Sleep quality and disturbance during the COVID-19 pandemic among people with HIV globally: associations with social determinants of health

Abstract

Objective: To examine the impact of coronavirus disease 2019 (COVID-19) on sleep quality and sleep disturbance and explore the relationship between social determinants of health, clinical factors, and sleep quality and sleep disturbance in a global sample of people with HIV (PWH).

Design: Cross-sectional prospective international observational study to examine the social, mental, and physical health impacts of COVID-19 on sleep health of PWH.

Methods: A modified version of the Adolescent Trials Network (ATN) COVID Questionnaire was utilized to collect sleep quality and social determinant of health data in adult PWH. Sleep disturbance was determined from a single item from the Fear of COVID-19 Scale. A series of logistic regressions were conducted to explore the relationship of social determinants of health with decreased sleep quality and disturbance.

Results: A sample of 1601 PWH from four continents (Africa, Asia, North America, and South America) were included with 61% male, a mean age of 44.18 (±13.67) and living with HIV for an average of 12.8 years (±9.6). During the COVID-19 pandemic, 26.8% of participants experienced decreased sleep quality and 27.1% experienced sleep disturbance with the highest prevalence among participants residing in Africa. Individuals with decreased access to resources (food and money) were 0.23 times more likely to have decreased sleep quality compared to individuals with increased access to resources ( P < 0.001). PWH with no education were 2.83 times more likely to experience sleep disturbance than those with at least some postsecondary education ( P < 0.001).

Conclusions: Our findings demonstrate the COVID-19 pandemic significantly impacted sleep quality and disturbance in PWH.

Keywords: adults with HIV; coronavirus disease 2019; resources; sleep health; social determinants of health.