TY - JOUR
T1 - HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo
AU - Shah, Gulzar H.
AU - Etheredge, Gina D.
AU - Smallwood, Stacy W.
AU - Maluantesa, Lievain
AU - Waterfield, Kristie C.
AU - Ikhile, Osaremhen
AU - Ditekemena, John
AU - Engetele, Elodie
AU - Ayangunna, Elizabeth
AU - Mulenga, Astrid
AU - Bossiky, Bernard
N1 - Publisher Copyright:
Copyright: © 2022. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.
PY - 2022
Y1 - 2022
N2 - Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible. Objectives: To generate practice-relevant evidence on the impact of initiating ART preCOVID-19 versus during the COVID-19 pandemic on HIV VL. Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021. Results: After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; P < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11). Conclusion: Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals. What this study adds: This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.
AB - Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible. Objectives: To generate practice-relevant evidence on the impact of initiating ART preCOVID-19 versus during the COVID-19 pandemic on HIV VL. Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021. Results: After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; P < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11). Conclusion: Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals. What this study adds: This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.
KW - COVID-19
KW - Democratic Republic of Congo
KW - HIV
KW - PLHIV
KW - antiretroviral treatment
KW - viral load
UR - http://www.scopus.com/inward/record.url?scp=85149043000&partnerID=8YFLogxK
U2 - 10.4102/SAJHIVMED.V23I1.1421
DO - 10.4102/SAJHIVMED.V23I1.1421
M3 - Article
AN - SCOPUS:85149043000
SN - 1608-9693
VL - 23
JO - Southern African Journal of HIV Medicine
JF - Southern African Journal of HIV Medicine
IS - 1
M1 - a1421
ER -