HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo

Shah, Gulzar H.; Etheredge, Gina D.; Smallwood, Stacy W.; Maluantesa, Lievain; Waterfield, Kristie Cason; Ikhile, Osaremhen; Ditekemena, John; Engetele, Elodie; Ayangunna, Elizabeth; Mulenga, Astrid; Bossiky, Bernard

doi:10.4102/sajhivmed.v23i1.1421

Cited by 6 publications

(8 citation statements)

References 26 publications

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“…In Tanzania, during COVID-19, the government allowed the dispensing of extra ART to minimize physical contact which likely protected against significant interruptions to treatment and declining rates virologic suppression as a result. Our findings are similar to those from the Congo and other SSA countries which also showed stable or improved VLS during COVID-19 for many of the same reasons [ 58 – 60 ]. High ratings in social support, and self-management also likely contributed to the high proportion with VLS, although associations between these factors and VLS were not significant after adjusting for other potential confounders.…”

Section: Discussionsupporting

confidence: 88%

Generalized and COVID related anxiety as risk factors for health outcomes among adolescents with HIV during COVID-19 in Tanzania

Siril,

Gitagno,

Kaaya

et al. 2024

Preprint

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The COVID-19 pandemic and associated prevention strategies caused widespread interruptions to care and treatment for people living with HIV. Adolescents living with HIV (AWHIV) were particularly vulnerable to poor mental and physical health during COVID-19. We assessed the burden of generalized and COVID-19–related anxiety and associations with adherence to HIV care and treatment and viral load suppression (VLS) among AWHIV during the peak of the COVID-19 pandemic in Tanzania. Methods This cross-sectional study was conducted among AWHIV aged 15–19 years attending 10 clinics in Dar es Salaam from April 2022-February 2023. Study participants completed a self-administered questionnaire including Generalized Anxiety Disorder (GAD), COVID-19-related anxiety, and other psychosocial and physical health and support measures. HIV visit adherence, viral load and sociodemographic data were abstracted from patient health records. Analysis: Multivariable (MV) quasibinomial and logistic regression models examined associations of Generalized and COVID-19-related anxiety with visit adherence and HIV virologic suppression (HIV VL < 50 copies/mL). Data were analyzed using R software. Results 658 AWHIV (52% male) were included in this analysis. Most (86%) had been on antiretroviral treatment (ART) for at least four years, 55% attended at least 75% of their scheduled clinic visits, and 78% were HIV virologically suppressed. The median GAD and COVID-19-related anxiety scores were 2 (IQR: 0–5, and 26 (IQR: 13–43; respectively. Only 2% scored moderate-severe generalized anxiety (score 10–21). We found no significant associations between COVID-19-related anxiety or GAD and visit adherence. Higher GAD was inversely associated with VLS (adjusted odds ratio (AOR): 0.89 (95% CI 0.81, 0.98)). Female gender and higher quality of physical life were significantly associated with VLS. Conclusion. Low levels of generalized and COVID-19 related anxiety were reported among Tanzanian AWHIV. Integrating screening and management of generalized anxiety screening into HIV care for AWHIV could improve VLS among this population.

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Section: Discussionsupporting

confidence: 88%

Generalized and COVID related anxiety as risk factors for health outcomes among adolescents with HIV during COVID-19 in Tanzania

Siril,

Gitagno,

Kaaya

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…15 The small changes observed in VLC and VLS between the pre-COVID-19 and during COVID-19 time period may suggest that these approaches contributed to treatment continuation among adolescents during the initial stages of the COVID-19 pandemic; however, further investigation is warranted. 27 Preliminary USAID/PEPFAR programmatic data suggest that MMD may be correlated with higher rates of VLS and improved adherence across populations 28 and data from cohort studies in Malawi and Italy also show increased rates of VLS during COVID-19 due to introducing patientcentered care models. 25,29 Given that the total number of adolescents on ART grew only modestly during FY20, strategies to keep adolescents engaged in treatment should be emphasized.…”

Section: Discussionmentioning

confidence: 99%

Impact of COVID-19 on HIV Adolescent Programming in 16 Countries With USAID-Supported PEPFAR Programs

