on emerging literature demonstrating the impact of mental health on the burden and disruption associated with the COVID-19 pandemic, providing context specific to PWH. The ongoing pandemic requires structural and social interventions to decrease disruption to resources and health resource needs among these vulnerable populations.

Original languageEnglish (US)
Pages (from-to)567-575
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number5
StatePublished - Aug 15 2022


  • COVID-19
  • HIV
  • MACS
  • WIHS
  • posttraumatic stress disorder

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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