The Impact of COVID-19 on UNAIDS 90–90–90 Targets: Calls for New HIV Care Models

Guaraldi, Giovanni; Borghi, Vanni; Milić, Jovana; Carli, Federica; Cuomo, Gianluca; Menozzi, Marianna; Santoro, Antonella; Orlando, Gabriella; Puzzolante, Cinzia; Meschiari, Marianna; Franceschini, Erica; Bedini, Andrea; Ferrari, Filippo; Gennari, William; Sarti, Mario; Mussini, Cristina

doi:10.1093/ofid/ofab283

Cited by 17 publications

(12 citation statements)

References 10 publications

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“…An 85% reduction in HIV/gonorrhea/chlamydia tests was reported in the first quarter of the year 2020 in the Boston area. The same reduction was reported in Lombardy, Italy (7). A report from Melbourne showed that 25% of PrEP users stopped taking PrEP during the COVID-19 outbreak (16) (Table 1).…”

Section: % Use Combination Preventionsupporting

confidence: 68%

“…Between April and June 2020 alone, the COVID-19 has led to about a 30% reduction in the use of HIV testing services in communities and health facilities in Uganda (6). Compared to the pre-COVID-19 period, there was about 20% reduction of HIV tests in Italy (7). In addition, since more than half of HIV clinics had stopped in-person visits and blood testing and focused on ART drug distribution to patients diagnosed before the pandemic (8), the second "95%" target of ART might be the least impacted.…”

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confidence: 99%

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Impact of the COVID-19 Pandemic on the UNAIDS Six 95% HIV Control Targets

et al. 2022

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Section: % Use Combination Preventionsupporting

confidence: 68%

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confidence: 99%

Impact of the COVID-19 Pandemic on the UNAIDS Six 95% HIV Control Targets

et al. 2022

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“…HIV health systems were overloaded and in 42.1% of cases, HIV drug procurement might have been affected [8]. Additionally, Western Europe reported that there were significant losses in the 90-90-90 objectives in 2020, which were associated with the introduction of lockdowns and limited access to HIV outpatient services [1]. This situation, worldwide, led to new ideas and solutions that allowed the continuity of care for HIV patients to be maintained during this difficult time for the HIV epidemic.…”

Section: Discussionmentioning

confidence: 99%

“…COVID-19 has been a challenging time for all medical services, especially at the beginning of the pandemic, and it has been difficult to maintain continued care for HIV patients [1]. After almost two years, it is still a challenge, but it is also an opportunity for Central and Eastern Europe (CEE) to modernize old systems and introduce modern tools to HIV care [2].…”

Section: Introductionmentioning

confidence: 99%

The Management of HIV Care Services in Central and Eastern Europe: Data from the Euroguidelines in Central and Eastern Europe Network Group

Skrzat‐Klapaczyńska

Kowalska

Afonina

et al. 2022

IJERPH

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Introduction: The COVID-19 pandemic has been challenging time for medical care, especially in the field of infectious diseases (ID), but it has also provided an opportunity to introduce new solutions in HIV management. Here, we investigated the changes in HIV service provision across Central and Eastern European (CEE) countries before and after the COVID-19 outbreak. Methods: The Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of ID from 24 countries within the CEE region. Between September 11 and September 29, 2021, the group produced an on-line survey, consisting of 32 questions on models of care among HIV clinics before and after the SARS-CoV-2 outbreak. Results: Twenty-three HIV centers from 19 countries (79.2% of all countries invited) participated in the survey. In 69.5% of the countries, there were more than four HIV centers, in three countries there were four centers (21%), and in four countries there was only one HIV center in each country. HIV care was based in ID hospitals plus out-patient clinics (52%), was centralized in big cities (52%), and was publicly financed (96%). Integrated services were available in 21 clinics (91%) with access to specialists other than ID, including psychologists in 71.5% of the centers, psychiatrists in 43%, gynecologists in 47.5%, dermatologists in 52.5%, and social workers in 62% of all clinics. Patient-centered care was provided in 17 centers (74%), allowing consultations and tests to be planned for the same day. Telehealth tools were used in 11 centers (47%) before the COVID-19 pandemic outbreak, and in 18 (78%) after (p = 0.36), but were represented mostly by consultations over the telephone or via e-mail. After the COVID-19 outbreak, telehealth was introduced as a new medical tool in nine centers (39%). In five centers (28%), no new services or tools were introduced. Conclusions: As a consequence of the COVID-19 pandemic, tools such as telehealth have become popularized in CEE countries, challenging the traditional approach to HIV care. These implications need to be further evaluated in order to ascertain the best adaptations, especially for HIV medicine.

