ABSTRACT
BACKGROUND: The COVID-19 pandemic has threatened continued access to public health services worldwide, including HIV prevention and care. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV service access and delivery in the Asia region. METHODS: A descriptive, cross-sectional, online study, conducted between October-November 2020, assessed the impact of COVID-19 on HIV prevention and care among people living with HIV (PLHIV), key populations (KPs), and healthcare providers (HCPs). The study populations were recruited across ten Asian countries/territories, covering Hong Kong, India, Japan, Malaysia, Philippines, Singapore, Korea, Taiwan, Thailand, and Vietnam. RESULTS: Across the region, 702 PLHIV, 551 KPs, and 145 HCPs were recruited. Both PLHIV and KPs reported decreased or had yet to visit hospitals/clinics (PLHIV: 35.9%; KPs: 57.5%), reduced HIV RNA viral load testing (21.9%; 47.3%), and interruptions in antiretroviral therapy (ART) (22.3%) or decreased/complete stop of HIV prevention medication consumption (40.9%). Travel constraints (40.6%), financial issues (28.9%), and not receiving prescription refills (26.9%) were common reasons for interrupted ART access, whereas reduced engagements in behaviours that could increase the risks of HIV acquisition and transmission (57.7%), travel constraints (41.8%), and less hospital/clinic visits (36.7%) underlie the disruptions in HIV preventive medications. Decreased visits from PLHIV/KPs and rescheduled appointments due to clinic closure were respectively reported by 50.7%-52.1% and 15.6%-17.0% of HCPs; 43.6%-61.9% observed decreased ART/preventive medication refills. Although 85.0% of HCPs adopted telemedicine to deliver HIV care services, 56.4%-64.1% of PLHIV/KPs were not using telehealth services. CONCLUSIONS: The COVID-19 pandemic substantially disrupted HIV prevention to care continuum in Asia at the time of the study. The findings highlighted differences in HIV prevention to care continuum via telehealth services utilisation by PLHIV, KPs, and HCPs. Efforts are needed to optimise infrastructure and adapt systems for continued HIV care with minimal disruptions during health emergency crises.
Subject(s)
Acquired Immunodeficiency Syndrome , COVID-19 , HIV Infections , Acquired Immunodeficiency Syndrome/epidemiology , COVID-19/epidemiology , Continuity of Patient Care , Cross-Sectional Studies , HIV Infections/drug therapy , HIV Infections/epidemiology , Health Personnel , Hong Kong , Humans , PandemicsABSTRACT
DESIGN: A descriptive cohort study was performed. METHODS: Retrospective data were collected for 63 patients aged >18 years with COVID-19- or non-COVID19-related debility between January 2015 and September 2020. RESULTS: Patients admitted with COVID-19-related debility had a mean length of stay of 20.35 days. 15.4% were transferred back to acute service, 92.3% required respiratory interventions, and 88.5% were discharged to the same residence.Patients with COVID-19-related debility were significantly older, required more respiratory interventions, and had a longer length of stay than the non-COVID-19 group. No significant differences were found in functional outcomes. CONCLUSIONS: Functional outcomes improved, allowing most patients to return to their same residence. CLINICAL RELEVANCE: Patients with COVID-19-related debility responded to rehabilitation as well as the non-COVID-19 group.
Subject(s)
COVID-19 , Frailty , Cohort Studies , Humans , Length of Stay , Patient Discharge , Retrospective StudiesABSTRACT
The Asia-Pacific region is home to nearly 6 million people living with HIV. Across the region, key populations - men who have sex with men, transgender women, people who inject drugs, sex workers, prisoners - and their sexual partners make up the majority of those living with HIV. While significant progress has been made in the past 5 years towards UNAIDS's 90-90-90 goals (90% of people with HIV diagnosed, 90% on antiretroviral therapy, 90% virologically suppressed), significant gaps remain. The papers in this Special Issue address important questions: are we on track to end the AIDS epidemic in the Asia-Pacific region? And can countries in this region reach the new UNAIDS targets for 2030?