This study focused on psychological distress in middle-aged and older individuals living with HIV. Data collection began after the implementation of confinement measures for COVID-19 in Quebec and continued through the first wave of the pandemic until COVID incidence in Quebec started to decline and lockdown measures were loosened. The sample for the study was drawn from participants in a longitudinal cohort study of aging with HIV.  Participants completed weekly online questionnaires assessing mental health during this period, and those experiencing high levels of distress were offered clinical follow-up by a psychological intervention team.   The interventions, delivered remotely, were organized according to a series of steps that aimed to adapt the duration, intensity, and goals of intervention based on individual needs assessment. Thus, the first contact between therapist and participant followed the principles and approaches of Psychological First Aid but was combined with an assessment of intensity of need that determined the structure and content of further intervention sessions, based on clinical judgment. When the risk of ongoing distress was moderate or high, patients were offered a course of short-term psychotherapy.  Participants experienced decreased distress levels. The article emphasizes the importance of identifying at-risk individuals and providing psychological support during crisis situations.


Research on the psychosocial impact of COVID-19 has found significant levels of distress among the general population, and among those especially vulnerable due to chronic social or health challenges. Among these are individuals aging with HIV infection, who are encountering COVID-19 as a new infectious threat to their health and wellbeing. In a longitudinal observational study of the psychosocial impact of COVID-19 in middle-aged and older people living with HIV, we identified a subset of participants who expressed heightened levels of distress and were referred for clinical intervention. This paper describes the supportive and contemporary cognitive-behavioral interventions that were provided and presents data on changes in distress in this case series. This work provides a model for identifying people in at-risk groups in acute need of psychological intervention and for implementing an individualized clinical response that can be safely delivered in the context of COVID-19 and future crisis situations.


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