Understanding the impact of interruptions to HIV services during the COVID-19 pandemic: A modelling study.
Understanding the impact of interruptions to HIV services during the COVID-19 pandemic: A modelling study.
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DOI：
10.1016/j.eclinm.2020.100483
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发表时间：
2020-09
影响因子：
15.1
通讯作者：
Hallett TB
中科院分区：
文献类型：
--
作者：
Jewell BL;Smith JA;Hallett TB
人们担心 COVID-19 大流行可能会严重扰乱撒哈拉以南非洲地区的艾滋病毒服务。然而，鉴于普遍存在的不确定性，很难确定维持现有艾滋病毒服务不同要素的优先事项。我们使用数学模型探讨了南非、马拉维、津巴布韦和乌干达的干扰对艾滋病毒结果的影响，研究了模型假设如何影响影响，并将潜在的艾滋病毒死亡人数与相同环境下的 COVID-19 可能造成的死亡人数进行比较。 HIV 相关死亡率的最重要决定因素是抗逆转录病毒治疗 (ART) 供应的中断。 40% 的 ART 治疗中断三个月可能导致的额外死亡人数与通过社交距离避免感染 COVID-19 的人数相似。根据 COVID-19 预测，超过 6-90% 的人中断 ART 治疗九个月可能会导致 HIV 死亡人数超过 COVID-19 死亡人数。然而，如果维持 ART 供应，但新的治疗、自愿医疗男性包皮环切术和暴露前预防措施停止 3 个月，并减少安全套的使用，则五年内艾滋病毒死亡人数的增加将限制在 <2%，尽管这仍可能伴随着新发艾滋病毒感染人数的 7% 增加。在关于艾滋病毒服务中断的合理最坏情况假设下，在 COVID-19 大流行期间，艾滋病毒死亡人数可能会大幅增加。确保抗病毒治疗在大流行期间的连续性是高负担国家的首要任务。比尔及梅琳达·盖茨基金会。
There is concern that the COVID-19 pandemic could severely disrupt HIV services in sub-Saharan Africa. However, it is difficult to determine priorities for maintaining different elements of existing HIV services given widespread uncertainty. We explore the impact of disruptions on HIV outcomes in South Africa, Malawi, Zimbabwe, and Uganda using a mathematical model, examine how impact is affected by model assumptions, and compare potential HIV deaths to those that may be caused by COVID-19 in the same settings. The most important determinant of HIV-related mortality is an interruption to antiretroviral treatment (ART) supply. A three-month interruption for 40% of those on ART could cause a similar number of additional deaths as those that might be saved from COVID-19 through social distancing. An interruption for more than 6–90% of individuals on ART for nine months could cause the number of HIV deaths to exceed the number of COVID-19 deaths, depending on the COVID-19 projection. However, if ART supply is maintained, but new treatment, voluntary medical male circumcision, and pre-exposure prophylaxis initiations cease for 3 months and condom use is reduced, increases in HIV deaths would be limited to <2% over five years, although this could still be accompanied by a 7% increase in new HIV infections. HIV deaths could increase substantially during the COVID-19 pandemic under reasonable worst-case assumptions about interruptions to HIV services. It is a priority in high-burden countries to ensure continuity of ART during the pandemic. Bill & Melinda Gates Foundation.
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影响因子：
16.1
作者：
Jewell, Britta L.;Mudimu, Edinah;Kelly, Sherrie L.
通讯作者：
Kelly, Sherrie L.
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DOI：
10.1097/01.aids.0000299411.75269.e8
发表时间：
2007-11
期刊：
AIDS (London, England)
影响因子：
--
作者：
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通讯作者：
Zaba B
影响因子：
3.8
作者：
Cremin, Ide;Alsallaq, Ramzi;Hallett, Timothy B.
通讯作者：
Hallett, Timothy B.
影响因子：
6
作者：
Beacroft, Leo;Smith, Jennifer A.;Hallett, Timothy B.
通讯作者：
Hallett, Timothy B.
DOI：
10.1016/s1473-3099(20)30243-7
发表时间：
2020-06-01
期刊：
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影响因子：
--
作者：
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通讯作者：
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