AIDS Healthcare Foundation Global Program, São Paulo, Brazil.
Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil.
HIV Med. 2022 Feb;23(2):169-177. doi: 10.1111/hiv.13180. Epub 2021 Oct 10.
The coronavirus disease (COVID-19) pandemic has been associated with severe disruptions in health care services, and nonpharmacological measures such as social distancing also have an impact on access to screening tests and on the long-term care of patients with chronic conditions globally. We aimed to describe the impact of the COVID-19 pandemic on HIV testing and treatment and to describe strategies employed to mitigate the impact of COVID-19 on HIV care.
In this retrospective cohort study, we used secondary data from the AIDS Healthcare Foundation (AHF) Global Quality Program from 44 countries in four continents (Asia, Latin America and the Caribbean, Europe and Africa), and compared information on HIV testing, percentage of positive results, number of in-person appointments, and number of new enrolments in HIV care from 1 January 2020 to 31 August 2020 with the equivalent period in 2019.
Despite marked inter-country heterogeneities, we found that COVID-19 was associated with a significant reduction in HIV testing, an increase in the percentage of positive tests, a reduction in the number of in-person consultations and a reduction in the number of new enrolments in care, despite the implementation of several mitigation strategies. The impact of COVID-19 differed across continents and key populations.
Our findings suggest that, in the years to come, health care services must be prepared to respond to the impact of COVID-19 on HIV testing and care. Providers and facilities should build on the lessons learned so far to further improve mitigation strategies and establish care priorities for both the pandemic and the post-pandemic periods.
冠状病毒病（COVID-19）大流行严重扰乱了医疗服务，而社交隔离等非药物措施也对全球范围内的筛查检测以及慢性病患者的长期护理产生了影响。本研究旨在描述 COVID-19 大流行对 HIV 检测和治疗的影响，并描述减轻 COVID-19 对 HIV 护理影响所采用的策略。
在这项回顾性队列研究中，我们使用了来自四大洲（亚洲、拉丁美洲和加勒比、欧洲和非洲）44 个国家的艾滋病保健基金会（AHF）全球质量计划的二级数据，并比较了 2020 年 1 月 1 日至 2020 年 8 月 31 日与 2019 年同期的 HIV 检测、阳性结果百分比、面对面预约次数和新入组 HIV 护理人数的信息。
尽管各国之间存在显著的异质性，但我们发现，尽管实施了几种缓解策略，COVID-19 与 HIV 检测数量显著减少、阳性检测比例增加、面对面咨询次数减少以及新入组护理人数减少有关。COVID-19 的影响因大洲和重点人群而异。
我们的研究结果表明，在未来几年，医疗保健服务必须做好应对 COVID-19 对 HIV 检测和护理影响的准备。提供者和医疗机构应借鉴迄今为止所取得的经验教训，进一步改进缓解策略，并为大流行和大流行后时期确定护理重点。
