Understanding the clinical impact of COVID-19 has been central to emerging research in the HIV field, but in focusing on the biomedical, researchers must not overlook the socially embedded nature of HIV and the potential social impacts of this new pandemic on PLHIV. We conducted a scoping review to explore emerging research examining the social impacts of COVID-19 on PLHIV in OECD countries over the first 12 months of the pandemic. Twenty articles were identified and included for review. Key themes included: impacts on HIV care access/telehealth; stress and mental health; social isolation and loneliness; food insecurity; changes to sexual behaviour; changes to substance use; impacts on income, education and employment; and racial and social inequality. Results from this review can help guide research into areas where it is needed to help minimise the negative social impacts of the COVID-19 pandemic.

The ageing of the first generation of HIV long-term survivors brings into sharp focus the suffering that activism and the clinical management of HIV has not solved, particularly in regional areas. Although HIV is now usually a manageable chronic condition, it also involves navigating unrelenting social stigma. Quality of life beyond viral suppression is not assured. Despite a history of affected communities demanding equal partnership with health-care providers, an increasingly biomedicalized orientation risks neglecting the psycho-social needs of those with a history of trauma, depression and other co-morbidities often more difficult to manage than HIV itself.

One hundred and sixty-five patients were seen after one week of day-hospital attendance, and 82 of them four weeks later. Their demographic characteristics, and their preferences in day-hospital treatment are described. Non specific factors of getting out of the home and mixing with other people, the opportunity to discuss problems, and taking part in various occupational activities concerned with improving coping skills were seen by the patients as valuable. Staff visits to the patient's home, family interviews and ward rounds were much less supported.

Kate Rears provided 13 hours of professional editing services, primarily proof reading of the thesis post-examination to ensure consistency.Chris Howard who worked for Positive Directions and then Queensland Positive People was a particularly active and insightful collaborator throughout the study.Throughout this journey, Charoensak Srikanchana, my partner of 23 years, provided unfailing support, kindness and enthusiasm, as well as practical support such as delicious meals for interview teams in the field.

Introduction Cervical cancer is the commonest cancer among Zimbabwean women; HIV positive women are disproportionately affected. Access to cervical cancer screening (CCS) is suboptimal. To improve access, PSI-Zimbabwe integrated CCS with HIV testing services from September 2013. We used serial qualitative interviews to explore evolution of client views on service integration and barriers and facilitators to CCS uptake. Methods In-depth interviews were held with clients at four clinics providing integrated services in November/2013-March/2014 and November/2014-March/2015. Interviews were audiorecorded, transcribed, translated and analysed thematically. Results 32 and 37 women accessing integrated services were interviewed in Phases 1&2 respectively. Participants (aged 18-52 years) included women who had declined CCS and women who had been screened. Demand increased and views on CCS became more positive over time. In both phases women were positive about services being integrated because it enabled i) access to services under one roof; ii) information to spread (many in Phase 1 had not known about CCS before visiting integrated services for other reasons). Other factors that facilitated CCS uptake were i) knowing someone who have suffered/died of cervical cancer, ii) peers iii) having suspicious symptoms iv) free services. Barriers were the same across phases; i) fear of cancer diagnosis which was greater among HIV positive women ii) concern that CCS is complex, women sometimes called it 'an operation' iii) belief that the cervix is very fragile and should not be tampered with, some feared that 'tampering' would cause cancer. Low risk perception was common with many believing that i) only old/HIV positive women are affected, ii) absence of signs/symptoms equates with low risk of disease. Conclusion Integration has increased access to CCS while also facilitating spread of information on CCS, resulting in more positive views over time. Interventions that address myths/misconceptions are likely to improve uptake of CCS. Disclosure of interest statement The study was funded by the Integrated Support Programme and no conflicts of interest are declared.