Harris Tiffany G, Jaszi Edward, Lamb Matthew R, Laudari Carlos A, Furtado Maria Lúcia Mendes, Nijirazana Bonaparte, Aimé Ndayizeye, Loni Ekali Gabriel, Ebiama Lifanda Lifanda, Brou Hermann, Ehui Eboi, Malele Bazola Faustin, Mboyo Aimé, Sahabo Ruben, Advocate Dlamini Nkhosikhona, Melaku Zenebe, Getachew Meselu Mirtie, Hawken Mark, Ngugi Catherine, Vitale Mirriah, Abudou Munira Abubakar Bin, Bayoa Florence, Achut Victoria, Kasonde Prisca, Munsanje Paul, El-Sadr Wafaa M
ICAP and Department of Epidemiology, Columbia University, New York, New York, USA.
ICAP Columbia University, New York, New York, USA.
Clin Infect Dis. 2022 Aug 24;75(1):e1046-e1053. doi: 10.1093/cid/ciab951.
Due to concerns about the effects of the coronavirus disease 2019 (COVID-19 pandemic on health services, we examined its effects on human immunodeficiency virus (HIV) services in sub-Saharan Africa.
Quarterly data (Q1, 10/2019-12/2019; Q2, 1/2020-3/2020; Q3, 4/2020-6/2020; Q4, 7/2020-9/2020) from 1059 health facilities in 11 countries were analyzed and categorized by stringency of pandemic measures. We conducted a difference-in-differences assessment of HIV service changes from Q1-Q2 to Q3-Q4 by higher vs lower stringency.
There was a 3.3% decrease in the number HIV tested from Q2 to Q3 (572 845 to 553 780), with the number testing HIV-positive declining by 4.9% from Q2 to Q3. From Q3 to Q4, the number tested increased by 10.6% (612 646), with an increase of 8.8% (23 457) in the number testing HIV-positive with similar yield (3.8%). New antiretroviral therapy (ART) initiations declined by 9.8% from Q2 to Q3 but increased in Q4 by 9.8%. Across all quarters, the number on ART increased (Q1, 419 028 to Q4, 476 010). The number receiving viral load (VL) testing in the prior 12 months increased (Q1, 255 290 to Q4, 312 869). No decrease was noted in VL suppression (Q1, 87.5% to Q4, 90.1%). HIV testing (P < .0001) and new ART initiations (P = .001) were inversely associated with stringency.
After initial declines, rebound was brisk, with increases noted in the number HIV tested, newly initiated or currently on ART, VL testing, and VL suppression throughout the period, demonstrating HIV program resilience in the face of the COVID-19 crisis.
由于担心2019冠状病毒病（COVID-19）大流行对卫生服务的影响，我们研究了其对撒哈拉以南非洲地区人类免疫缺陷病毒（HIV）服务的影响。
分析了11个国家1059家医疗机构的季度数据（2019年第1季度，2019年10月至12月；2020年第2季度，2020年1月至3月；2020年第3季度，2020年4月至6月；2020年第4季度，2020年7月至9月），并根据大流行措施的严格程度进行分类。我们对2019年第1季度至第2季度与2020年第3季度至第4季度HIV服务变化进行了双重差分评估，比较了严格程度较高与较低的情况。
从第2季度到第3季度，HIV检测数量下降了3.3%（从572845例降至553780例），HIV检测呈阳性的数量从第2季度到第3季度下降了4.9%。从第3季度到第4季度，检测数量增加了10.6%（612646例），HIV检测呈阳性的数量增加了8.8%（23457例），阳性率相似（3.8%）。新开始抗逆转录病毒治疗（ART）的人数从第2季度到第3季度下降了9.8%，但在第4季度增加了9.8%。在所有季度中，接受ART治疗的人数有所增加（从第1季度的419028例增至第4季度的476010例）。在过去12个月接受病毒载量（VL）检测的人数有所增加（从第1季度的255290例增至第4季度的312869例）。VL抑制率没有下降（从第1季度的87.5%增至第4季度的90.1%）。HIV检测（P <.0001）和新开始ART治疗（P =.001）与严格程度呈负相关。
在最初下降之后，反弹迅速，在此期间，HIV检测数量、新开始或正在接受ART治疗的人数、VL检测以及VL抑制率均有所增加，表明HIV项目在面对COVID-19危机时具有恢复能力。
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