The Effect of COVID-19 on Routine HIV Care Services from Health Facilities in Northwest Ethiopia

Abstract

Background: There is mounting evidence that the risk of death from COVID-19 among people with HIV could be as much as twice that of the general population. Recent evidence revealed that HIV services has been decreased by 75% and the problem is much more extensive in Ethiopia since most of the logistics for HIV services and fund donated by the good will of NGOs. Understanding the impact of COVID-19 on HIV services is a crucial first step to draw appropriate intervention. Thus, this study aimed to assess the impact of COVID-19 pandemic on HIV services in northwest Ethiopia.

Methods: An institution-based repeated cross-sectional study was conducted in Gondar city in August 2021. The DHIS-2 system, operated by FMOH contains data from all the nine health facilities for HIV care was used to extract data from the central repository. Excel data was exported to STATA 14 for analysis. We calculated indicators of HIV services, representing the 12 months pre-COVID 19 (2019) and 16 months during the COVID-19 period (2020 and 2021). ANOVA was used to detect the presence of significant mean differences between those periods. Assumptions of ANOVA was checked. The statistical significance was declared at 95% confidence interval (CI), p-value less than 0.05.

Results: The mean difference was significant within HIV_VCT, HIV_PICT, ART between the years 2019 before COVID-19 and 2020 during COVID-19 (p-value < 0.05). HIV_VCT, ART variability was substantial between the years 2019 and 2021 (p-value < 0.05).

Conclusion: COVID-19 seriously affected all aspects of HIV service uptake such as HIV VCT, HIV PICT, ART, newly started ART, TB screening, and lost to ART follow-up. This study urges optimizing ART delivery mitigation with the ongoing COVID-19 in Ethiopia and beyond, in order to maintain progress toward HIV epidemic control.

Keywords: COVID-19; HIV care services; impact; northwest Ethiopia.

Figure 1

Number of HIV_VCT, HIV_PICT and ART attendants against Time in Months. In the figure the green colored line represents number of ART attendants, the yellow-colored line represents HIV_PICT and the bright Orange colored line represents HIV_VCT.

Figure 2

Number of HIV_VCT and HIV_PICT Attendants within Twenty-eight months. In the figure the blue colored bar represents HIV_VCT and the bright Orange colored bar represents HIV_PICT.

Figure 3

Newly initiation of ART and lost PLWHA of participants’ pre COVID-19, during and post COVID-19 lockdown periods in 28 Months. In the figure the green colored line represents number of peoples lost HIV follow up, the yellow-colored line represents number of individuals started ART.

Figure 4

Comparison of number of clients screened for TB of participants’ before COVID-19, during and post lockdown periods in 28 Months. In the figure the bright Orange colored line represents number of ART patients screened for tuberculosis.