Adapting to the COVID-19 Pandemic: Continuing HIV Prevention Services for Adolescents Through Telemonitoring, Brazil
Adapting to the COVID-19 Pandemic: Continuing HIV Prevention Services for Adolescents Through Telemonitoring, Brazil
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DOI：
10.1007/s10461-020-02927-w
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发表时间：
2020-05-21
影响因子：
4.4
通讯作者：
Grangeiro, Alexandre
中科院分区：
文献类型：
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作者：
Dourado, Ines;Magno, Laio;Grangeiro, Alexandre
COVID-19大流行正在影响各地的卫生保健服务提供，尽管还处于早期阶段，但中断的结果正变得越来越明显。传染病和性健康提供者可能会被转移到照顾COVID-19患者。由于COVID-19隔离政策而关闭性健康服务可能会对低收入和中等收入国家边缘化人群的卫生服务获取和护理中断产生不利影响。这些挑战对于性少数群体和性别少数群体，如男男性行为者（MSM）和变性女性（TGW）来说可能尤其严重，但对于女性的性健康和生殖健康以及计划生育服务来说也是如此[2-5]。获得避孕套以及抗逆转录病毒药物和抗生素治疗性传播感染（STIs）和艾滋病毒也可能受到影响，并可能最终破坏艾滋病毒暴露前预防（PrEP）的开始和持续[3,6]。2020年3月20日，巴西卫生部宣布巴西所有州都有冠状病毒病例[8]，并发布了有关社会距离措施的指导方针，如自愿居家隔离和社会隔离[8]。截至5月20日，全国累计确诊病例271628例（129.3例/10万居民），累计死亡病例17971例，病死率为6.6%。巴西是世界上该病毒传播率最高的国家之一，但面临着国家政府不协调的应对措施[11,12]。另一方面，国家卫生系统（SUS）的存在有利于州政府和市政府采取自己的方法，从自愿的社会隔离到部分封锁。
The COVID-19 pandemic is impacting the delivery of health care services everywhere, and although in the early stages, the results of disruptions are becoming clearer. Infectious disease and sexual health providers may be diverted to care for COVID-19 patients. Closing sexual health services due to COVID-19 quarantine policies will likely have detrimental impacts on health services access and discontinuity of care among marginalized populations in low-and middleincome countries [1]. These challenges may be particularly acute for sexual and gender minorities such as men who have sex with men (MSM) and transgender women (TGW), but also for sexual and reproductive health and family planning services for women [2–5]. Access to condoms as well as antiretroviral drugs and antibiotics to treat sexually transmitted infections (STIs) and HIV may also be affected, and may ultimately undermine HIV pre-exposure prophylaxis (PrEP) initiation and persistence [3, 6]. On March 20th, 2020 the Brazilian Ministry of Health (MoH) announced that all Brazilian states had coronavirus cases [7], and issued guidelines on social distancing measures, such as voluntary home quarantine, and social isolation [8]. On May 20th, the country had accumulated 271,628 confirmed cases of COVID-19 (129.3 cases/100.000 inhabitants) and 17,971 COVID-19 related deaths, fatality rate of 6.6%[9]. Brazil has one of the highest transmission rates of the virus in the world [10], but faces an uncoordinated national government response [11, 12]. On the other hand, the existence of a National Health System (SUS)[13] favors state and city governments to adopt their own approaches that range from voluntary social isolation to partial lockdown.