COVID/HIV Co-infection: A Syndemic Perspective on What to Ask and How to Answer

Hailay Gesesew, Lillian Mwanri, Jacqueline H Stephens, Kifle Woldemichael, Paul Ward

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)
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The present commentary explored the intersecting nature of the COVID-19 and HIV pandemics to identify a shared research agenda using a syndemic approach. The research agenda posits the following questions. Questions around HIV infection, transmission, and diagnosis include: (i) molecular, genetic, clinical, and environmental assessments of COVID-19 in people living with HIV, (ii) alternative options for facility-based HIV testing services such as self- and home-based HIV testing, and (iii) COVID-19 related sexual violence and mental health on HIV transmission and early diagnosis. These and related questions could be assessed using Biopsychosocial and socio-ecological models. Questions around HIV treatment include: (i) the effect of COVID-19 on HIV treatment services, (ii) alternative options for facility-based treatment provision such as community-based antiretroviral therapy groups, and (iii) equitable distribution of treatment and vaccines for COVID-19, if successful. Bickman's logic model and the social determinants of health framework could guide these issues. The impact of stigma, the role of leveraging lessons on sustained intra-behavioral change, the role of medical mistrust and conspiracy beliefs, and the role of digital health on integrated management of HIV care and spectrum of care of COVID-19 need assessment using several frameworks including Goffman's stigma framework, Luhmann's Trust theory, and Gidden's theory of structuration. In conclusion, the potential research agenda of this commentary encompasses a variety of research fields and disciplinary areas—clinicians, laboratory scientists, public health practitioners, health economists, and psychologists—, and suggests several theoretical frameworks to guide examination of complex issues comprehensively.

Original languageEnglish
Article number623468
Number of pages7
JournalFrontiers in Public Health
Publication statusPublished - 10 Mar 2021


  • COVID-19
  • HIV
  • HIV care continuum
  • framework
  • syndemic approach


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