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

Adugna, Asmamaw; Azanaw, Jember; Melaku, Mequannent Sharew

doi:10.2147/hiv.s341012

Cited by 19 publications

(25 citation statements)

References 19 publications

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“…Similarly, another included study in this review conducted among healthcare providers reported ART application service suspension or postponement due to COVID-19 restrictions or short supplies [ 32 ]. A similar study carried out in Northwest Ethiopia reported a substantial decline in ART services between 2019 and 2020 due to a full national lockdown [ 35 ]. Another similar study in China reported difficulties with refilling ART stocks due to lockdowns [ 36 ].…”

Section: Resultsmentioning

confidence: 99%

“…Chronic diseases generally account for about 60% of all deaths worldwide. HIV is one of the leading causes of death worldwide, with about 690,000 people dying each year [ 11 , 12 ]. Global efforts to combat HIV have been hampered since the outbreak of the coronavirus (COVID-19), and global funding to respond to the disease has dwindled [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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“…While clinics in high-prevalence settings were less http://onlinelibrary.wiley.com/doi/10.1002/jia2.26036/full | https://doi.org/10.1002/jia2.26036 likely to report suspending HIV services and appointments, other care-seeking barriers (e.g. lockdown restrictions, transportation and financial barriers, and concerns about COVID-19 exposure) may have presented insurmountable obstacles for patients in these settings, and early data from diverse settings have highlighted sharp decreases in healthcare-seeking for HIV-related services early in the pandemic, including HIV prevention [49,53], diagnosis [24,41,42,[44][45][46][47][48][53][54][55] and treatment [24,43,44,53,55,56], as well as diagnostics and treatment for other infectious diseases and chronic conditions [55][56][57][58]. While some studies in sub-Saharan Africa have reported rebounds in HIV testing and ART initiation [24,59], our findings related to stockouts of second-and third-line ART regimens in high-prevalence and low/lower-income settings are concerning, as the lack of such essential medicines may result in setbacks for both HIV treatment and prevention.…”

Section: Discussionmentioning

confidence: 99%

Service delivery challenges in HIV care during the first year of the COVID‐19 pandemic: results from a site assessment survey across the global IeDEA consortium

Ajeh¹,

Lee

Shamu

et al. 2022

J Int AIDS Soc.

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Introduction Interruptions in treatment pose risks for people with HIV (PWH) and threaten progress in ending the HIV epidemic; however, the COVID‐19 pandemic's impact on HIV service delivery across diverse settings is not broadly documented. Methods From September 2020 to March 2021, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium surveyed 238 HIV care sites across seven geographic regions to document constraints in HIV service delivery during the first year of the pandemic and strategies for ensuring care continuity for PWH. Descriptive statistics were stratified by national HIV prevalence (<1%, 1–4.9% and ≥5%) and country income levels. Results Questions about pandemic‐related consequences for HIV care were completed by 225 (95%) sites in 42 countries with low ( n = 82), medium ( n = 86) and high ( n = 57) HIV prevalence, including low‐ ( n = 57), lower‐middle ( n = 79), upper‐middle ( n = 39) and high‐ ( n = 50) income countries. Most sites reported being subject to pandemic‐related restrictions on travel, service provision or other operations (75%), and experiencing negative impacts (76%) on clinic operations, including decreased hours/days, reduced provider availability, clinic reconfiguration for COVID‐19 services, record‐keeping interruptions and suspension of partner support. Almost all sites in low‐prevalence and high‐income countries reported increased use of telemedicine (85% and 100%, respectively), compared with less than half of sites in high‐prevalence and lower‐income settings. Few sites in high‐prevalence settings (2%) reported suspending antiretroviral therapy (ART) clinic services, and many reported adopting mitigation strategies to support adherence, including multi‐month dispensing of ART (95%) and designating community ART pick‐up points (44%). While few sites (5%) reported stockouts of first‐line ART regimens, 10–11% reported stockouts of second‐ and third‐line regimens, respectively, primarily in high‐prevalence and lower‐income settings. Interruptions in HIV viral load (VL) testing included suspension of testing (22%), longer turnaround times (41%) and supply/reagent stockouts (22%), but did not differ across settings. Conclusions While many sites in high HIV prevalence settings and lower‐income countries reported introducing or expanding measures to support treatment adherence and continuity of care, the COVID‐19 pandemic resulted in disruptions to VL testing and ART supply chains that may negatively affect the quality of HIV care in these settings.

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“…There have been some reports of late presenters of an AIDS-defining lifethreatening condition as a result of difficulties accessing hospital care [32]. In addition, during the COVID-19 pandemic, there have been many reports indicating a reduction in HIV testing rates in many countries [33][34][35].…”

Section: Discussionmentioning

confidence: 99%

Incidence and severity prediction score of COVID-19 in people living with HIV (SCOVHIV): experience from the first and second waves of the pandemic in Indonesia

et al. 2022

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Background People living with HIV (PLHIV) have higher risk of COVID-19 infection and mortality due to COVID-19. Health professionals should be able to assess PLHIV who are more likely to develop severe COVID-19 and provide appropriate medical treatment. This study aimed to assess clinical factors associated with COVID-19 severity and developed a scoring system to predict severe COVID-19 infection among PLHIV. Methods This retrospective cohort study evaluated PLHIV at four hospitals diagnosed with COVID-19 during the first and second wave COVID-19 pandemic in Indonesia. The independent risk factors related to the severity of COVID-19 were identified with multivariate logistic regression. Results 342 PLHIV were diagnosed with COVID-19, including 23 with severe-critical diseases. The cumulative incidence up to December 2021 was 0.083 (95% CI 0.074–0.092). Twenty-three patients developed severe-critical COVID-19, and the mortality rate was 3.2% (95% CI 1.61%–5.76%). Having any comorbidity, CD4 count of < 200 cells/mm3, not being on ART, and active opportunistic infection were independent risk factors for developing severe COVID-19. SCOVHIV score was formulated to predict severity, with 1 point for each item. A minimum score of 3 indicated a 58.4% probability of progressing to severe COVID-19. This scoring system had a good discrimination ability with the area under the curve (AUC) of 0.856 (95% CI 0.775–0.936). Conclusion SCOVHIV score, a four-point scoring system, had good accuracy in predicting COVID-19 severity in PLHIV.

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

Cited by 19 publications

References 19 publications

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

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

Service delivery challenges in HIV care during the first year of the COVID‐19 pandemic: results from a site assessment survey across the global IeDEA consortium

Incidence and severity prediction score of COVID-19 in people living with HIV (SCOVHIV): experience from the first and second waves of the pandemic in Indonesia

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