Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 24;75(1):e1046-e1053.
doi: 10.1093/cid/ciab951.

Effects of the Coronavirus Disease 2019 Pandemic on Human Immunodeficiency Virus Services: Findings from 11 Sub-Saharan African Countries

Tiffany G Harris  1 , Edward Jaszi  2 , Matthew R Lamb  1 , Carlos A Laudari  3 , Maria Lúcia Mendes Furtado  4 , Bonaparte Nijirazana  5 , Ndayizeye Aimé  6 , Gabriel Loni Ekali  7 , Lifanda Ebiama Lifanda  8 , Hermann Brou  9 , Eboi Ehui  10 , Faustin Malele Bazola  11 , Aimé Mboyo  12 , Ruben Sahabo  13 , Nkhosikhona Advocate Dlamini  14 , Zenebe Melaku  15 , Mirtie Getachew Meselu  16 , Mark Hawken  17 , Catherine Ngugi  18 , Mirriah Vitale  19 , Munira Abubakar Bin Abudou  20 , Florence Bayoa  21 , Victoria Achut  22 , Prisca Kasonde  23 , Paul Munsanje  24 , Wafaa M El-Sadr  1
Affiliations

Effects of the Coronavirus Disease 2019 Pandemic on Human Immunodeficiency Virus Services: Findings from 11 Sub-Saharan African Countries

Tiffany G Harris et al. Clin Infect Dis. .

Abstract

Background: Due to concerns about the effects of the coronavirus disease 2019 (COVID-19 pandemic on health services, we examined its effects on human immunodeficiency virus (HIV) services in sub-Saharan Africa.

Methods: Quarterly data (Q1, 10/2019-12/2019; Q2, 1/2020-3/2020; Q3, 4/2020-6/2020; Q4, 7/2020-9/2020) from 1059 health facilities in 11 countries were analyzed and categorized by stringency of pandemic measures. We conducted a difference-in-differences assessment of HIV service changes from Q1-Q2 to Q3-Q4 by higher vs lower stringency.

Results: There was a 3.3% decrease in the number HIV tested from Q2 to Q3 (572 845 to 553 780), with the number testing HIV-positive declining by 4.9% from Q2 to Q3. From Q3 to Q4, the number tested increased by 10.6% (612 646), with an increase of 8.8% (23 457) in the number testing HIV-positive with similar yield (3.8%). New antiretroviral therapy (ART) initiations declined by 9.8% from Q2 to Q3 but increased in Q4 by 9.8%. Across all quarters, the number on ART increased (Q1, 419 028 to Q4, 476 010). The number receiving viral load (VL) testing in the prior 12 months increased (Q1, 255 290 to Q4, 312 869). No decrease was noted in VL suppression (Q1, 87.5% to Q4, 90.1%). HIV testing (P < .0001) and new ART initiations (P = .001) were inversely associated with stringency.

Conclusions: After initial declines, rebound was brisk, with increases noted in the number HIV tested, newly initiated or currently on ART, VL testing, and VL suppression throughout the period, demonstrating HIV program resilience in the face of the COVID-19 crisis.

Keywords: Africa; COVID-19; HIV; SARS-CoV-2; delivery of healthcare.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Difference-in-differences analysis: human immunodeficiency virus testing by point of service at 1059 health facilities in 11 African countries, October 2019–September 2020. ∗P  <.05 for difference-in-difference. Abbreviations: ANC, antenatal care; HIV, human immunodeficiency virus; TB, tuberculosis; VCT, voluntary counseling and testing; VMMC, voluntary medical male circumcision.
Figure 2.
Figure 2.
Difference-in-differences analysis: human immunodeficiency virus testing yield and ART at 1059 health facilities in 11 African countries, October 2019–September 2020. ∗P < .05 for difference-in-difference. Abbreviations: ART, antiretroviral therapy; HIV, human immunodeficiency virus.
See this image and copyright information in PMC

References

    1. World Health Organization. Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-sur.... Accessed 22 April 2021.
    1. World Health Organization. Second round of the national pulse survey on continuity of essential health services during the COVID-19 pandemic: January-March 2021. Available at: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS-continuity-sur.... Accessed 28 April 2021.
    1. Hrynick TA, Ripoll Lorenzo S, Carter SE.. COVID-19 response: mitigating negative impacts on other areas of health. BMJ Global Health 2021; 6:e004110. - PMC - PubMed
    1. The Global Fund. COVID-19 Situation Report #40. Available at: https://www.theglobalfund.org/en/covid-19/news/2021-03-12-situation-report/. Accessed 29 March 2021.
    1. Jewell BL, Mudimu E, Stover J, et al. . Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple mathematical models. Lancet HIV 2020; 7:e629–40. - PMC - PubMed

Publication types

Substances