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Assessing the Potential Impact of Disruptions Due to COVID-19 on HIV Among Key and Lower-Risk Populations in the Largest Cities of Cameroon and Benin.
Silhol, Romain; Geidelberg, Lily; Mitchell, Kate M; Mishra, Sharmistha; Dimitrov, Dobromir; Bowring, Anna; Béhanzin, Luc; Guédou, Fernand; Diabaté, Souleymane; Schwartz, Sheree; Billong, Serge C; Njindam, Iliassou Mfochive; Levitt, Daniel; Mukandavire, Christinah; Maheu-Giroux, Mathieu; Rönn, Minttu M; Dalal, Shona; Vickerman, Peter; Baral, Stefan; Alary, Michel; Boily, Marie-Claude.
  • Silhol R; MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom.
  • Geidelberg L; MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom.
  • Mitchell KM; MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom.
  • Mishra S; Department of Medicine, Division of Infectious Disease, University of Toronto, Toronto, Ontario, Canada.
  • Dimitrov D; Fred Hutchinson Cancer Research Center, Seattle, WA.
  • Bowring A; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD.
  • Béhanzin L; National School of Public Health and Epidemiological Surveillance workers, Parakou University, Bénin.
  • Guédou F; Free STI clinic, Cotonou Communal Health Center, Cotonou, Bénin.
  • Diabaté S; Population Health and Optimal Health Practices, Québec University Hospital Research Center, Laval University, Québec, Quebec, Canada.
  • Schwartz S; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD.
  • Billong SC; Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
  • Njindam IM; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD.
  • Levitt D; HIV/AIDS Heath Equity and Rights, CARE USA, New York, NY.
  • Mukandavire C; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Maheu-Giroux M; Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, Quebec, Canada.
  • Rönn MM; Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA.
  • Dalal S; Department of HIV/AIDS, World Health Organization, Geneva, Switzerland; and.
  • Vickerman P; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.
  • Baral S; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD.
  • Alary M; Population Health and Optimal Health Practices, Québec University Hospital Research Center, Laval University, Québec, Quebec, Canada.
  • Boily MC; MRC Centre for Global Infectious Disease Analysis, Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), School of Public Health, Imperial College London, London, United Kingdom.
J Acquir Immune Defic Syndr ; 87(3): 899-911, 2021 07 01.
Article in English | MEDLINE | ID: covidwho-1169727
ABSTRACT

BACKGROUND:

The COVID-19 pandemic indirectly impacts HIV epidemiology in Central/West Africa. We estimated the potential impact of COVID-19-related disruptions to HIV prevention/treatment services and sexual partnerships on HIV incidence and HIV-related deaths among key populations including female sex workers (FSW), their clients, men who have sex with men, and overall.

SETTING:

Yaoundé (Cameroon) and Cotonou (Benin).

METHODS:

We used mathematical models of HIV calibrated to city population-specific and risk population-specific demographic/behavioral/epidemic data. We estimated the relative change in 1-year HIV incidence and HIV-related deaths for various disruption scenarios of HIV prevention/treatment services and decreased casual/commercial partnerships, compared with a scenario without COVID-19.

RESULTS:

A 50% reduction in condom use in all partnerships over 6 months would increase 1-year HIV incidence by 39%, 42%, 31%, and 23% among men who have sex with men, FSW, clients, and overall in Yaoundé, respectively, and 69%, 49%, and 23% among FSW, clients, and overall, respectively, in Cotonou. Combining a 6-month interruption of ART initiation and 50% reduction in HIV prevention/treatment use would increase HIV incidence by 50% and HIV-related deaths by 20%. This increase in HIV infections would be halved by a simultaneous 50% reduction in casual and commercial partnerships.

CONCLUSIONS:

Reductions in condom use after COVID-19 would increase infections among key populations disproportionately, particularly FSW in Cotonou, who need uninterrupted condom provision. Disruptions in HIV prevention/treatment services have the biggest impacts on HIV infections and deaths overall, only partially mitigated by equal reductions in casual/commercial sexual partnerships. Maintaining ART provision must be prioritized to minimize short-term excess HIV-related deaths.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / HIV-1 / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Country/Region as subject: Africa Language: English Journal: J Acquir Immune Defic Syndr Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2021 Document Type: Article Affiliation country: QAI.0000000000002663

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Full text: Available Collection: International databases Database: MEDLINE Main subject: HIV Infections / HIV-1 / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Country/Region as subject: Africa Language: English Journal: J Acquir Immune Defic Syndr Journal subject: SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS) Year: 2021 Document Type: Article Affiliation country: QAI.0000000000002663