Effects of the COVID-19 Pandemic on ART Initiation and Access to HIV Viral Load Monitoring in Adults Living With HIV in West Africa: A Regression Discontinuity Analysis.

Autor:	Ben Farhat J; Department of Epidemiology and Training, Epicentre, Médecins Sans Frontières, Paris, France.; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France.; Univ. Bordeaux, INSERM, BPH, U1219, Team PHARes, Bordeaux, France., Tiendrebeogo T; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France., Malateste K; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France., Poda A; Department of Infectious Diseases, Université Nazi Boni, Bobo-Dioulasso, Burkina Faso., Minga A; Centre médical de Suivi des Donneurs de Sang (CMSDS), Centre National de Transfusion Sanguine (CNTS), Abidjan, Côte d'Ivoire., Messou E; Centre de Prise en charge de Recherche et de Formation (CePReF), Abidjan, Côte d'Ivoire.; Programme PACCI/ANRS Research Center, Abidjan, Côte d'Ivoire.; Département de Dermatologie et d'Infectiologie, Unité de Formation et de Recherche des Sciences Médicales, Université Félix Houphouët Boigny, Abidjan, Côte d'Ivoire., Chenal H; Virology Laboratory, Integrated Centre for Bioclinical Research in Abidjan (CIRBA), BP 2071 Abidjan, Côte d'Ivoire., Ezechi O; Office of the Central Secretariat, Nigeria Institute for Medical Research, Yaba, Lagos, Nigeria., Ofotokun I; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA., Ekouevi DK; Université de Lomé, Département de Santé Publique, Lomé, Togo ; and., Bonnet F; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France.; CHU de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, INSERM, U1219, Bordeaux, France ., Barger D; Univ. Bordeaux, INSERM, BPH, U1219, Team PHARes, Bordeaux, France., Jaquet A; University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Research Centre, Bordeaux, France.
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2024 Jun 01; Vol. 96 (2), pp. 114-120.
DOI:	10.1097/QAI.0000000000003404
Abstrakt:	Objectives: Efforts to control the COVID-19 pandemic have potentially compromised the availability and/or quality of HIV services. We aimed to assess the pandemic's impact on antiretroviral therapy (ART) initiation and HIV viral load (VL) monitoring in 3 West African countries. Methods: We used routinely collected data from 5 clinics contributing to the International epidemiologic Database to Evaluate AIDS collaboration in Burkina Faso, Côte d'Ivoire, and Nigeria. We included ART-naïve adults living with HIV initiating ART from January 1, 2018. We conducted regression discontinuity analysis to estimate changes in the number of ART initiations and VL measures per week, before and during the pandemic period in each country. Results: In clinics in Burkina Faso and Côte d'Ivoire, ART initiations per week remained constant throughout the studied periods (-0.24 points (p) of ART initiations/week 95% CI: -5.5 to 5.9, -0.9 p, 95% CI: -8.5 to 8.6, respectively), whereas in Nigeria's clinic, they decreased significantly (-6.3 p, 95% CI: -10.8 to -1.7) after the beginning of the pandemic. The volume of VL tests performed decreased significantly in all 3 countries (-17.0 p, 95% CI: -25.3 to -8.6 in Burkina Faso, -118.4 p, 95% CI: -171.1 to -65.8 in Côte d'Ivoire and -169.1 p, 95% CI: -282.6 to -55.6 in Nigeria). Conclusions: HIV clinics in two out of three countries in West Africa demonstrated resilience as they successfully maintained access to ART for ALWH despite the challenges imposed by the pandemic. However, VL monitoring was severely disrupted and did not return to prepandemic levels approximately 1 year after the beginning of the pandemic. Continued monitoring of the HIV care continuum in the postpandemic period is essential to mitigate potential enduring effects on ALWH's virological and clinical outcomes. Competing Interests: D.B. has received speaking fees from Gilead, MSD, and ViiV outside the scope of the submitted work. The remaining authors have no funding or conflicts of interest to disclose. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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