Impact of the COVID-19 pandemic on HIV care in Guatemala

HIV Testing Disruptions and Service Adaptations During the COVID-19 Pandemic: A Systematic Literature Review

Access to treatment and care in safe clinical settings improves people's lives with HIV. The COVID-19 pandemic disrupted vital HIV programs and services, increasing the risk of adverse health outcomes for people with HIV and HIV transmission rates in the community. This systematic literature review provides a meta-analysis of HIV testing disruptions and a synthesis of HIV/AIDS services adapted during COVID-19. We searched scholarly databases from 01 January 2020 to 30 June 2022 using key terms on HIV testing rates and services during the COVID-19 pandemic. The process of how the included articles were identified, selected, appraised, and synthesised was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included 17 articles that reported changes in HIV testing during the COVID-19 pandemic and 22 that reported adaptations in HIV/AIDS services. We found that HIV testing decreased by 37% during the search period because of the COVID-19 pandemic. Service providers adopted novel strategies to support remote service delivery by expanding community antiretroviral therapy dispensing, setting up primary care outreach points, and instituting multi-month dispensing services to sustain client care. Therefore, service providers and policymakers should explore alternative strategies to increase HIV testing rates impacted by COVID-19 and leverage funding to continue providing the identified adapted services.

Syndemic effect of COVID-19 outbreak on HIV care delivery around the globe: A systematic review using narrative synthesis

Background

The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis.

Methods

This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies.

Results

In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article.

Conclusion

Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat.

Registration

Open Science Framework (DOI: 10.17605/OSF.IO/74GHM).

Progress of the Gulf Cooperation Council (GCC) Countries Towards Achieving the 95-95-95 UNAIDS Targets: A Review

BACKGROUND

In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and partners launched the 90-90-90 targets. These were further updated to correspond to 95-95-95 by the year 2025. We present an overview of the progress made by Gulf Cooperated Council (GCC) countries towards meeting the global targets.

METHODS

We extracted data from Global AIDS Monitoring (GAM), UNAIDS AIDS Info, HIV case reporting database, and the WHO global policy uptake for six countries: Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab of Emirates (UAE) to assess the HIV/AIDS burden in the six GCC countries, and the progress towards achieving the 95-95-95 goal.

RESULTS

By the end of 2021, an estimated 42,015 people living with HIV (PLHIV) were residing in the GCC countries with prevalence levels below 0.01%. Data from four GCC countries, Bahrain, Oman, Qatar and UAE, indicated that by 2021, 94%, 80%, 66%, and 85% of HIV-positive population knew their status, respectively. 68%, 93% (2020 data), 65%, 58% and 85% of PLHIV in Bahrain, Kuwait, Oman, Qatar and UAE who knew their status were on anti-retroviral therapy (ART), respectively, and 55%, 92%, 58% and 90% (2020 data) among those who were on ART had viral suppression in Bahrain, Kuwait, Oman and KSA, respectively.

CONCLUSION

The GCC countries have made great strides toward fulfilling the 95-95-95 targets, but the interim 2025 overall UNAIDS targets remain unmet. The GCC countries must strive diligently to accomplish the targets by emphasising early identification of the cases by enhanced screening and testing, as well as prompt commencement of ART therapy with viral load suppression.

The impact of COVID-19 lockdown on cases and deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C in China: an interrupted time series analysis

BACKGROUND

China has implemented nationwide lockdown to contain COVID-19 from an early stage. Previous studies of the impact of COVID-19 on sexually transmitted diseases (STDs) and diseases caused by blood-borne viruses (BBVs) in China have yielded widely disparate results, and study on deaths attributable to STDs and BBVs are scarce.

OBJECTIVE

We aimed to elucidate the impact of COVID-19 lockdown on the cases, deaths, and case-fatality ratios of STDs and BBVs.

METHODS

We extracted the monthly cases and deaths data for AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C between January 2015 and December 2021 from the notifiable disease reporting database on the official website of the National Health Commission of China. We used descriptive statistics to summarize the number of cases and deaths, and calculated incidence and case-fatality ratios before and after implementing nationwide lockdown (January 2020). We used negative binominal segmented regression models to estimate the immediate and long-term impacts of lockdown on cases, deaths, and case-fatality ratios in January 2020 and December 2021, respectively.

RESULTS

A total of 14,800,330 cases and 127,030 deaths of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C were reported from January 2015 to December 2021, with an incidence of 149.11/100,000 before lockdown and 151.41/100,000 after lockdown , and a case-fatality ratio of 8.21/1000 before lockdown and 9.50/1000 after lockdown . In the negative binominal model, AIDS cases (-23.4%; 0.766, 0.626-0.939) and deaths (-23.9%; 0.761, 0.647-0.896), gonorrhea cases (-34.3%; 0.657, 0.524-0.823), syphilis cases (-15.4%; 0.846, 0.763-0.937), hepatitis B cases (-17.5%; 0.825, 0.726-0.937) and hepatitis C cases (-19.6%; 0.804, 0.693-0.933) showed significant decreases in January 2020. Gonorrhea, syphilis and hepatitis C showed small increases in the number of deaths or case-fatality ratios in January 2020. By December 2021, the cases, deaths, and case-fatality ratios for each disease had either reached or remained below expected levels.

