Challenges to HIV Care and Psychological Health During the COVID-19 Pandemic Among People Living with HIV in China

Sun, Shufang; Hou, Jun; Chen, Yaokai; Lu, Yanqiu; Brown, Larry K.; Operario, Don

doi:10.1007/s10461-020-02903-4

Cited by 87 publications

(113 citation statements)

References 11 publications

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“…Although disruptions to VS had consequences for HIV incidence/mortality, data from Jiangsu [17] indicated no change in VS among PLWH due to COVID-19 disruption. Other surveys among PLWH in China indicate disruptions to ART access [4] which could lead to . CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Section: Discussionmentioning

confidence: 99%

“…In China, a recent systematic review indicated an HIV prevalence of 5.7% (95% CI:5.4-6.1%) among MSM, with increasing HIV prevalence in this group over time (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018) [3]. Efforts to manage the HIV epidemic in China have been made increasingly difficult by the emergent COVID-19 pandemic [4,5], having significant potential to affect the HIV care continuum and patterns of sexual risk behaviour in numerous settings worldwide [6][7][8][9][10]. Close examination of this syndemic is a key issue for global public health [11].…”

Section: Introductionmentioning

confidence: 99%

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Estimating the impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China

Booton

MacGregor

et al. 2020

Preprint

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Introduction The COVID-19 pandemic is impacting HIV care globally, with gaps in HIV treatment expected to increase HIV transmission and HIV-related mortality. We estimated how COVID-19-related disruptions could impact HIV transmission and mortality among men who have sex with men (MSM) in four cities in China. Methods Regional data from China indicated that the number of MSM undergoing facility-based HIV testing reduced by 59% during the COVID-19 pandemic, alongside reductions in ART initiation (34%), numbers of sexual partners (62%) and consistency of condom use (25%). A deterministic mathematical model of HIV transmission and treatment among MSM in China was used to estimate the impact of these disruptions on the number of new HIV infections and HIV-related deaths. Disruption scenarios were assessed for their individual and combined impact over 1 and 5 years for a 3-, 4- or 6-month disruption period. Results Our China model predicted that new HIV infections and HIV-related deaths would be increased most by disruptions to viral suppression, with 25% reductions for a 3-month period increasing HIV infections by 5-14% over 1 year and deaths by 7-12%. Observed reductions in condom use increased HIV infections by 5-14% but had minimal impact (<1%) on deaths. Smaller impacts on infections and deaths (<3%) were seen for disruptions to facility testing and ART initiation, but reduced partner numbers resulted in 11-23% fewer infections and 0.4-1.0% fewer deaths. Longer disruption periods of 4 and 6 months amplified the impact of combined disruption scenarios. When all realistic disruptions were modelled simultaneously, an overall decrease in new HIV infections was always predicted over one year (3-17%), but not over 5 years (1% increase - 4% decrease), while deaths mostly increased over one year (1-2%) and 5 years (1.2 increase - 0.3 decrease). Conclusions The overall impact of COVID-19 on new HIV infections and HIV-related deaths is dependent on the nature, scale and length of the various disruptions. Resources should be directed to ensuring levels of viral suppression and condom use are maintained to mitigate any adverse effects of COVID-19 related disruption on HIV transmission and control among MSM in China.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Estimating the impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China

Booton

MacGregor

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…PLHIV are more likely to experience social isolation; however, as a consequence of measures to prevent the spread of COVID-19, this experience may be amplified, which may have a negative effect on mental health [43]. Furthermore, COVID-19 will potentially exacerbate other psychological stressors such as food insecurity and increased societal stigma [42,44,45]. These psychosocial stressors further may increase the risk of adverse health outcomes among PLHIV as a consequence of reduced medication adherence, leading to failure to achieve adequate HIV management [42].…”

