The impact of COVID-19 pandemic on HIV care continuum in Jiangsu, China

Abstract

Background The COVID-19 pandemic seriously threatens general public health services globally. This study aimed to evaluate the impact of the COVID-19 pandemic on the HIV care continuum in Jiangsu province, China. Methods Data on newly diagnosed HIV persons for analysis were retrieved from Chinas’ web-based Comprehensive Response Information Management System (CRIMS) for HIV/AIDS from 2016 to 2020. We recorded data for the first 3 months (January to March, 2020) of strictly implementing COVID-19 measures from publicly available disease databases of the Jiangsu provincial Health Committee. We used seasonal autoregressive integrated moving average (SARIMA) and exponential smoothing in forecasting the parameters. Subgroup differences were accessed using Chi-square tests. Results Compared to the estimated proportions, the HIV testing rates decreased by 49.0% (919,938) in the first three months of implementing COVID-19 measures. Of an estimated 1555 new HIV diagnosis expected in the same period, only 63.0% (980) new diagnoses were recorded. According to actual data recorded during the said period, 980 positively tested persons received confirmatory tests, of which 71.4% (700) were reportedly linked to care. And only 49.5% (235) out of the expected 475 newly diagnosed HIV persons received CD4 cell count testing. Meanwhile 91.6% (208) of newly diagnosed HIV persons who received CD4 count tests reportedly initiated antiretroviral therapy (ART) compared to the 227 expected. Compared to the same period from 2016 to 2019, PLWH less than 30 years old and migrants were more likely to be affected by the COVID-19 policies. Conclusions The COVID-19 pandemic negatively impacted HIV healthcare systems in Jiangsu, China. Further measures that can counter the impact of the pandemic are needed to maintain the HIV care continuum.

Research Progress in the Epidemiology of HIV/AIDS in China

“…From January 1 to April 16, 2020, 35 (0.58%) of 6,001 PLWH experienced COVID-19 in Wuhan city, and 197 (3.3%) had discontinued ART despite tremendous supportive efforts from both governmental and non-governmental organizations ( 66 ). In Jiangsu Province, the HIV testing rates decreased by 49.0% (919,938) in the first three months of implementing COVID-19 measures ( 67 ). Of an estimated 1,555 new HIV diagnoses expected in the same period, only 63.0% new diagnoses were recorded ( 67 ).…”

“…In Jiangsu Province, the HIV testing rates decreased by 49.0% (919,938) in the first three months of implementing COVID-19 measures ( 67 ). Of an estimated 1,555 new HIV diagnoses expected in the same period, only 63.0% new diagnoses were recorded ( 67 ). Links to HIV healthcare services including CD4 testing and ART were also seriously affected ( 67 ).…”

“…Of an estimated 1,555 new HIV diagnoses expected in the same period, only 63.0% new diagnoses were recorded ( 67 ). Links to HIV healthcare services including CD4 testing and ART were also seriously affected ( 67 ). Alternative or substitute ways to access healthcare for HIV during the COVID-19 epidemic might be considered.…”

Cost-effectiveness of oral pre-exposure prophylaxis and expanded antiretroviral therapy for preventing HIV infections in the presence of drug resistance among men who have sex with men in China: A mathematical modelling study

“…There were over 31,000 people living with HIV (PLWH) in Jiangsu by the end of 2020. 28 Among newly diagnosed people living with HIV, the proportion infected through same sex sexual activity increased from 28·0% in 2008 to 56·0% in 2020. 28 Since 2019, Jiangsu province has set up HIV PrEP and PEP service network with 28 outpatient service points of PEP.…”

“… 28 Among newly diagnosed people living with HIV, the proportion infected through same sex sexual activity increased from 28·0% in 2008 to 56·0% in 2020. 28 Since 2019, Jiangsu province has set up HIV PrEP and PEP service network with 28 outpatient service points of PEP. 29 However, PrEP have not been implemented in Jiangsu to date.…”