Challenges and Innovation in Community-Based Organization HIV/AIDS Services During COVID-19 in China

Abstract

Introduction People living with HIV relied on community-based organizations (CBOs) in accessing HIV care and support during the COVID-19 pandemic in China. However, little is known on the impact of, and challenges faced by Chinese CBOs supporting PLHIV during lockdowns. Methods A mixed methods study was conducted among 29 CBOs serving PLHIV in China between November 10 and November 23, 2020. Participants were asked to complete a 20-minute online survey on their routine operations, organizational capacity building, service provided, and challenges during the pandemic. A focus group interview was conducted with CBOs after the survey to gain further insights on data interpretations. Quantitative data analysis was conducted using STATA 17.0 while qualitative data was examined using thematic analysis. Results HIV-focused CBOs in China serve diverse clients including PLHIV, high-risk groups, and the general public. The scope of services provided is broad, ranging from HIV testing to peer support. All CBOs maintained their services during the pandemic, many by switching to online or hybrid mode. Many CBOs reported adding new clients and services, such as mailing medications. Top challenges faced by CBOs included service reduction due to staff shortage, lack of PPE for staff, and lack of funding during COVID-19 lockdowns. In addition to the staff and funding needs, the ability to better network with other CBOs and other sectors (e.g., clinics, governments), a standard emergency response guideline, and ready strategies to help PLHIV build resilience are critical for future emergency preparation. Conclusions Chinese CBOs serving vulnerable populations affected by HIV/AIDS are instrumental in building resilience in their communities during the COVID-19 pandemic, and they can play significant roles in providing uninterrupted services during emergencies by mobilizing resources, creating new services and operation methods, and utilizing existing networks. Chinese CBOs’ experiences, challenges, and their policy recommendations can inform policy makers on how to support future CBO capacity building to bridge service gaps during crises and reduce health inequalities in China and globally.