Publications
Resilience, leadership, and crisis competence: Lessons from people living with HIV during the COVID-19 pandemic
2025
Wu, Y., Kaufman, J. E., Manalel, J. A., Gao, A., Antonios, V., Brandenburg, C., Scaccabarrozzi, L., Ernst, J., & Brennan-Ing, M. (2025). Resilience, leadership, and crisis competence: Lessons from people living with HIV during the COVID-19 pandemic. [Poster presentation]. IAS 2025, the 13th IAS Conference on HIV Science, Kigali, Rwanda.
Yiyi Wu, Jennie Kaufman, Jasmine Manalel and Mark Brennan Ing
Introduction: While much research has described the COVID-19 pandemic disruptions to HIV care services, the strategies employed by people living with HIV (PLWH) to cope with these challenges remains understudied. Recognizing PLWH’s active management of their health, this study examined sources of resilience and crisis competence among PLWH in the USA during the COVID pandemic. Our goal was to inform the design of future care engagement initiatives to strengthen crisis resilience in HIV care.
Method: We conducted in-depth interviews with 40 participants (22 cisgender men, 10 cisgender women, 8 transgender/gender diverse; aged between 23 and 64 years) in New York City during the fall of 2023. We asked participants about their experiences during the pandemic, their coping mechanisms, adaptation to evolving pandemic-related challenges to care engagement, and resources they considered necessary to navigate the healthcare system during the pandemic and beyond.
Findings: Proactive resource-seeking and self-advocacy, involving collaboration with multiple stakeholders across social agencies and their personal networks, enabled many PLWH to effectively manage their care needs and maintain the standard of care they desired. Participants’ prior and ongoing community engagement and leadership roles had fostered resilience, enabling them to navigate social mitigation efforts like lockdowns. Despite challenges, participants demonstrated competency in managing their own care while also providing support to others in the HIV community. Additionally, several PLWH advocated for greater involvement of patients in decisions about their health care and the design of healthcare systems overall.
Implications: Findings reveal how PLWH leverage the knowledge cultivated through years of managing their HIV to overcome pandemic-related care challenges. This study further highlights the enduring value of community engagement in fostering crisis resilience. To build a more resilient healthcare delivery system for PLWH, clinical practice should work with community programs and peer-led interventions in a collaborative manner. Moreover, it is important for PLWH to be acknowledged as leaders within their communities. Future research on HIV care engagement should avoid defining this population solely by their vulnerabilities but recognize their resilience, strengths, and leadership qualities as resources in maintaining engagement in care.