Ministry of Health Zambia, Department of Communicable Diseases, Lusaka, Zambia.
World Health Organization, Global HIV, Hepatitis and STI Programmes, Geneva, Switzerland.
Glob Health Action. 2023 Dec 31;16(1):2175992. doi: 10.1080/16549716.2023.2175992.
Coronavirus disease 2019 (COVID-19) is caused by a virus called severe acute respiratory syndrome coronavirus. As countries struggled to control the spread of the virus through among other measures closure of health facilities, repurposing of health care workers, and restrictions on people's movement, HIV service delivery was affected.
To assess the impact of COVID-19 on HIV service delivery in Zambia by comparing uptake of HIV services before and during COVID-19.
We used repeated cross-sectional quarterly and monthly data on HIV testing, HIV positivity rate, people living with HIV initiating ART and use of essential hospital services from July 2018 to December 2020. We assessed quarterly trends and measured proportionate changes comparing periods before and during COVID-19 divided into three different comparison time frames: (1) annual comparison 2019 versus 2020; (2) April to December 2019 versus same period in 2020; and (3) Quarter 1 of 2020 as base period versus each of the other quarters of year 2020.
Annual HIV testing dropped by 43.7% (95%CI 43.6-43.7) in 2020 compared to 2019 and was similar by sex. Overall, annual recorded number of newly diagnosed PLHIV fell by 26.5% (95% CI 26.37-26.73) in 2020 compared to 2019, but HIV positivity rate was higher in 2020, 6.44% (95%CI 6.41-6.47) compared to 4.94% (95% CI 4.92-4.96) in 2019. Annual ART initiation dropped by 19.9% (95%CI 19.7-20.0) in 2020 compared to 2019 while use of essential hospital services dropped during the early months of COVID-19 April to August 2020 but picked up later in the year.
While COVID-19 had a negative impact on health service delivery, its impact on HIV service delivery was not huge. HIV policies that were implemented before COVID-19 on testing made it easier to adopt COVID-19 control measures and to continue providing HIV testing services without much disruption.
2019 年冠状病毒病（COVID-19）是由一种称为严重急性呼吸系统综合症冠状病毒的病毒引起的。随着各国努力通过关闭卫生设施、重新调配医护人员以及限制人们的行动等措施来控制病毒的传播，艾滋病毒服务的提供受到了影响。
通过比较 COVID-19 前后艾滋病毒服务的利用情况，评估 COVID-19 对赞比亚艾滋病毒服务提供的影响。
我们使用了 2018 年 7 月至 2020 年 12 月期间艾滋病毒检测、艾滋病毒阳性率、开始接受抗逆转录病毒治疗的艾滋病毒感染者人数和基本医院服务利用的重复横断面季度和月度数据。我们评估了季度趋势，并通过在 COVID-19 前后三个不同的比较时间框架内进行比例变化测量，比较了 COVID-19 前后的情况：（1）2019 年与 2020 年的年度比较；（2）2019 年 4 月至 12 月与 2020 年同期的比较；（3）2020 年第一季度为基础期，与 2020 年其他季度的比较。
与 2019 年相比，2020 年的年度艾滋病毒检测量下降了 43.7%（95%CI 43.6-43.7），且在性别方面相似。总体而言，2020 年新诊断出的艾滋病毒感染者人数比 2019 年下降了 26.5%（95%CI 26.37-26.73），但 2020 年的艾滋病毒阳性率更高，为 6.44%（95%CI 6.41-6.47），而 2019 年为 4.94%（95%CI 4.92-4.96）。与 2019 年相比，2020 年的年度抗逆转录病毒治疗开始人数下降了 19.9%（95%CI 19.7-20.0），而在 COVID-19 早期的 2020 年 4 月至 8 月期间，基本医院服务的利用下降，但在当年晚些时候有所回升。
虽然 COVID-19 对卫生服务的提供产生了负面影响，但对艾滋病毒服务的影响并不大。在 COVID-19 之前实施的艾滋病毒政策使更容易采取 COVID-19 控制措施，并在没有太大干扰的情况下继续提供艾滋病毒检测服务。
