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中国江苏省 COVID-19 大流行对艾滋病防治连续服务的影响。

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

机构信息

Institute for STI and HIV Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, No. 172 Jiangsu Road, Gulou District, Nanjing, 21009, Jiangsu, China.

University of North Carolina Project-China, Guangzhou, 510095, China.

出版信息

BMC Infect Dis. 2021 Aug 7;21(1):768. doi: 10.1186/s12879-021-06490-0.


DOI:10.1186/s12879-021-06490-0
PMID:34364383
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8346346/
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.

摘要

背景:COVID-19 大流行严重威胁着全球的公共卫生服务。本研究旨在评估 COVID-19 大流行对中国江苏省 HIV 护理连续体的影响。

方法:从中国基于网络的 HIV/AIDS 综合反应信息管理系统(CRIMS)中检索分析新诊断的 HIV 感染者的数据。我们记录了从江苏省卫生委员会公开的疾病数据库中获取的 COVID-19 措施实施前 3 个月(2020 年 1 月至 3 月)的数据。我们使用季节性自回归综合移动平均(SARIMA)和指数平滑法进行参数预测。使用卡方检验评估亚组差异。

结果:与估计比例相比,在实施 COVID-19 措施的前三个月,HIV 检测率下降了 49.0%(919938 人)。在同期预计的 1555 例新 HIV 诊断中,仅记录到 63.0%(980 例)新诊断。根据同期实际记录的数据,980 例阳性检测者接受了确认检测,其中 71.4%(700 例)被报告与护理相关。在预期的 475 例新诊断 HIV 感染者中,仅有 49.5%(235 例)接受了 CD4 细胞计数检测。同时,与同期相比,接受 CD4 计数检测的新诊断 HIV 感染者中有 91.6%(208 例)报告开始接受抗逆转录病毒治疗(ART),而预期的为 227 例。与 2016 年至 2019 年同期相比,年龄小于 30 岁和流动人口的 PLWH 更有可能受到 COVID-19 政策的影响。

结论:COVID-19 大流行对中国江苏省的 HIV 医疗保健系统产生了负面影响。需要采取进一步的措施来应对大流行的影响,以维持 HIV 护理连续体。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/e1f1b1bfd38e/12879_2021_6490_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/5b5135b2100f/12879_2021_6490_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/852bac5b6175/12879_2021_6490_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/6f47eace2dea/12879_2021_6490_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/e1f1b1bfd38e/12879_2021_6490_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/5b5135b2100f/12879_2021_6490_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/852bac5b6175/12879_2021_6490_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/6f47eace2dea/12879_2021_6490_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac98/8348844/e1f1b1bfd38e/12879_2021_6490_Fig4_HTML.jpg

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本文引用的文献

[1]
The impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China.

J Int AIDS Soc. 2021-4

[2]
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BMJ Open. 2020-12-29

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Challenges to HIV Care and Psychological Health During the COVID-19 Pandemic Among People Living with HIV in China.

AIDS Behav. 2020-10

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HIV self-testing among young women in rural South Africa: A randomized controlled trial comparing clinic-based HIV testing to the choice of either clinic testing or HIV self-testing with secondary distribution to peers and partners.

EClinicalMedicine. 2020-4-18

[10]
"Meet people where they are": a qualitative study of community barriers and facilitators to HIV testing and HIV self-testing among African Americans in urban and rural areas in North Carolina.

BMC Public Health. 2020-4-15

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