Résumé
Background: The social measures taken to control the COVID-19 pandemic can potentially disrupt the management of HIV. The objective of this study was to examine the impact of the Australian COVID-19 lockdown restrictions on access to antiretroviral therapy (ART) for people living with HIV in Melbourne.Methods: Using data from the Melbourne Sexual Health Centre (MSHC), we assessed the changes in rates of ART postal delivery, controlled viral load, and ART dispensing from 2018 to 2020. The percentage of ART delivered by postage from MSHC pharmacy was calculated weekly. The percentage of people living with HIV with a controlled viral load (≤ 200 copies/mL) was calculated monthly. We calculated a yearly Medication Possession Ratio (MPR).Findings: The average percentage of HIV ART dispensed through postage for the years 2018, 2019, and 2020 was 3∙7% (371/10023), 3∙6% (380/10685), and 14% (1478/10765), respectively (Ptrend < 0∙0001). Of the 3115 people living with HIV, the average MPR for 2018, 2019, and 2020 was 1∙05, 1∙06, and 1∙14, respectively (Ptrend = 0.28). The average percentage of people with an HIV viral load of < 200 copies/mL for the years 2018, 2019, and 2020 were 97∙6% (2271/2327), 98∙0% (2390/2438), and 99∙2% (2048/2064), respectively (Ptrend < 0∙0001).Interpretation: This study found that the proportion of controlled viral load and access to ART of people living with HIV in Melbourne was largely unaffected by the COVID-19 lockdown restrictions. This suggests that some of the services provided by MSHC during the pandemic, such as HIV ART postal delivery, may assist long-term HIV management.Funding: Chow EPF and Ong JJ are supported by an Australian National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (GNT1172873, GNT1193955). Fairley CK is supported by an Australian NHMRC Leadership Investigator Grant (GNT1172900).Declaration of Interest: The authors declare they do not have any conflicts of interest.Ethical Approval: This study was approved by the Alfred Hospital Ethics Committee, Melbourne, Australia (773/20).