Division of Epidemiology and Biostatistics, Stellenbosch University, Cape Town, South Africa.
Harvard AIDS Institute Partnership, Gaberone, Botswana.
AIDS Behav. 2024 Aug;28(8):2630-2638. doi: 10.1007/s10461-024-04388-x. Epub 2024 Jun 10.
Globally, Botswana has one of the highest burdens of HIV. This study estimated the impact of the COVID-19 pandemic on the HIV cascade of care in Sub-Saharan Africa. We conducted an interrupted time series analysis on national-level data to estimate the effect of COVID-19 on the numbers of HIV tests, positive HIV tests and ART initiations from April 2019 until March 2021. In multivariable Poisson interrupted time series regression, the COVID-19 lockdown was associated with a 27% decrease in the monthly numbers of HIV tests (IRR 0.73, 95%CI 0.72-0.73), a 25% decrease in HIV positive tests (IRR 0.75, 95%CI 0.71-0.79), and a 43% reduction in ART initiations (IRR 0.57, 95%CI 0.55-0.60). The impact of the pandemic on all three outcomes was worse in males and those aged ≥ 50 years. In conclusion, COVID-19 had a strong negative impact on HIV screening, diagnosis and ART initiation in Botswana.
在全球范围内，博茨瓦纳的艾滋病毒负担最重之一。本研究估计了 COVID-19 大流行对撒哈拉以南非洲艾滋病毒护理连续体的影响。我们对国家级数据进行了中断时间序列分析，以估计 COVID-19 对 2019 年 4 月至 2021 年 3 月期间艾滋病毒检测、阳性艾滋病毒检测和抗逆转录病毒治疗（ART）启动数量的影响。在多变量泊松中断时间序列回归中，COVID-19 封锁与每月艾滋病毒检测数量减少 27%（相对危险度 0.73，95%CI 0.72-0.73）、艾滋病毒阳性检测减少 25%（相对危险度 0.75，95%CI 0.71-0.79）和抗逆转录病毒治疗启动减少 43%（相对危险度 0.57，95%CI 0.55-0.60）有关。大流行对所有三个结果的影响在男性和年龄≥50 岁的人群中更为严重。总之，COVID-19 对博茨瓦纳的艾滋病毒筛查、诊断和抗逆转录病毒治疗启动产生了强烈的负面影响。
