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

Abstract

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.

The impact of COVID-19 pandemic on HIV care continuum in Jiangsu, China

“…The rules were vital for COVID-19 containment but seriously affected other public health systems and HIV care services [ 6 ]. Furthermore, HIV-related deaths and new HIV infections were expected to increase with the duration of pandemic COVID-19 due to the interruption of antiretroviral therapy (ART) [ 7 , 8 ].…”

“…A recent study found that HIV testing rates decreased by 36.7% during the COVID-19 pandemic in China compared with the first quarter of 2019 [ 16 ]. Another study also observed a 59% decrease in the number of MSM undergoing facility-based HIV testing and a 34% reduction in ART initiation rate during the implementation of COVID-19 measures in Jiangsu province [ 8 ]. Meanwhile, PLWH faced the risk of ART interruption and disruption in chronic conditions treatment as hospitals were closed and some medical resources were re-purposed for COVID-19 cases [ 17 – 20 ].…”

Einschätzung des subjektiven Infektionsrisikos und Impfbereitschaft gegen SARS-CoV-2 unter deutschen Augenärzten

“…Die Daten zur Impfbereitschaft im Gesundheitswesen sind aber noch sehr begrenzt. Studien aus China und der Trkei berichten von einer Bereitschaft zur SARS-CoV-2-Impfung unter Angestellten im Gesundheitswesen von ca.70% [ 18 , 19 ] und in Frankreich von 76,9% [ 20 ]. Der Anteil der impfbereiten Augenrzte in unserer Studie ist somit vergleichsweise hoch.…”

“…Wie in der Allgemeinbevlkerung (s.oben) wird in Publikationen aus Israel, der Trkei, USA und China eine Abhngigkeit der Impfbereitschaft bei Angestellten im Gesundheitswesen von Alter und Geschlecht beschrieben, auerdem aber auch von der Berufsgruppe (rzte, Pflege, Auszubildende, Sonstige), von der jeweiligen medizinischen Fachrichtung und von der direkten Arbeit mit COVID-19-positiven Patienten oder der subjektiven Risikobewertung [ 18 22 ]. Tendenziell wrden sich in Umfragen unter Angestellten im Gesundheitssektor Mnner, ltere Personen und Personen, die das persnliche Risiko z.B.…”

Impact of the COVID-19 Pandemic on HIV Care Continuum in Jiangsu, China

“…These COVID-19 measures are extremely important for COVID-19 control, but it also seriously impacted other public health services including services for HIV care continuum [6]. According to some modelling studies, HIV related deaths and new HIV infection will increase with the duration of pandemic COVID-19 because of the interruption of antiretroviral therapy (ART), compared with if there was no COVID-19 pandemic [7][8].…”