CONCLUSIONS

COVID-19 lockdown may have contributed to fewer reported cases of AIDS, gonorrhea, syphilis, hepatitis B, and hepatitis C, and more reported deaths or case-fatality ratios of gonorrhea, syphilis and hepatitis C in China.

CLINICALTRIAL

The impacts of COVID-19 pandemic on service delivery and treatment outcomes in people living with HIV: a systematic review

INTRODUCTION

The COVID-19 epidemic and various control and mitigation measures to combat the widespread outbreak of the disease may affect other parts of health care systems. There is a concern that the COVID-19 pandemic could disrupt HIV services. Therefore, this study aimed to systematically evaluate the effect of the COVID-19 pandemic on service delivery and treatment outcomes in people with HIV.

METHODS

In this study, a systematic search was conducted using the keywords in the online databases including Scopus, PubMed, Web of Science, and Cochrane databases. The retrieved articles underwent a two-step title/abstract and full-text review process, and the eligible papers were selected and included in the qualitative synthesis.

RESULT

We selected 16 studies out of 529 retrieved records that met the inclusion criteria for this review. Study populations of the selected studies were either HIV-positive patients or HIV clinics and healthcare providers. Most studies were focused on adhering to and obtaining medication and attending clinical appointments and their decrement during the pandemic. Other aspects of HIV care (alternative healthcare settings, viral suppression, psychological care, etc.) were discussed to a lesser extent by the included studies.

CONCLUSION

Interruption in in-person visits and medical follow-up services, loss of adherence to treatment, and subsequent increase in mortality due to the COVID-19 pandemic complications in PLHIV have led to growing concerns. Other challenges were psychological disorders such as anxiety and depression, an increase in substance abuse, and a rise in experienced stigma and discrimination. However, the use of telemedicine in some countries helps to alleviate the situation to some extent and is recommended in similar settings in the future.

Response of Care Services for Patients with HIV/AIDS during a Pandemic: Perspectives of Health Staff in Bolivia

The COVID-19 pandemic has caused an unprecedented crisis striking health services, generating risks of setbacks in health care and affecting the most vulnerable populations such as HIV patients. This study aims to explore the impact of the COVID-19 pandemic on the operational management of health services for people living with HIV/AIDS in Cochabamba, Bolivia. We applied a qualitative approach using semi-structured in-depth interviews with ten key health professionals who care for patients with HIV/AIDS in Cochabamba, Bolivia. Interviews were transcribed verbatim and uploaded to Atlas.ti software for analysis. We used an ethnographic approach within the interpretive paradigm to carry out the thematic analysis, considering the "Determinants of health systems resilience framework" of five dimensions developed by the World Health Organization. Even though the provision of services in public care services was not interrupted during the COVID-19 pandemic, health service delivery was severely affected. Digital technology could be used to compensate in urban areas. Regarding the distribution of medications, adaptative strategies to reduce patient complications were implemented. Unfortunately, the complementary tests availability was limited. The COVID-19 pandemic had a significant impact on HIV/AIDS patient care services in Cochabamba, with repercussions for HIV treatment access and virologic suppression.

The Effect of COVID-19 on Routine HIV Care Services from Health Facilities in Northwest Ethiopia

BACKGROUND

There is mounting evidence that the risk of death from COVID-19 among people with HIV could be as much as twice that of the general population. Recent evidence revealed that HIV services has been decreased by 75% and the problem is much more extensive in Ethiopia since most of the logistics for HIV services and fund donated by the good will of NGOs. Understanding the impact of COVID-19 on HIV services is a crucial first step to draw appropriate intervention. Thus, this study aimed to assess the impact of COVID-19 pandemic on HIV services in northwest Ethiopia.

METHODS

An institution-based repeated cross-sectional study was conducted in Gondar city in August 2021. The DHIS-2 system, operated by FMOH contains data from all the nine health facilities for HIV care was used to extract data from the central repository. Excel data was exported to STATA 14 for analysis. We calculated indicators of HIV services, representing the 12 months pre-COVID 19 (2019) and 16 months during the COVID-19 period (2020 and 2021). ANOVA was used to detect the presence of significant mean differences between those periods. Assumptions of ANOVA was checked. The statistical significance was declared at 95% confidence interval (CI), p-value less than 0.05.

RESULTS

The mean difference was significant within HIV_VCT, HIV_PICT, ART between the years 2019 before COVID-19 and 2020 during COVID-19 (p-value < 0.05). HIV_VCT, ART variability was substantial between the years 2019 and 2021 (p-value < 0.05).

CONCLUSION

COVID-19 seriously affected all aspects of HIV service uptake such as HIV VCT, HIV PICT, ART, newly started ART, TB screening, and lost to ART follow-up. This study urges optimizing ART delivery mitigation with the ongoing COVID-19 in Ethiopia and beyond, in order to maintain progress toward HIV epidemic control.

The impact of the COVID-19 pandemic on accessing HIV care: A case report

The coronavirus disease 2019 (COVID-19) pandemic has had an enormous impact on the provision of human immunodeficiency virus (HIV) services amongst people living with HIV. Many people have adopted different health-seeking behaviour in alignment with the lockdown provisions during the COVID-19 pandemic. These lockdown regulations have had a huge impact on healthcare access for people on chronic medication. The disruption of antiretroviral therapy (ART) has a profound effect on HIV-associated morbidity and mortality. The impact on HIV programmes as a result of the interruption in ART could be bigger than the HIV pandemic alone.