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

Autor: Shah GH; Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of America., Etheredge GD; FHI 360, Washington, United States of America., Smallwood SW; Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of America., Maluantesa L; FHI 360, Kinshasa, Democratic Republic of the Congo., Waterfield KC; Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of America., Ikhile O; Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of America., Ditekemena J; FHI 360, Kinshasa, Democratic Republic of the Congo., Engetele E; FHI 360, Washington, United States of America., Ayangunna E; Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of America., Mulenga A; FHI 360, Kinshasa, Democratic Republic of the Congo., Bossiky B; National Multisectoral HIV/AIDS program (PNMLS), HIV Program, Presidency of DRC, Democratic Republic of the Congo.
Jazyk: angličtina
Zdroj: Southern African journal of HIV medicine [South Afr J HIV Med] 2022 Oct 28; Vol. 23 (1), pp. 1421. Date of Electronic Publication: 2022 Oct 28 (Print Publication: 2022).
DOI: 10.4102/sajhivmed.v23i1.1421
Abstrakt: Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.
Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.
Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.
Results: After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; P < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11).
Conclusion: Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals.
What This Study Adds: This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.
Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
(© 2022. The Authors.)
Databáze: MEDLINE
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