HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo

Southern African Journal of HIV Medicine

Field Value
Title HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo
Creator Shah, Gulzar H. Etheredge, Gina Smallwood, Stacy W. Maluantesa, Lievain Waterfield, Kristie Ikhile, Osaremhen Ditekemena, John Engetele, Elodie Ayangunna, Elizabeth Mulenga, Astrid Bossiky, Bernard
Subject Public Health; Healthcare; HIV care HIV; viral load; antiretroviral treatment; COVID-19; Democratic Republic of Congo; PLHIV
Description 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 pre-COVID-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.
Publisher AOSIS
Contributor CDC
Date 2022-10-28
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — The study uses quantitative, retrospective cohort design based on the date of ART initiation reported in the secondary data collected primarily for HIV program administration.
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v23i1.1421
Source Southern African Journal of HIV Medicine; Vol 23, No 1 (2022); 6 pages 2078-6751 1608-9693
Language eng
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Coverage Democratic Republic of Congo; Haut-Katanga; Kinshasa Current Ages 0 to all; Gender male and female; rural and urban
Rights Copyright (c) 2022 Gulzar H. Shah, Gina D. Etheredge, Stacy W. Smallwood, Lievain Maluantesa, Kristie C. Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky