HIV care in times of the COVID-19 crisis — Where are we now in Central and Eastern Europe?

Kowalska, Justyna D.; Skrzat‐Klapaczyńska, Agata; Bursa, Dominik; Balayan, Tatevik; Begovać, Josip; Chkhartishvili, Nikoloz; Gökengin, Deniz; Harxhi, Arjan; Jilich, David; Jevtović, Djordje; Kase, Kerstin; Lakatos, Botond; Matulionytė, Raimonda; Mulabdic, Velida; Nagîţ, Angela; Παπαδοπουλοσ, Αντωνιοσ; Stefanović, Maja; Vassilenko, Anna; Vasylyev, Marta; Yancheva, Nina; Yurin, Oleg; Horban, Andrzéj

doi:10.1016/j.ijid.2020.05.013

Cited by 88 publications

(108 citation statements)

References 8 publications

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“…The fear of contracting COVID-19 has led to decreased engagement with care among PLWH in several countries [ [39] , [40] , [41] , [42] ]. The reasons for this are unsurprising- people who have faced stigma for decades due to their HIV status and live under the burden of a chronic virus are hesitant to engage in care when the prospect of being infected with another, more deadly virus is real.…”

Section: Resultsmentioning

confidence: 99%

“…The rapidly growing pandemic has strained national healthcare systems worldwide. In Eastern Europe, HIV physicians have been called to care for patients with COVID-19, creating staffing shortages [ 39 ]. This has forced some clinics to suspend in-person visits, others to postpone blood tests, and some to solely focus on ART distribution.…”

Section: Resultsmentioning

confidence: 99%

“…Despite such monumental challenges, this pandemic creates the opportunity to accelerate much needed changes in care delivery. Multi-month prescribing has now taken off in several African and Eastern European countries [ 39 , 49 ]. While this has the obvious drawback of limited viral load/ CD4 monitoring, it provides an opportunity for innovation in point-of-care testing solutions.…”

Section: Resultsmentioning

confidence: 99%

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Impact of COVID-19 on people living with HIV: A review

Prabhu

Poongulali

Kumarasamy

2020

Journal of Virus Eradication

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There is great concern about the impact of COVID-19 among the nearly 40 million people living with HIV (PLWH) worldwide. In this review, we surveyed current literature and found no evidence of higher prevalence of COVID-19 among PLWH but equivocal data on increased mortality and worse clinical outcomes. Having HIV does not confer protection against severe manifestations of COVID-19. Several studies looking at antiretroviral drugs against HIV to treat SARS-CoV-2 have shown no mortality benefit. Thus, there is no indication to change ART regimens among virologically suppressed PLWH to prevent COVID-19. HIV care delivery has been adversely impacted in several countries during this pandemic but has created an opportunity for accelerating effective strategies like multi-month ART. Decentralizing HIV care in low-resource settings and incorporating telemedicine in high-resource settings will be critical in mitigating shocks to healthcare systems in the future.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Impact of COVID-19 on people living with HIV: A review

Prabhu

Poongulali

Kumarasamy

2020

Journal of Virus Eradication

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“…COVID-19 poses a particular challenge for the African continent because of existing high prevalence rates of other infectious diseases including human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS), TB, cholera, and malaria, along with high rates of AMR and a disproportionate burden of poverty ( UNAIDS, 2019 ; World Health Organisation, 2019 ; WHO, 2019a ; Ataguba, 2020 ; Godman et al., 2020a ; Simpson, 2020 ; United Nations Economic Commission for Africa, 2020a ; WHO, 2020b ; WHO, 2020c ), with ongoing infectious disease initiatives appreciably challenged by COVID-19 ( Mendelson and Matsoso, 2015 ; Ghana Ministry of Health, 2018 ; Godman et al., 2020a ; Kowalska et al., 2020 ). The presence of multi-morbidity with NCDs will aggravate the situation further ( Oni et al., 2015 ; So-Armah and Freiberg, 2018 ; Achwoka et al., 2019 ; Chang et al., 2019 ; Kansiime et al., 2019 ; Woldesemayat, 2020 ), with already high rates of CVD and diabetes a growing concern across Africa ( Mensah et al., 2015 ; Godman et al., 2020b ; Godman et al., 2020c ).…”

Section: Introductionmentioning

confidence: 99%

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Ogunleye

Basu

Mueller³

et al. 2020

Front. Pharmacol.

176

215

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Background: The COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of other infectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa. Objective: Document current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups. Our Approach: Contextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel. Ongoing Activities: Prevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on Ogunleye et al. COVID-19 in Africa NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality. Conclusion: There are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other.

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“…One survey conducted among 19 countries in Central and Eastern Europe reported that HIV clinics were normally operating in only six of these countries (∼32%) during the pandemic. In 11 countries (∼58%), health providers had dual duties for HIV and COVID-19 care (Kowalska et al, 2020). One study conducted among people living with HIV (PLWH) in Atlanta, the United States suggested that responses to COVID-19 such as social distancing were associated with increased cancelations of HIV care appointment (Kalichman et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Challenges to HIV service delivery and the impacts on patient care during COVID-19: perspective of HIV care providers in Guangxi, China

et al. 2020

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The COVID-19 pandemic has brought immense challenges on the health system including HIV care service. Based on online survey data of 1,029 HIV care providers in Guangxi, China, we assessed their perspectives on the challenges for HIV service delivery and perceived impacts of such challenges on patient care during the COVID-19 outbreak. Multivariate regression analysis was conducted to test the association between specific challenges and patient care outcomes controlling for socio-demographics of HIV care providers. The prominent impacts of COVID-19 on patient care outcomes included "not being able to make follow-up visits on time", "not being able to get ARV refills timely", and "compromised ART adherence". Patient care outcome was significantly associated with "not being able to go to work due to quarantine and traffic restriction", "no overall arrangement", "no guideline for HIV service", "conflicts between HIV care and response to COVID-19", and "clinics were overwhelmed by COVID-19 care". In response to dual epidemics of COVID-19 and HIV, policy makers may consider the potential impact of largescale preventive strategies (e.g., lockdowns) on HIV care, assist healthcare providers to navigate shifting tasks and resetting priorities effectively, and develop clear guidelines and clinic-level arrangements to best serve both COVID-19 and HIV patients.

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HIV care in times of the COVID-19 crisis — Where are we now in Central and Eastern Europe?

Cited by 88 publications

References 8 publications

Impact of COVID-19 on people living with HIV: A review

Impact of COVID-19 on people living with HIV: A review

Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Challenges to HIV service delivery and the impacts on patient care during COVID-19: perspective of HIV care providers in Guangxi, China

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