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
. 2024 Apr;28(4):1235-1243.
doi: 10.1007/s10461-023-04149-2. Epub 2023 Aug 29.

Impact of COVID-19 on the Utilization of HIV Testing and Linkage Services in Sierra Leone: Experience from Three Public Health Facilities in Freetown

Sulaiman Lakoh #  1   2   3 , Moses M Bangura  1 , Olukemi Adekanmbi  4   5 , Umu Barrie  6 , Darlinda F Jiba  2 , Matilda N Kamara  1 , Daniel Sesay  2 , Abdulai Tejan Jalloh  2 , Gibrilla F Deen  1   2 , James B W Russell  1   2 , Ginika Egesimba  7 , George A Yendewa  8   9   10 , Emmanuel Firima #  11   12   13   14
Affiliations

Impact of COVID-19 on the Utilization of HIV Testing and Linkage Services in Sierra Leone: Experience from Three Public Health Facilities in Freetown

Sulaiman Lakoh et al. AIDS Behav. 2024 Apr.

Abstract

The COVID-19 pandemic adversely affected the delivery of essential health services globally. In this study, we aimed to assess the impact of the pandemic on HIV testing and linkage services at three public health facilities in Freetown, Sierra Leone. We conducted a retrospective study to assess the impact of COVID-19 on HIV testing and linkage to treatment services (HTS) at Connaught Hospital (CH-tertiary), Lumley Government Hospital (LGH-secondary) and George Brooke Community Health Center (GBC-primary) in Freetown. Statistical analyses were conducted in Stata (16.1, StataCorp LLC, College Station, TX). Intra-pandemic HTS (2020) and HTS during recovery (2021) were compared with pre-pandemic HTS (2019). Of the 8538 people tested for HIV in the three facilities, 4929 (57.5%) visited CH. Only 2249 people were tested for HIV in 2020 compared to 3825 in 2019 (difference: - 41.2%, P < 0.001). Fewer people were also tested in 2021 (difference: - 35.6% P < 0.001). The largest reductions in testing in 2020 occurred in women (- 47.7%), children under 15 (- 95.2%), married people (- 42.6%), and CH (- 46.2%). Overall, 1369 (16.0%) people were positive for HIV; CH (878, 17.9%), LGH (469, 15.6%) and GBC (22, 3.5%). The likelihood of a positive HIV test was 26% lower in 2020 than 2019 (PR 0.74; 95% CI 0.64-0.85; P < 0.001), but 16% higher in 2021 than 2019 (PR 1.16; 95% CI 1.03-1.30; P < 0.05). Of the 1369 HIV diagnosis, 526 (38.4%) were linked to care. We found significant disruptions in HIV testing and linkage services at different levels of service delivery during the COVID-19 pandemic, underscoring the need to strengthen essential health services during public health emergencies.

Keywords: COVID-19 pandemic; Coronavirus 2019; HIV testing; HIV testing services; Linkage to HIV care; Sierra Leone.

PubMed Disclaimer

Conflict of interest statement

E.F. receives his salary from the European Union’s Horizon 2020 research and innovation programme under Marie Skłodowska-Curie Grant Agreement (No. 801076), through SSPH + Global PhD Fellowship Programme in Public Health Sciences (GlobalP3HS). G.A.Y. reports salary support from the National Institutes of Health/AIDS Clinical Trials Group under Award Numbers 5UM1AI068636-15, 5UM1AI069501-09 and AI068636 (150GYD212), and consultancy fees from Pfizer. All the other authors have no financial or proprietary interests in any material discussed in this article.

Figures

Fig. 1
Fig. 1
Locations of Connaught Hospital, Lumley Government Hospital and George Brooke Community Health Center
Fig. 2
Fig. 2
HIV testing services among study participants for first 6 months of 2019, 2020 and 2021
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization. Coronavirus disease (COVID-2019) Situation Reports. https://www.who.int/europe/emergencies/situations/covid-19. Accessed 16 Oct 2020.
    1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. 10.1016/S0140-6736(20)30183-5. Erratum in: Lancet. 2020. - PMC - PubMed
    1. Joffe AR. COVID-19: Rethinking the lockdown groupthink. Front Public Health. 2021;9:625778. doi: 10.3389/fpubh.2021.625778. - DOI - PMC - PubMed
    1. Kidd M. Australia’s primary care COVID-19 response. Aust J Gen Pract. 2020 doi: 10.31128/AJGP-COVID-02. - DOI - PubMed
    1. Birkmeyer JD, Barnato A, Birkmeyer N, Bessler R, Skinner J. The impact of the COVID-19 pandemic on hospital admissions in the United States. Health Aff (Millwood) 2020;39(11):2010–2017. doi: 10.1377/hlthaff.2020.00980. - DOI - PMC - PubMed