COVID-19 Burden on HIV Patients Attending Antiretroviral Therapy in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

The impact of the COVID-19 pandemic on people living with HIV: a cross-sectional study in Caracas, Venezuela

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has disrupted multiple health services, including human immunodeficiency virus (HIV) testing, care, and treatment services, jeopardizing the achievement of the Joint United Nations Programme on HIV/AIDS 90-90-90 global target. While there are limited studies assessing the impact of the COVID-19 pandemic on people living with HIV (PLHIV) in Latin America, there are none, to our knowledge, in Venezuela. This study aims to assess the impact of the COVID-19 pandemic among PLHIV seen at the outpatient clinic of a reference hospital in Venezuela.

METHODS

We conducted a cross-sectional study among PLHIV aged 18 years and over seen at the Infectious Diseases Department of the University Hospital of Caracas, Venezuela between March 2021 and February 2022.

RESULTS

A total of 238 PLHIV were included in the study. The median age was 43 (IQR 31-55) years, and the majority were male (68.9%). Most patients (88.2%, n = 210) came for routine check-ups, while 28 (11.3%) were newly diagnosed. The majority of patients (96.1%) were on antiretroviral therapy (ART), but only 67.8% had a viral load test, with almost all (95.6%) being undetectable. Among those who attended regular appointments, 11.9% reported missing at least one medical consultation, and 3.3% reported an interruption in their ART refill. More than half of the patients (55.5%) had received at least one dose of the COVID-19 vaccine, while the rest expressed hesitancy to get vaccinated. Most patients with COVID-19 vaccine hesitancy were male (65.1%), younger than 44 years (57.5%), employed (47.2%), and had been diagnosed with HIV for less than one year (33%). However, no statistically significant differences were found between vaccinated patients and those with COVID-19 vaccine hesitancy. Older age was a risk factor for missing consultations, while not having an alcoholic habit was identified as a protective factor against missing consultations.

CONCLUSION

This study found that the COVID-19 pandemic had a limited impact on adherence to medical consultations and interruptions in ART among PLHIV seen at the University Hospital of Caracas, Venezuela.

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

BACKGROUND

There is mounting evidence that the risk of death from COVID-19 among people with HIV could be as much as twice that of the general population. Recent evidence revealed that HIV services has been decreased by 75% and the problem is much more extensive in Ethiopia since most of the logistics for HIV services and fund donated by the good will of NGOs. Understanding the impact of COVID-19 on HIV services is a crucial first step to draw appropriate intervention. Thus, this study aimed to assess the impact of COVID-19 pandemic on HIV services in northwest Ethiopia.

METHODS

An institution-based repeated cross-sectional study was conducted in Gondar city in August 2021. The DHIS-2 system, operated by FMOH contains data from all the nine health facilities for HIV care was used to extract data from the central repository. Excel data was exported to STATA 14 for analysis. We calculated indicators of HIV services, representing the 12 months pre-COVID 19 (2019) and 16 months during the COVID-19 period (2020 and 2021). ANOVA was used to detect the presence of significant mean differences between those periods. Assumptions of ANOVA was checked. The statistical significance was declared at 95% confidence interval (CI), p-value less than 0.05.

RESULTS

The mean difference was significant within HIV_VCT, HIV_PICT, ART between the years 2019 before COVID-19 and 2020 during COVID-19 (p-value < 0.05). HIV_VCT, ART variability was substantial between the years 2019 and 2021 (p-value < 0.05).

CONCLUSION

COVID-19 seriously affected all aspects of HIV service uptake such as HIV VCT, HIV PICT, ART, newly started ART, TB screening, and lost to ART follow-up. This study urges optimizing ART delivery mitigation with the ongoing COVID-19 in Ethiopia and beyond, in order to maintain progress toward HIV epidemic control.