Disrupted HIV care during COVID-19 pandemic associated with increased disabilities among people living with HIV in Belize

The COVID-19 pandemic may have impacted disabilities among people living with HIV; however, data on the association between COVID-19 pandemic-related healthcare disruptions and disabilities among people living with HIV is limited. We aimed to evaluate the association between COVID-19-affected HIV care behaviors and disability domains among people living with HIV in Belize. A cross-sectional study was conducted at the Western Regional Hospital and Southern Regional Hospital between August and October 2021 among people living with HIV in Belize aged >= 21 years and on antiretroviral therapy. A self-reported questionnaire captured data on demographic and clinical characteristics (gender, age, ethnicity, marital status, employment, education, CD4 count, and viral load), COVID-19-affected HIV care behaviors, and disability across six domains (physical, cognitive, and mental-emotional symptoms and impairments; uncertainty; difficulties carrying out day-to-day activities; and social inclusion challenges) using the Short-Form HIV Disability Questionnaire. Univariate and multivariate logistic regression analyses were employed to analyze the data. Of the 489 participants, 276 (56.4%) were women and 213 (43.6%) were men. After adjusting for covariates, (age, gender, employment, CD4 count, viral load, COVID-19-affected HIV care behaviours), our results showed that people living with HIV, whose HIV care behaviors were greatly affected by COVID-19, were more likely to have disabilities across various domains: physical (adjusted odds ratio (AOR): 1.61, 95% confidence interval (CI): 1.08-2.41, p = 0.018), cognitive (AOR: 2.49, 95% CI: 1.58-3.94, p < 0.001), uncertainty (AOR: 2.94, 95% CI: 1.68-5.12, p < 0.001), difficulties carrying out day-to-day activities (AOR: 1.69, 95% CI: 1.06-2.69, p = 0.027), and social inclusion challenges (AOR: 1.89, 95% CI: 1.27-2.81, p = 0.002). Mitigating disruptions in care behaviors through the implementation of more accessible and comprehensive healthcare services may potentially address the multifaceted nature of HIV disabilities.