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. 2024 May 20;25(1):1557.
doi: 10.4102/sajhivmed.v25i1.1557. eCollection 2024.

How paediatric HIV services weathered the COVID-19 storm in Tshwane District, South Africa

Michael Christie  1   2   3 , Ahmad Haeri Mazanderani  4   5 , Gayle Sherman  4   5 , Ute Feucht  1   2   3
Affiliations

How paediatric HIV services weathered the COVID-19 storm in Tshwane District, South Africa

Michael Christie et al. South Afr J HIV Med. .

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted paediatric HIV services across South Africa. Shortly before COVID-19, updated national HIV guidelines were released.

Objectives: This study describes COVID-19's impact on paediatric HIV services in Tshwane District, South Africa.

Method: A retrospective review of National Institute for Communicable Diseases and District Health Information System data for Tshwane District from April 2019 to March 2022. Data included: Early Infant Diagnosis (EID), HIV viral load (VL) and CD4 monitoring and HIV management among children (< 15 years) living with HIV (CLHIV). Pre-pandemic (2019/2020) and pandemic periods (2020/2021, 2021/2022) were compared.

Results: Year-on-year, HIV testing improved at 10 weeks, 6 months, and 18 months, whereas birth testing decreased. HIV EID case rates were 485 (2019/2020), 410 (2020/2021) and 454 (2021/2022). HIV EID test positivity was 0.77% - 1.2%. Antiretroviral treatment initiation declined from 2019/2020 to 2020/2021, but improved in 2021/2022.Initial HIV VL and CD4 testing declined, with HIV VL testing increasing in 2021/2022, and CD4 testing further declining. HIV VL suppression rate among CLHIV ranged from 69% to 73%.

Conclusion: Initially, COVID-19 resulted in reduced paediatric HIV services as children disengaged from care. Indicators eventually recovered to proximate pre-pandemic levels; however, compensatory increases did not occur. Thus, some children may not have returned to care.

Keywords: COVID-19; HIV management; HIV services; children living with HIV; paediatric HIV; public health.

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Conflict of interest statement

The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Routine HIV disease monitoring among women living with HIV (15–45 years) per quarter from April 2019 to March 2022 showing (a) HIV VL monitoring among WLHIV, and (b) CD4 count monitoring amongst WLHIV.
FIGURE 2
FIGURE 2
Number of age-specific paediatric HIV tests performed per year and year-on-year percentage change from April 2019 to March 2022.
FIGURE 3
FIGURE 3
Routine HIV monitoring among children living with HIV per quarter from April 2019 to March 2022. (a) Routine HIV VL tests performed among children living with HIV per quarter from April 2019 to March 2022, (b) Routine CD4 tests performed among children living with HIV per quarter from April 2019 to March 2022.
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