Self-silencing, resilience, depression, & anti-retroviral treatment (ART) adherence among racially and ethnically minoritized women living with HIV during the COVID-19 pandemic.

Minoritized U.S. women living with HIV face persistent health disparities. Coping strategies like self-silencing are linked to depression and poorer HIV outcomes, while resilience may be protective. COVID-19 further intensified these challenges. We surveyed 85 African American/Black and Hispanic/Latina women receiving care at a Los Angeles public HIV clinic. Participants completed measures of self-silencing, resilience, depression and ART adherence, and open-ended pandemic-related questions. Mean age was 37.1 years; 71% were Hispanic/Latina, and 41% reported prior COVID-19. Overall, 33% (n = 27) had low resilience, 25% (n = 63) mild-to-severe depression, and 36% (n = 27) low ART adherence. In multivariable analyses, living with HIV ≥15 years (vs. <15 years) was associated with 3.94 greater odds of depression (p < .01) and was significant for participants with self-reported prior COVID-19 (p = .02) vs. those without COVID-19 (p = .97). Self-silencing was positively associated with depression (p = .0005), and significant for those living ≥15 years with HIV (p = .0002) compared to <15 years (p = .38). Open-ended responses highlighted emotional distress, financial insecurity, healthcare disruptions, and reliance on social support and spirituality. Findings underscore heightened vulnerability among those living longer with HIV and support culturally responsive interventions during public health crises.