South American Program in HIV Prevention Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
The Warren Alpert Medical School of Brown University, 222 Richmond St, Box G-M117, Providence, RI, 02912, USA.
AIDS Behav. 2023 Aug;27(8):2629-2641. doi: 10.1007/s10461-023-03988-3. Epub 2023 Jan 30.
We evaluated COVID-19's impact on HIV care indicators among INI/FIOCRUZ's HIV Clinical Cohort in Rio de Janeiro, Brazil: (1) Adequate care visits: two visits ≥ 90 days apart; (2) Adequate viral load monitoring: ≥ 2 viral load results ≥ 90 days apart; (3) Consistent viral suppression: all viral loads < 40 copies/mL; and (4) ART medication possession ratio (MPR) ≥ 95%. Chi-square tests compared the fraction of participants meeting each indicator per period: pre-pandemic (3/1/2019-2/29/2020) and post-pandemic (3/1/2020-2/28/2021). Logistic regression models were used to assess disparities in adequate care visits. Among 906 participants, care visits and viral load monitoring decreased pre-pandemic to post-pandemic: 77.0-55.1% and 36.6-11.6% (both p < 0.001), respectively. The optimal MPR rate improved from 25.5 to 40.0% (p < 0.001). Post-pandemic period (aOR 0.33, CI 0.28-0.40), transgender women (aOR 0.34, CI 0.22-0.53), and those aged 18-24 years (aOR 0.67, CI 0.45-0.97) had lower odds of adequate care visits. COVID-19 disrupted care access disproportionately for transgender women and younger participants.
我们评估了 COVID-19 对巴西里约热内卢 INI/FIOCRUZ 的艾滋病毒临床队列中艾滋病毒护理指标的影响：（1）适当的护理就诊：两次就诊间隔时间≥90 天；（2）适当的病毒载量监测：≥2 次病毒载量结果间隔时间≥90 天；（3）持续病毒抑制：所有病毒载量<40 拷贝/mL；以及（4）抗逆转录病毒治疗药物（ART）药物持有率（MPR）≥95%。卡方检验比较了每个指标在每个时期的参与者比例：大流行前（2019 年 3 月 1 日-2020 年 2 月 29 日）和大流行后（2020 年 3 月 1 日-2021 年 2 月 28 日）。Logistic 回归模型用于评估适当护理就诊的差异。在 906 名参与者中，大流行前和大流行后的护理就诊和病毒载量监测均减少：分别为 77.0-55.1%和 36.6-11.6%（均 P<0.001）。最佳 MPR 率从 25.5%提高到 40.0%（P<0.001）。大流行后时期（比值比 0.33，95%置信区间 0.28-0.40）、跨性别女性（比值比 0.34，95%置信区间 0.22-0.53）和 18-24 岁的参与者（比值比 0.67，95%置信区间 0.45-0.97）的适当护理就诊的可能性更低。COVID-19 对跨性别女性和年轻参与者的护理机会产生了不成比例的影响。