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“…The emergence of SARS-CoV-2 epidemics may have also affected established measures for the prevention and diagnosis of HIV infection and other sexually transmitted diseases and the clinical care of HIV-infected patients, although data are limited [7,8]. The WHO warned that the access to HIV medicines could be severely impacted by COVID-19 [9].…”

Section: Introductionmentioning

confidence: 99%

Impact of coronavirus disease 2019 epidemics on prevention and care for HIV and other sexually transmitted infections

Lazzari

Martínez-Mimbrero

Chivite

et al. 2022

Aids

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Objective: To assess the impact of coronavirus disease 2019 (COVID-19) epidemics on the prevention and care for HIV and other sexually transmitted infections at a major reference centre providing preventive and clinical services in Catalonia, Spain. Design:We retrospectively compared anonymized clinical and laboratory data from March to December 2020 vs. 2019.Methods: Monthly clinical data on HIV preexposure and postexposure prophylaxis users and on adults with HIV infection were retrieved from the administrative hospital database. Monthly tests for HIV, hepatitis B and C, Treponema pallidum, Neisseria gonorrhoeae,and Chlamydia trachomatis, and plasma lipids and glucose were recovered from the laboratory database.Results: There were less (#28%, P ¼ 0.003) but more advanced (mean CD4 þ cells/ml 305 vs. 370, P < 0.001) HIV infections and more gonorrhoea ("39%, P < 0.001) and chlamydia ("37%, P < 0.001) infections in 2020 vs. 2019. In people with HIV, rates of HIV RNA less than 50 copies/ml remained stable (11 vs. 11%, P ¼ 0.147) despite less scheduled visits (#25%, P < 0.001). However, they had less antiretroviral prescription changes (#10%, P ¼ 0.018), worse plasma lipids [mean total cholesterol 190 vs. 185 mg/ dl, P < 0.001;mean low-density lipoprotein (LDL) cholesterol 114 vs. 110 mg/dl, P < 0.001; mean triglycerides 136 vs. 125 mg/dl, P < 0.001; mean high-density lipoprotein (HDL) cholesterol 47 vs. 48 mg/dl, P ¼ 006], and an excess of mortality ("264%, P ¼ 0.006) due in great part not only to COVID-19 but also to other causes. Conclusion:In our setting, COVID-19 epidemics was associated with an increase in some prevalent sexually transmitted infections, with less but more advanced HIV infections, and with worse nonvirologic healthcare outcomes and higher mortality in people living with HIV.

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The Impact of COVID-19 on UNAIDS 90–90–90 Targets: Calls for New HIV Care Models

Abstract: We compared 90-90-90 targets in 2020, during the COVID-19 pandemic, with the targets across the period 2017-2019 in people living with HIV. We observed a significant loss in the 90-90-90 objectives in 2020 when compared to 2017-2019 that might be attributable to COVID-19 crisis.

Cited by 17 publications

References 10 publications

Impact of the COVID-19 Pandemic on the UNAIDS Six 95% HIV Control Targets

Impact of the COVID-19 Pandemic on the UNAIDS Six 95% HIV Control Targets

The Management of HIV Care Services in Central and Eastern Europe: Data from the Euroguidelines in Central and Eastern Europe Network Group

Impact of coronavirus disease 2019 epidemics on prevention and care for HIV and other sexually transmitted infections

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