Abstract
The purpose of this study was to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic and mitigation efforts on health and social outcomes for people with HIV at the individual, social, and structural levels of the Social Ecological Model. The International Nursing Network for HIV collected data for a cross-sectional survey of people with HIV in Botswana, Canada, Colombia, Hong Kong, Kenya, Nigeria, South Africa, Thailand, and the United States from August 2021 through June 2023. Among 1,400 participants, 47.5% experienced decreased quality of life, 40.9% experienced increased anxiety, 33.0% had reduced connection with friends, and 38.8% had reduced access to resources. Participants' reported impacts of COVID-19 varied by socioeconomic factors. Among these people with HIV, changes in quality of life, anxiety, social connectedness, and access to resources due to the COVID-19 pandemic were significantly associated with individual, social, and structural level factors using the Social Ecological Framework.