Department of HIV Services, Populations Solutions for Health, Harare, Zimbabwe.
Department of Health Studies, University of South Africa, Pretoria, South Africa.
PLoS One. 2023 Apr 14;18(4):e0281799. doi: 10.1371/journal.pone.0281799. eCollection 2023.
Key populations are disproportionately affected by the human immunodeficiency virus (HIV) but have less access to HIV prevention and treatment services. The Coronavirus disease-2019 (COVID-19) pandemic is reinforcing health inequities among vulnerable populations, including men who have sex with men (MSM). Therefore, this article presents the findings describing the experiences of MSM in accessing HIV services during COVID-19 in the second largest city of Zimbabwe.
An interpretative phenomenological analysis design was applied to gain some insights regarding the lived experiences of MSM in accessing HIV prevention, treatment, and care services during COVID-19 lockdowns era in Zimbabwe. Data were collected from 14 criterion purposively selected MSM using in-depth, one-on-one interviews. Data were analysed thematically guided by the interpretative phenomenological analysis framework for data analysis.
The findings demonstrated that during the COVID -19 lockdowns in Zimbabwe, MSM faced several barriers as they tried to access HIV services. Some of the barriers included the need for travel authorisation letters and treatment interruption. The study also found that COVID-19 and related restrictive measures had psychosocial and economic effects that encompassed loss of income, intimate partner violence and psychological effects.
Limited access to healthcare services by MSM due to COVID-19 lockdown may negatively affect the viral suppression and fuel the spread of HIV, which may reverse the gains toward the control of HIV epidemic. To sustain the gains toward HIV epidemic control and to ensure continuity of treatment, particularly for members of key populations, it is critical that the health-care delivery system adjusts by taking service to the community through adopting a differentiated service delivery approach.
关键人群受人类免疫缺陷病毒（HIV）的影响不成比例，但获得 HIV 预防和治疗服务的机会较少。冠状病毒病-2019（COVID-19）大流行正在加剧弱势人群中的健康不平等，包括男男性行为者（MSM）。因此，本文介绍了在津巴布韦第二大城市，描述 MSM 在 COVID-19 期间获得 HIV 服务的经验的研究结果。
应用解释现象学分析设计，深入了解 MSM 在 COVID-19 封锁期间获得 HIV 预防、治疗和护理服务的生活体验。通过深入的一对一访谈，从 14 名符合标准的 MSM 中收集数据。数据分析采用解释现象学分析框架，进行主题分析。
研究结果表明，在津巴布韦 COVID-19 封锁期间，MSM 在尝试获得 HIV 服务时面临多种障碍。一些障碍包括需要旅行授权信和治疗中断。研究还发现，COVID-19 及其相关限制措施对 MSM 产生了心理和经济影响，包括收入损失、亲密伴侣暴力和心理影响。
由于 COVID-19 封锁，MSM 获得医疗保健服务的机会有限，可能会对病毒抑制产生负面影响，并助长 HIV 的传播，这可能会逆转控制 HIV 流行的成果。为了维持控制 HIV 流行的成果，并确保关键人群的治疗连续性，至关重要的是医疗保健提供系统通过采用差异化的服务提供方法，将服务推向社区进行调整。