Section: The Psychological Impact Of Covid-19 On Plhivmentioning

confidence: 99%

Coronavirus disease 2019 (COVID‐19) outcomes in HIV/AIDS patients: a systematic review

et al. 2020

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Objectives The aim of the study was to systematically review current studies reporting on clinical outcomes in people living with HIV (PLHIV) infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines. A comprehensive literature search was conducted in Global Health, SCOPUS, Medline and EMBASE using pertinent key words and Medical Subject Headings (MeSH) terms relating to coronavirus disease 2019 (COVID‐19) and HIV. A narrative synthesis was undertaken. Articles are summarized in relevant sections. Results Two hundred and eighty‐five articles were identified after duplicates had been removed. After screening, eight studies were analysed, totalling 70 HIV‐infected patients (57 without AIDS and 13 with AIDS). Three themes were identified: (1) controlled HIV infection does not appear to result in poorer COVID‐19 outcomes, (2) more data are needed to determine COVID‐19 outcomes in patients with AIDS and (3) HIV‐infected patients presenting with COVID‐19 symptoms should be investigated for superinfections. Conclusions Our findings suggest that PLHIV with well‐controlled disease are not at risk of poorer COVID‐19 disease outcomes than the general population. It is not clear whether those with poorly controlled HIV disease and AIDS have poorer outcomes. Superimposed bacterial pneumonia may be a risk factor for more severe COVID‐19 but further research is urgently needed to elucidate whether PLHIV are more at risk than the general population.

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“…To adapt the personnel shortage during the COVID-19 pandemic, many hospitals in China reassigned HIV healthcare providers to fight against the COVID-19 outbreak. As a result, HIV healthcare providers might put aside the ongoing needs of people living with HIV (PLWH) [ 9 ] while lacking alternative strategies to maintain core HIV services (e.g., pick-up points for refills, virtual support platforms) [ 10 – 13 ]. As a consequence, HIV care services have been significantly interrupted by the COVID-19 pandemic due to strict quarantine enforcement and transportation lockdown in various cities across China [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…As a result, HIV healthcare providers might put aside the ongoing needs of people living with HIV (PLWH) [ 9 ] while lacking alternative strategies to maintain core HIV services (e.g., pick-up points for refills, virtual support platforms) [ 10 – 13 ]. As a consequence, HIV care services have been significantly interrupted by the COVID-19 pandemic due to strict quarantine enforcement and transportation lockdown in various cities across China [ 9 ]. A national anonymous survey in China reported 32.6% of PLWH were at risk of antiretroviral therapy discontinuation during the pandemic [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Mental Health Problems of HIV Healthcare Providers During the COVID-19 Pandemic: The Interactive Effects of Stressors and Coping

Yang

Sun

et al. 2020

AIDS Behav

Self Cite

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HIV healthcare providers might be vulnerable to mental health problems during the COVID-19 pandemic. Guided by the stress and coping paradigm, the current study aimed at examining the interactive effects of COVID-19-related stressors and coping on mental health problems. A cross-sectional online survey was conducted among 1029 HIV healthcare providers in Guangxi, China. The prevalence of depression and anxiety in the current study was 13.31% and 6.61%, respectively. Results from path analyses revealed that the main effects of COVID-19-related stressors and coping were significant on both depression and anxiety. The interaction of coping and COVID-19-related stressors had significant effects on depression and anxiety. Simple slope tests revealed that more coping behaviors buffered against the negative effect of COVID-19-related stressors on mental health problems. Coping acted as a protective factor that alleviated the harm of COVID-19-related stressors on mental health. Intervention targeting coping management might benefit the mental health of HIV healthcare providers.

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Challenges to HIV Care and Psychological Health During the COVID-19 Pandemic Among People Living with HIV in China

Cited by 87 publications

References 11 publications

Estimating the impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China

Estimating the impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China

Coronavirus disease 2019 (COVID‐19) outcomes in HIV/AIDS patients: a systematic review

Mental Health Problems of HIV Healthcare Providers During the COVID-19 Pandemic: The Interactive Effects of Stressors and Coping

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