The impact of COVID‐19 on HIV testing in the UK’s first Fast‐Track HIV city

Wenlock, Rhys; Shillingford, Chante; Mear, John; Churchill, Duncan; Vera, Jaime H.; Dean, Gillian

doi:10.1111/hiv.13235

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…A study performed in Brighton (UK) have shown that by June 2021 testing had still not returned to normal across the city. 32 A new analysis on new data collected is planned and will allow to check if testing had recovered the numbers of before the COVID-19 pandemic.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on community-based testing for HIV, viral hepatitis and sexually transmitted infections in the WHO European Region, March to August 2020

Fernàndez‐López

Simões

Casabona

et al. 2023

European Journal of Public Health

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Background COVID-19 affected testing for HIV, viral hepatitis and sexually transmitted infections (STIs) worldwide. We aimed to assess the impact of the COVID-19 pandemic on community-based voluntary, counselling and testing (CBVCT) services for those infections in the WHO European Region. Methods An online survey was distributed between 14 October and 13 November 2020 to testing providers in the WHO European Region. Key questions included: impact on testing volume, reasons for this impact, measures to mitigate, economic effects, areas where guidance or support were needed. A descriptive analysis on data reported by CBVCT services was performed. Results In total, 71 CBVCT services from 28 countries completed the survey. From March to May 2020, compared to the same period in 2019, most respondents reported a very major decrease (>50%) in the volume of testing for all the infections, ranging from 68% (Chlamydia) to 81% (HCV), and testing levels were not recovered during post-confinement. Main reasons reported were: site closure during lockdown (69.0%), reduced attendance and fewer appointments scheduled (66.2%), reduced staff (59.7%), and testing only by appointment (56.7%). Measures implemented to mitigate the decreased testing were remote appointments (64.8%), testing by appointment (50.7%), referral to other sites (33.8%), testing campaigns (35.2%) and promotion of self-testing (36.6%). Eighty-two percent of respondents reported a need for guidance/support. Conclusion Results suggest that people attending CBVCT services experienced reductions in access to testing compared to before the pandemic. National governmental agencies need to support European CBVCT services to ensure recovery of community counselling and testing.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on community-based testing for HIV, viral hepatitis and sexually transmitted infections in the WHO European Region, March to August 2020

Fernàndez‐López

Simões

Casabona

et al. 2023

European Journal of Public Health

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“…With data from 225 HIV treatment sites across 42 countries at the end of the first year of the COVID-19 pandemic, this study found that most had experienced disruptions in clinic operations and in the provision of HIV care. Such disruptions were reported by sites across high-, medium-and low-HIV prevalence settings and country income levels, reinforcing concerns raised by modelling studies [9,[11][12][13] and observational research [41][42][43][44][45][46][47][48][49] about the potential of COVID-19 to reverse progress towards 95-95-95 UNAIDS targets to end the HIV epidemic, particularly in settings with a high HIV burden [50].…”

Section: Discussionmentioning

confidence: 99%

“…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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“…Thirty-seven documents were included in our study. Seventeen papers [ 25 , 34 – 49 ] were included in the meta-analysis related to HIV testing, see Supplementary Table 2. For the meta-synthesis related to HIV service adaptations, 20 papers [ 50 – 69 ] were included, see Supplementary Table 3.…”

Section: Resultsmentioning

confidence: 99%

HIV Testing Disruptions and Service Adaptations During the COVID-19 Pandemic: A Systematic Literature Review

Mude,

Mwenyango,

Preston

et al. 2023

AIDS Behav

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Access to treatment and care in safe clinical settings improves people’s lives with HIV. The COVID-19 pandemic disrupted vital HIV programs and services, increasing the risk of adverse health outcomes for people with HIV and HIV transmission rates in the community. This systematic literature review provides a meta-analysis of HIV testing disruptions and a synthesis of HIV/AIDS services adapted during COVID-19. We searched scholarly databases from 01 January 2020 to 30 June 2022 using key terms on HIV testing rates and services during the COVID-19 pandemic. The process of how the included articles were identified, selected, appraised, and synthesised was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included 17 articles that reported changes in HIV testing during the COVID-19 pandemic and 22 that reported adaptations in HIV/AIDS services. We found that HIV testing decreased by 37% during the search period because of the COVID-19 pandemic. Service providers adopted novel strategies to support remote service delivery by expanding community antiretroviral therapy dispensing, setting up primary care outreach points, and instituting multi-month dispensing services to sustain client care. Therefore, service providers and policymakers should explore alternative strategies to increase HIV testing rates impacted by COVID-19 and leverage funding to continue providing the identified adapted services.

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The impact of COVID‐19 on HIV testing in the UK’s first Fast‐Track HIV city

Cited by 5 publications

References 20 publications

Impact of the COVID-19 pandemic on community-based testing for HIV, viral hepatitis and sexually transmitted infections in the WHO European Region, March to August 2020

Impact of the COVID-19 pandemic on community-based testing for HIV, viral hepatitis and sexually transmitted infections in the WHO European Region, March to August 2020

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

HIV Testing Disruptions and Service Adaptations During the COVID-19 Pandemic: A Systematic Literature Review

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