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COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic

INTRODUCTION: The COVID-19 pandemic has impacted population health around the globe, directly and indirectly. The objective of this study was to document changes in HIV care associated with the COVID-19 pandemic at selected clinics in Central Africa, along with clinic-level strategies for minimizing...

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Autores principales: Rogers, Ajeh, Brazier, Ellen, Dzudie, Anastase, Adedimeji, Adebola, Yotebieng, Marcel, Muhoza, Benjamin, Twizere, Christella, Lelo, Patricia, Nsonde, Dominique, Mafoua, Adolphe, Munyaneza, Athanase, Gateretse, Patrick, Diafouka, Merlin, Murenzi, Gad, Niyongabo, Théodore, Anastos, Kathryn, Nash, Denis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710788/
https://www.ncbi.nlm.nih.gov/pubmed/36449454
http://dx.doi.org/10.1371/journal.pone.0275429
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author Rogers, Ajeh
Brazier, Ellen
Dzudie, Anastase
Adedimeji, Adebola
Yotebieng, Marcel
Muhoza, Benjamin
Twizere, Christella
Lelo, Patricia
Nsonde, Dominique
Mafoua, Adolphe
Munyaneza, Athanase
Gateretse, Patrick
Diafouka, Merlin
Murenzi, Gad
Niyongabo, Théodore
Anastos, Kathryn
Nash, Denis
author_facet Rogers, Ajeh
Brazier, Ellen
Dzudie, Anastase
Adedimeji, Adebola
Yotebieng, Marcel
Muhoza, Benjamin
Twizere, Christella
Lelo, Patricia
Nsonde, Dominique
Mafoua, Adolphe
Munyaneza, Athanase
Gateretse, Patrick
Diafouka, Merlin
Murenzi, Gad
Niyongabo, Théodore
Anastos, Kathryn
Nash, Denis
author_sort Rogers, Ajeh
collection PubMed
description INTRODUCTION: The COVID-19 pandemic has impacted population health around the globe, directly and indirectly. The objective of this study was to document changes in HIV care associated with the COVID-19 pandemic at selected clinics in Central Africa, along with clinic-level strategies for minimizing disruptions in HIV care and treatment for people with HIV (PWH). METHODS: A 51-item questionnaire on COVID-19 pandemic-associated changes in HIV service delivery was completed by clinicians involved in HIV care at 21 clinics in five countries participating in Central Africa International epidemiology Databases to Evaluate AIDS (CA-IeDEA). The survey was completed at two timepoints: June-July 2020 and October 2020 to February 2021. Descriptive statistics were used to characterize changes in HIV care and related services. RESULTS: While 81% of sites reported at least one negative consequence of COVID-19 for clinic operations during the first survey, none reported suspending antiretroviral therapy (ART) initiation services for new patients, and 24% reported adopting telemedicine. In the follow-up survey, fewer sites (48%) reported at least one disruption to clinic operations, and more sites reported mitigation strategies, including expanding rapid ART initiation services and providing extra supplies of ART medications to reduce visit frequency. In the follow-up survey, more sites, especially in Rwanda, reported stockouts of commodities, including HIV and viral load testing and HIV pre-exposure prophylaxis. More than one-fifth of sites reported stockouts of second- or third-line ART at each survey timepoint. CONCLUSIONS: While the initial wave of the COVID-19 pandemic resulted in concerning disruptions to HIV service delivery at CA-IeDEA sites, most of these disruptions attenuated over time, and many sites introduced measures to help PWH avoid frequent visits to the clinic for care and medications. The impact of HIV commodity stockouts and clinic mitigation strategies on treatment outcomes needs to be assessed.
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spelling pubmed-97107882022-12-01 COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic Rogers, Ajeh Brazier, Ellen Dzudie, Anastase Adedimeji, Adebola Yotebieng, Marcel Muhoza, Benjamin Twizere, Christella Lelo, Patricia Nsonde, Dominique Mafoua, Adolphe Munyaneza, Athanase Gateretse, Patrick Diafouka, Merlin Murenzi, Gad Niyongabo, Théodore Anastos, Kathryn Nash, Denis PLoS One Research Article INTRODUCTION: The COVID-19 pandemic has impacted population health around the globe, directly and indirectly. The objective of this study was to document changes in HIV care associated with the COVID-19 pandemic at selected clinics in Central Africa, along with clinic-level strategies for minimizing disruptions in HIV care and treatment for people with HIV (PWH). METHODS: A 51-item questionnaire on COVID-19 pandemic-associated changes in HIV service delivery was completed by clinicians involved in HIV care at 21 clinics in five countries participating in Central Africa International epidemiology Databases to Evaluate AIDS (CA-IeDEA). The survey was completed at two timepoints: June-July 2020 and October 2020 to February 2021. Descriptive statistics were used to characterize changes in HIV care and related services. RESULTS: While 81% of sites reported at least one negative consequence of COVID-19 for clinic operations during the first survey, none reported suspending antiretroviral therapy (ART) initiation services for new patients, and 24% reported adopting telemedicine. In the follow-up survey, fewer sites (48%) reported at least one disruption to clinic operations, and more sites reported mitigation strategies, including expanding rapid ART initiation services and providing extra supplies of ART medications to reduce visit frequency. In the follow-up survey, more sites, especially in Rwanda, reported stockouts of commodities, including HIV and viral load testing and HIV pre-exposure prophylaxis. More than one-fifth of sites reported stockouts of second- or third-line ART at each survey timepoint. CONCLUSIONS: While the initial wave of the COVID-19 pandemic resulted in concerning disruptions to HIV service delivery at CA-IeDEA sites, most of these disruptions attenuated over time, and many sites introduced measures to help PWH avoid frequent visits to the clinic for care and medications. The impact of HIV commodity stockouts and clinic mitigation strategies on treatment outcomes needs to be assessed. Public Library of Science 2022-11-30 /pmc/articles/PMC9710788/ /pubmed/36449454 http://dx.doi.org/10.1371/journal.pone.0275429 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Rogers, Ajeh
Brazier, Ellen
Dzudie, Anastase
Adedimeji, Adebola
Yotebieng, Marcel
Muhoza, Benjamin
Twizere, Christella
Lelo, Patricia
Nsonde, Dominique
Mafoua, Adolphe
Munyaneza, Athanase
Gateretse, Patrick
Diafouka, Merlin
Murenzi, Gad
Niyongabo, Théodore
Anastos, Kathryn
Nash, Denis
COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic
title COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic
title_full COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic
title_fullStr COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic
title_full_unstemmed COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic
title_short COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic
title_sort covid-19 associated changes in hiv service delivery over time in central africa: results from facility surveys during the first and second waves of the pandemic
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710788/
https://www.ncbi.nlm.nih.gov/pubmed/36449454
http://dx.doi.org/10.1371/journal.pone.0275429
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