Kidabulo Eva, Nkinda Lilian, Mwakawanga Dorkasi L, Joachim Agricola
Department of Microbiology and Immunology, College of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
BMJ Public Health. 2024 Jul 24;2(1):e000935. doi: 10.1136/bmjph-2024-000935. eCollection 2024 Jun.
The COVID-19 pandemic has caused substantial disruption on HIV care and treatment programmes, especially for adolescents living with HIV (ALHIV) who are known to have poorer health outcomes compared with adults. Efforts made to overcome the pre-existing challenges were hampered by the emergence of the pandemic which interrupted adolescent-friendly healthcare services. Therefore, the aim of this study was to assess the impacts of the pandemic on HIV care and treatment services from healthcare providers and adolescents' experiences at a tertiary hospital in Dar es Salaam, Tanzania.
A descriptive qualitative study using in-depth interviews was conducted with 17 study participants. Purposive and convenient sampling techniques were used to recruit healthcare providers and adolescents, respectively. Swahili semistructured interview guide was used to conduct interviews. Thematic analysis was conducted to generate themes and subthemes describing the experiences on effects brought by COVID-19 on HIV care and treatment among adolescents.
The study revealed that alteration of approach in delivery of healthcare and limited human and non-human resources in healthcare facilities during the COVID-19 pandemic decreased effectiveness and quality of care which resulted in adolescent's poor adherence to medication and loss to follow-up. Loss of family income, food insecurity and limited socialisation posed threat to adolescent's mental health and overall quality of life.
Our findings underscore the impacts of COVID-19 and its immediate responses that significantly affected adolescent HIV care and treatment services. Reinforcement of sustainable ALHIV programmes and funding supports to these programmes are essential to promote retention and engagement to care during pandemics.
新冠疫情对艾滋病病毒（HIV）的护理和治疗项目造成了严重干扰，尤其是对于感染HIV的青少年（ALHIV）而言，他们的健康状况相较于成年人更差。为克服先前存在的挑战所做的努力因疫情的出现而受阻，疫情中断了适合青少年的医疗服务。因此，本研究的目的是评估疫情对坦桑尼亚达累斯萨拉姆一家三级医院的医疗服务提供者所提供的HIV护理和治疗服务的影响，以及青少年的经历。
采用深入访谈进行了一项描述性定性研究，共17名研究参与者。分别采用目的抽样和便利抽样技术招募医疗服务提供者和青少年。使用斯瓦希里语半结构化访谈指南进行访谈。进行主题分析以生成主题和子主题，描述新冠疫情对青少年HIV护理和治疗所带来影响的经历。
研究表明，在新冠疫情期间，医疗服务提供方式的改变以及医疗机构人力和非人力资源的有限，降低了护理的有效性和质量，导致青少年用药依从性差和失访。家庭收入损失、粮食不安全和社交活动受限对青少年的心理健康和整体生活质量构成了威胁。
我们的研究结果强调了新冠疫情及其即时应对措施的影响，这些措施显著影响了青少年HIV护理和治疗服务。加强可持续的ALHIV项目以及为这些项目提供资金支持，对于在疫情期间促进青少年接受护理并保持参与度至关重要。
