Characterizing the Impact of the COVID-19 Pandemic on HIV PrEP care: A Review and Synthesis of the Literature

Hong, Chenglin

doi:10.1007/s10461-022-03941-w

Cited by 12 publications

(5 citation statements)

References 73 publications

(84 reference statements)

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“…Large-scale government mitigation efforts, including "stay-at-home" orders and lock-down measures that intend to limit the number of social contacts and interactions, have slowed the exponential growth of new cases but also led to unprecedented disruptions in society, such as deepening social inequality and exacerbating health disparities among some of the vulnerable populations, such as sexual and gender minorities and people living with HIV (PLWH) [2][3][4]. There is growing evidence suggesting that the pandemic has already influenced the delivery of routine HIV prevention and treatment services and created barriers and challenges to the HIV prevention and care continuum [5][6][7]. PLWH in many settings reported having difficulty seeing their healthcare providers and refilling the antiretroviral medicines since the pandemic began [4].…”

Section: Introductionmentioning

confidence: 99%

The impact of the COVID‐19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review

Hong¹,

Queiroz

Hoskin³

2023

J Int AIDS Soc.

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Introduction:The COVID-19 pandemic and associated measures implemented by authorities have created additional stressors and increased the risk of psychological illnesses among people living with HIV (PLWH). Yet, there is no collective evidence on the mental health status of this population during the global pandemic and associated factors. This scoping review aimed to synthesize the evidence in the current literature related to the mental health outcomes and challenges faced by PLWH during the COVID-19 pandemic, identify the associated factors with psychological distress and summarize various coping strategies to ease these psychological distresses used by this population. Methods: We conducted a scoping review following the PRISMA-ScR guideline and a literature search in four electronic databases in August 2022. Three reviewers independently screened all the search records and extracted the data from studies that met the inclusion criteria. Factors associated with worsened mental health outcomes were synthesized according to the socio-ecological framework. Results: Among 1100 research records, 45 articles met the eligibility criteria and were included in the final review and data extraction, most of which were quantitative analyses. PLWH reported high rates of mental health problems during the pandemic. Multi-level factors were associated with increased psychological distress, including substance use, antiretroviral adherence, social support, financial hardship and economic vulnerability during the pandemic. PLWH used social media as a coping strategy to foster social support to deal with growing mental distress. Increased mental health illnesses were associated with increased substance use, it was also found associated with suboptimal medication adherence and antiretroviral therapy (ART) care engagement. Discussion: PLWH experienced high rates of mental health illnesses, such as depression during the global COVID-19 pandemic. There is an urgent need to provide comprehensive HIV treatment and mental health services as the pandemic continues to evolve. Conclusions: The review summarized how the mental health of PLWH was affected during the COVID-19 pandemic. Future work in the implementation of effective interventions to promote mental health in this population is needed, not only to ensure their quality of life but also to help them maintain ART adherence and healthcare during more unprecedented times.

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Section: Introductionmentioning

confidence: 99%

The impact of the COVID‐19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review

Hong¹,

Queiroz

Hoskin³

2023

J Int AIDS Soc.

Self Cite

View full text Add to dashboard Cite

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“…Although FBOP’s PrEP guidance was released in 2021, many facilities had to prioritize healthcare resources for the COVID-19 pandemic response at that time. A review of 46 studies suggests the COVID-19 pandemic disrupted continuity of PrEP care in a variety of settings ( 17 ). As FBOP transitions out of pandemic response and returns to routine care, integrating evaluation for PrEP as part of a holistic approach to preparing AICs for release back to their communities will enable improved access to care and harm reduction.…”

Section: Discussionmentioning

confidence: 99%

HIV Care Continuum and Preexposure Prophylaxis Program in Federal Bureau of Prisons, United States

Huang,

Thompson,

Rodriguez

2024

Emerg. Infect. Dis.

