ABSTRACT
The COVID-19 pandemic reached the African continent in less than three months from when the first caseswere reported from mainland China. As COVID-19 preparedness and response plans were rapidly instituted across sub-Saharan Africa, many governments and donor organizations braced themselves for the unknown impact the COVID-19 pandemicwould have in under-resourced settings with high burdens of PLHIV. The potential negative impact of COVID-19 inthese countries is uncertain, but is estimated to contribute both directly and indirectly to the morbidity and mortality ofPLHIV, requiring countries to leverage existing HIV care systems to propel COVID-19 responses, while safeguarding PLHIVand HIV programme gains. In anticipation of COVID-19-related disruptions, PEPFAR promptly established guidance to rapidlyadapt HIV programmes to maintain essential HIV services while protecting recipients of care and staff from COVID-19. Thiscommentary reviews PEPFARs COVID-19 technical guidance and provides country-specific examples of programme adaptionsin sub-Saharan Africa.