Impact of the COVID-19 Pandemic on HIV Care Continuum in Jiangsu, China

Abstract

BackgroundThe COVID-19 pandemic seriously threatens general public health services globally. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV care continuum in Jiangsu province, China. MethodsData for analysis was retrieved from the web-based Comprehensive Response Information Management System (CRIMS) for HIV/AIDS in China. We used time series model of seasonal autoregressive integrated moving average (SARIMA) and Exponential smoothing to predict the amount of HIV care services during the COVID-19 measures, and Chi-square were performed to assess subgroup differences. ResultsOverall, the testing rated decreased 49.0% (919,938) decrease in the rst three months during the COVID-19 measures, as compared with the estimated number. Although an estimated of 1555 con rmatory tests were expected in the rst three months during the COVID-19 measures, only 48.7% (757) con rmed HIV/AIDS cases were actually recorded. In the actual data during the rst period of COVID-19, 980 clients received con rmatory tests, only 71.4% (700) were reportedly linked to care. Only 49.5% (235) out of the expected 475 estimated number of clients received CD4 cell count test services. Meanwhile 91.23% (208) had initiated antiretroviral therapy (ART) which compared to 227 the estimated number of initiated ART. Compared with the same period during 2016 to 2019, PLWHIV who were less than 30, migrants were more likely to be in uenced by the COVID-19 policies. ConclusionsThe COVID-19 pandemic had a negative impact on the HIV healthcare systems in Jiangsu, China. Further measures that can encounter the impact of the pandemic are needed, in order to maintain HIV care continuum.

Estimating the impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China

“…Although disruptions to VS had consequences for HIV incidence/mortality, data from Jiangsu [17] indicated no change in VS among PLWH due to COVID-19 disruption. Other surveys among PLWH in China indicate disruptions to ART access [4] which could lead to reductions in VS.…”

“…Our analysis has some limitations which should be acknowledged. Not all of the disruption estimates were MSM specific, and MSM may have had more substantial disruption when compared to other populations (MSM facility testing was reduced by 59%, compared to 29% for the entire population [17]). Therefore, we may have underestimated the disruption to ART initiations.…”

“…Estimates of changes in HIV testing (among MSM), treatment initiation and viral load suppression (among all PLWH) came from surveillance data from Jiangsu province (HIV testing/clinics), from the first quarter of 2019 and 2020 [17]. Estimates of changes in number of sexual partners and consistency of condom use came from an online survey conducted among MSM (N=731) across 31 provinces in China between 18/05/2020-02/06/2020, during the COVID-19 pandemic.…”

“…for the entire population [17]). Therefore, we may have underestimated the disruption to ART initiations.…”