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In 2019, the US Department of Health and Human Services launched the Ending the HIV Epidemic in the US initiative (EHE) with the goal of reducing new HIV infections by 90% by 2030. This initiative identifies 4 pillars (diagnose, treat, prevent, and respond) to address the HIV epidemic in the United States. To advance the EHE goals, the Federal Bureau of Prisons (FBOP) has implemented interventions at all points of the HIV care continuum. The FBOP has addressed the EHE pillar of prevention through implementing preexposure prophylaxis, developing a strategy to decrease the risk of new HIV infection, and providing guidance to FBOP healthcare providers. This article describes the implementation of programs to improve the HIV care continuum and end the epidemic of HIV within the FBOP including a review of methodology to implement an HIV preexposure prophylaxis program.

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“…shifting resources) but also transformative, resulting in service delivery innovations [30][31][32]. This transformative capacity of providers was also apparent in many recent reports on COVID-19-induced adaptations to PrEP service delivery [33][34][35][36]. Yet, considerably fewer studies have focused on PrEP providers' adaptive responses under "normal" conditions [19,20].…”

Section: Discussionmentioning

confidence: 99%

Understanding adaptive responses in PrEP service delivery in Belgian HIV clinics: a multiple case study using an implementation science framework

Vanhamel,

Reyniers,

Vuylsteke

et al. 2024

J Int AIDS Soc.

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IntroductionIn Belgium, oral HIV pre‐exposure prophylaxis (PrEP) is primarily provided in specialized clinical settings. Optimal implementation of PrEP services can help to substantially reduce HIV transmission. However, insights into implementation processes, and their complex interactions with local context, are limited. This study examined factors that influence providers’ adaptive responses in the implementation of PrEP services in Belgian HIV clinics.MethodsWe conducted a qualitative multiple case study on PrEP care implementation in eight HIV clinics. Thirty‐six semi‐structured interviews were conducted between January 2021 and May 2022 with a purposive sample of PrEP care providers (e.g. physicians, nurses, psychologists), supplemented by 50 hours of observations of healthcare settings and clinical interactions. Field notes from observations and verbatim interview transcripts were thematically analysed guided by a refined iteration of extended Normalisation Process Theory.ResultsImplementing PrEP care in a centralized service delivery system required considerable adaptive capacity of providers to balance the increasing workload with an adequate response to PrEP users’ individual care needs. As a result, clinic structures were re‐organized to allow for more efficient PrEP care processes, compatible with other clinic‐level priorities. Providers adapted clinical and policy norms on PrEP care (e.g. related to PrEP prescribing practices and which providers can deliver PrEP services), to flexibly tailor care to individual clients’ situations. Interprofessional relationships were reconfigured in line with organizational and clinical adaptations; these included task‐shifting from physicians to nurses, leading them to become increasingly trained and specialized in PrEP care. As nurse involvement grew, they adopted a crucial role in responding to PrEP users’ non‐medical needs (e.g. providing psychosocial support). Moreover, clinicians’ growing collaboration with sexologists and psychologists, and interactions with PrEP users’ family physician, became crucial in addressing complex psychosocial needs of PrEP clients, while also alleviating the burden of care on busy HIV clinics.ConclusionsOur study in Belgian HIV clinics reveals that the implementation of PrEP care presents a complex—multifaceted—undertaking that requires substantial adaptive work to ensure seamless integration within existing health services. To optimize integration in different settings, policies and guidelines governing PrEP care implementation should allow for sufficient flexibility and tailoring according to respective local health systems.

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Characterizing the Impact of the COVID-19 Pandemic on HIV PrEP care: A Review and Synthesis of the Literature

Cited by 12 publications

References 73 publications

The impact of the COVID‐19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review

The impact of the COVID‐19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review

HIV Care Continuum and Preexposure Prophylaxis Program in Federal Bureau of Prisons, United States

Understanding adaptive responses in PrEP service delivery in Belgian HIV clinics: a multiple case study using an implementation science framework

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