Exploring Health-seeking and High-risk Behavior among People Living with HIV (PLHIV) during the COVID-19 Pandemic in Tripura

A BSTRACT Background: The COVID-19 pandemic had far-reaching and unexpected consequences on global healthcare systems and this study addresses the insufficiently explored impact of the COVID-19 pandemic on healthcare services for people living with HIV (PLHIV) in Tripura, focusing on health-seeking behavior, high-risk behavior, and interruptions in antiretroviral therapy (ART). Material and Methods: This institution-based cross-sectional study, conducted at the ART Plus Centre of Tripura from July to September 2022, included HIV-positive individuals aged 18 and above who provided consent. Exclusions comprised seriously ill individuals, those registered after July 31, 2021, and those with follow-up visits during the study. Using non-probability sampling, 192 participants were interviewed using a pre-tested questionnaire. Data were analyzed using Microsoft Excel and IBM SPSS. Quantitative variables were expressed as mean (±SD), while categorical variables were described using frequency and percentages. Results: The study included 192 participants with a mean age of 32.3 (±7.5) years, ranging from 18 to 46. Most were male (66.2%), and rural residents (67.8%). Risky behaviors included irregular condom use (56.1%), engaging in sex for money (24.5%), and injectable drug use (21.9%), with 30.9% sharing syringes. Most received both COVID-19 vaccine doses (97.4%) and 64.1% initiated ART within the last five years. Notably, 91.7% reported uninterrupted ART during the COVID-19 lockdown. Conclusions: In summary, this study on PLHIV highlights alarming high-risk behaviors, such as inconsistent condom use and sex for money. Recreational drug use raises transmission concerns. COVID-19-related ART interruptions were minimal, with monthly medicine dispensing aiding adherence.