Okegbe¹,

Williams

Plourde

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Introduction:The COVID-19 pandemic has disrupted access to critical health services, resulting in diminished gains in HIV epidemic control. This review assesses the magnitude of the impact that the COVID-19 pandemic has had on HIV services for adolescents.Methods:PEPFAR Monitoring, Evaluation, and Reporting programmatic data were analyzed from across 16 USAID-supported adolescent care and treatment programs for fiscal year 2020 (FY20; October 2019–September 2020). Descriptive statistics were used to calculate absolute number and percent change between the pre-COVID-19 (Quarters 1–2; October 2019–March 2020) and COVID-19 periods (Quarters 3–4; April 2020–September 2020) for clinical cascade indicators. All analyses were conducted in Microsoft Excel.Results:The number of HIV tests conducted during COVID-19 decreased by 21.4% compared with pre-COVID-19, with a subsequent 28% decrease in adolescents identified living with HIV. The rate of proxy linkage to antiretroviral therapy increased between periods, from 86.9% to 90.4%. There was a 25.9% decrease in treatment initiations among adolescents during COVID-19. During FY20, viral load coverage rates for adolescents dropped from 81.6% in FY20Q1 to 76.5% in FY20Q4, whereas the rates of viral load suppression for adolescents increased from 76.1% in FY20Q1 to 80.5% in FY20Q4.Conclusion:There was a substantial decrease in case-finding, treatment initiations, and viral load coverage rates for adolescents supported in USAID/PEPFAR programs during the COVID-19 pandemic. Additional health systems adaptations and strategies are required to ensure adolescents have continued access to HIV services during pandemic disruptions.

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“…Eight studies documented negative impact of the pandemic on LRC [ 14 , 26 , 27 , 29 – 33 ]. Research conducted in low-income countries has provided evidence indicating the existence of various impediments to accessing and receiving necessary healthcare services, referred to as LRC, during the COVID-19 pandemic [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

Repercussions of the COVID-19 pandemic on the HIV care continuum and related factors in economically disadvantaged nations: an integrated analysis using mixed-methods systematic review

Ojukwu,

Pashaei,

Maia

et al. 2024

Eur J Med Res

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Background The COVID-19 pandemic affected the self-management and care of people living with HIV, requiring adaptations in the way health services are provided. However, it is unclear how these changes impacted HIV care in low-income countries. Methods A systematic review including the current evidence related to changes in HIV care continuum during COVID-19 was conducted through a systematic search in the online databases including CINAHL, OVID-Medline, CAB Direct, and OVID-Embase. A two-step screening process was carried out to include eligible papers and reports according to inclusion criteria. Results From the searches we identified 21 total studies published between 2021 and 2024, the studies revealed mostly negative impacts on all stages of the HIV care continuum in low-income countries. There were impacts related to the blocking measures due to COVID-19, fear of contracting the disease, difficulties in providing resources such as income, food and transports, reductions in the provision of care from prevention to viral suppression. Conclusion Overall, researchers identified several negative impacts of COVID-19 restrictions on HIV care continuum during pandemic; however, some observations indicated indirect positive impacts on some aspects of HIV care. Decline in HIV care practices during pandemic compared to before pandemic were observed including using preventative methods, counseling and testing, receiving HIV healthcare services, HIV medical appointments, antiretroviral adherence, engagement with treatment, and poor viral suppression. However, in some evidence improvement in ART adherence and PrEP use were observed.

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HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo

Cited by 6 publications

References 26 publications

Generalized and COVID related anxiety as risk factors for health outcomes among adolescents with HIV during COVID-19 in Tanzania

Generalized and COVID related anxiety as risk factors for health outcomes among adolescents with HIV during COVID-19 in Tanzania

Impact of COVID-19 on HIV Adolescent Programming in 16 Countries With USAID-Supported PEPFAR Programs

Repercussions of the COVID-19 pandemic on the HIV care continuum and related factors in economically disadvantaged nations: an integrated analysis using mixed-methods systematic review

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