COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic.
COVID-19 associated changes in HIV service delivery over time in Central Africa: Results from facility surveys during the first and second waves of the pandemic.
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DOI：
10.1371/journal.pone.0275429
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
COVID-19疫情直接及间接影响了地球仪各地的人口健康。这项研究的目的是记录中非选定诊所与COVID-19大流行相关的艾滋病毒护理变化，以及沿着减少艾滋病毒护理和艾滋病毒感染者（PWH）治疗中断的诊所级策略。参与中非国际艾滋病流行病学数据库评估（CA-IEDEA）的5个国家的21个诊所参与艾滋病毒护理的临床医生完成了一份关于COVID-19大流行病相关的艾滋病毒服务提供变化的51项调查问卷。调查在两个时间点完成：2020年6月至7月和2020年10月至2021年2月。描述性统计被用来描述艾滋病毒护理和相关服务的变化。虽然在第一次调查中，81%的地点报告了COVID-19对诊所运营的至少一个负面影响，但没有一个地点报告暂停了对新患者的抗逆转录病毒治疗（ART）启动服务，24%的地点报告采用了远程医疗。在后续调查中，较少的研究中心（48%）报告至少有一次诊所运营中断，更多的研究中心报告了缓解策略，包括扩大快速ART启动服务和提供额外的ART药物供应以减少就诊频率。在后续调查中，更多的地点，特别是在卢旺达，报告了艾滋病毒和病毒载量检测以及艾滋病毒暴露前预防等商品的缺货情况。在每个调查时间点，超过五分之一的研究中心报告二线或三线抗逆转录病毒药物缺货。虽然COVID-19大流行的第一波导致CA-IeDEA站点的艾滋病毒服务中断，但大多数中断随着时间的推移而减弱，许多站点采取措施帮助威尔斯亲王医院避免频繁前往诊所接受护理和药物治疗。需要评估艾滋病毒商品缺货和诊所缓解战略对治疗结果的影响。
The COVID-19 pandemic has impacted population health around the globe, directly and indirectly. The objective of this study was to document changes in HIV care associated with the COVID-19 pandemic at selected clinics in Central Africa, along with clinic-level strategies for minimizing disruptions in HIV care and treatment for people with HIV (PWH). A 51-item questionnaire on COVID-19 pandemic-associated changes in HIV service delivery was completed by clinicians involved in HIV care at 21 clinics in five countries participating in Central Africa International epidemiology Databases to Evaluate AIDS (CA-IeDEA). The survey was completed at two timepoints: June-July 2020 and October 2020 to February 2021. Descriptive statistics were used to characterize changes in HIV care and related services. While 81% of sites reported at least one negative consequence of COVID-19 for clinic operations during the first survey, none reported suspending antiretroviral therapy (ART) initiation services for new patients, and 24% reported adopting telemedicine. In the follow-up survey, fewer sites (48%) reported at least one disruption to clinic operations, and more sites reported mitigation strategies, including expanding rapid ART initiation services and providing extra supplies of ART medications to reduce visit frequency. In the follow-up survey, more sites, especially in Rwanda, reported stockouts of commodities, including HIV and viral load testing and HIV pre-exposure prophylaxis. More than one-fifth of sites reported stockouts of second- or third-line ART at each survey timepoint. While the initial wave of the COVID-19 pandemic resulted in concerning disruptions to HIV service delivery at CA-IeDEA sites, most of these disruptions attenuated over time, and many sites introduced measures to help PWH avoid frequent visits to the clinic for care and medications. The impact of HIV commodity stockouts and clinic mitigation strategies on treatment outcomes needs to be assessed.
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DOI：
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DOI：
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DOI：
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发表时间：
2021-04-03
期刊：
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