Access to care and impact on HIV treatment interruptions during the COVID-19 pandemic among people living with HIV in...

Area of Science:

• Public Health
• Infectious Diseases
• HIV/AIDS Research

Background:

• The COVID-19 pandemic significantly altered healthcare delivery globally.
• People living with HIV (PLWH) require consistent antiretroviral therapy (ART) to maintain viral suppression.
• Understanding the pandemic's impact on HIV care is crucial for maintaining treatment continuity.

Purpose of the Study:

• To evaluate the overall impact of the COVID-19 pandemic on PLWH in British Columbia, Canada.
• To specifically assess the effect of the pandemic on antiretroviral treatment interruptions (TIs) among PLWH.
• To examine associations between reported healthcare access challenges and TIs during the pandemic.

Main Methods:

• Utilized purposive sampling to enroll 581 PLWH (aged ≥19) in the STOP HIV/AIDS Program Evaluation study.
• Collected survey data at baseline, 18, and 36 months, with additional COVID-19 specific questions added in October 2020.
• Defined TIs as >60 days late for ART refill using BC HIV Drug Treatment Program data; analyzed trends using generalized linear mixed models.

Main Results:

• The frequency of TIs (6.1%-7.7% per 6-month period) did not statistically increase during the COVID-19 pandemic (March 2019 - August 2021).
• Among 188 participants completing COVID-19 questionnaires, 32.8% reported healthcare access difficulties, 9.7% avoided services, and 74.6% used virtual healthcare.
• No significant association was found between reported healthcare access challenges and TIs in multivariable analysis.

Conclusions:

• Despite reported challenges in accessing healthcare services due to COVID-19, TIs did not become more frequent among PLWH.
• HIV treatment adherence remained stable, suggesting effective adaptation of care delivery models during the pandemic.
• Virtual healthcare services were widely adopted by PLWH, potentially supporting treatment continuity.