The risks and benefits of providing HIV services during the COVID-19 pandemic.
The risks and benefits of providing HIV services during the COVID-19 pandemic.
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DOI：
10.1371/journal.pone.0260820
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Bershteyn A
中科院分区：
文献类型：
--
作者：
Stover J;Kelly SL;Mudimu E;Green D;Smith T;Taramusi I;Bansi-Matharu L;Martin-Hughes R;Phillips AN;Bershteyn A
COVID-19大流行造成广泛干扰，包括医疗服务。在对这一流行病的早期反应中，许多国家限制人口流动，一些保健服务暂停或受到限制。于二零二零年底及二零二一年初，部分国家重新实施限制。卫生当局需要平衡与卫生服务相关的接触导致的额外SARS-CoV-2传播的潜在危害与这些服务的好处，包括减少新的艾滋病毒感染和死亡。本文探讨这些权衡选择艾滋病毒服务。我们使用了四个艾滋病毒模拟模型（目标，艾滋病毒合成，最佳艾滋病毒和EMOD）来估计持续艾滋病毒服务在减少新的艾滋病毒感染和死亡方面的好处。我们使用了三种COVID-19传播模型（Covasim、库珀/史密斯和简单接触模型）来估计卫生工作者和客户中因SARS-CoV-2传播而增加的死亡人数。我们研究了四种艾滋病毒服务：自愿医疗男性包皮环切术、艾滋病毒诊断检测、病毒载量检测和预防母婴传播的方案。我们比较了2020年和2021年的COVID-19死亡人数与现在和未来50年发生的艾滋病毒死亡人数贴现至现值。这些模型被应用于出现一系列艾滋病毒和COVID-19疫情的国家。维持这些艾滋病毒服务可能会导致每10，000名客户增加0. 002至0. 15例COVID-19死亡。据估计，避免的艾滋病毒相关死亡人数要高得多，每10 000名病人中有19至146人死亡。虽然提供艾滋病毒服务会带来一些额外的短期SARS-CoV-2传播风险，但额外的COVID-19死亡风险至少比这些服务避免的艾滋病毒死亡风险低100倍。卫生部在决定COVID-19大流行期间何时以及如何提供基本卫生服务时需要考虑许多因素。这项工作表明，继续提供关键的艾滋病毒服务的好处远远大于额外的SARS-CoV-2传播的风险。
The COVID-19 pandemic has caused widespread disruptions including to health services. In the early response to the pandemic many countries restricted population movements and some health services were suspended or limited. In late 2020 and early 2021 some countries re-imposed restrictions. Health authorities need to balance the potential harms of additional SARS-CoV-2 transmission due to contacts associated with health services against the benefits of those services, including fewer new HIV infections and deaths. This paper examines these trade-offs for select HIV services. We used four HIV simulation models (Goals, HIV Synthesis, Optima HIV and EMOD) to estimate the benefits of continuing HIV services in terms of fewer new HIV infections and deaths. We used three COVID-19 transmission models (Covasim, Cooper/Smith and a simple contact model) to estimate the additional deaths due to SARS-CoV-2 transmission among health workers and clients. We examined four HIV services: voluntary medical male circumcision, HIV diagnostic testing, viral load testing and programs to prevent mother-to-child transmission. We compared COVID-19 deaths in 2020 and 2021 with HIV deaths occurring now and over the next 50 years discounted to present value. The models were applied to countries with a range of HIV and COVID-19 epidemics. Maintaining these HIV services could lead to additional COVID-19 deaths of 0.002 to 0.15 per 10,000 clients. HIV-related deaths averted are estimated to be much larger, 19–146 discounted deaths per 10,000 clients. While there is some additional short-term risk of SARS-CoV-2 transmission associated with providing HIV services, the risk of additional COVID-19 deaths is at least 100 times less than the HIV deaths averted by those services. Ministries of Health need to take into account many factors in deciding when and how to offer essential health services during the COVID-19 pandemic. This work shows that the benefits of continuing key HIV services are far larger than the risks of additional SARS-CoV-2 transmission.
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影响因子：
3.7
作者：
Mudimu E;Peebles K;Mukandavire Z;Nightingale E;Sharma M;Medley GF;Klein DJ;Kripke K;Bershteyn A
通讯作者：
Bershteyn A
DOI：
10.1016/s2352-3018(20)30279-4
发表时间：
2021-04
期刊：
The lancet. HIV
影响因子：
--
作者：
Sharma M;Mudimu E;Simeon K;Bershteyn A;Dorward J;Violette LR;Akullian A;Abdool Karim SS;Celum C;Garrett N;Drain PK
通讯作者：
Drain PK
影响因子：
4.6
作者：
Selinger, Christian;Dimitrov, Dobromir T.;Bershteyn, Anna
通讯作者：
Bershteyn, Anna
影响因子：
3.3
作者：
Bershteyn, Anna;Gerardin, Jaline;Wiswell, Christian N.
通讯作者：
Wiswell, Christian N.
影响因子：
3.2
作者：
Haacker, Markus;Hallett, Timothy B.;Atun, Rifat
通讯作者：
Atun, Rifat