HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo
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. Obje...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2022-10-01
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| Series: | Southern African Journal of HIV Medicine |
| Subjects: | |
| Online Access: | https://sajhivmed.org.za/index.php/hivmed/article/view/1421 |
| _version_ | 1811244544271843328 |
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| author | Gulzar H. Shah Gina Etheredge Stacy W. Smallwood Lievain Maluantesa Kristie Waterfield Osaremhen Ikhile John Ditekemena Elodie Engetele Elizabeth Ayangunna Astrid Mulenga Bernard Bossiky |
| author_facet | Gulzar H. Shah Gina Etheredge Stacy W. Smallwood Lievain Maluantesa Kristie Waterfield Osaremhen Ikhile John Ditekemena Elodie Engetele Elizabeth Ayangunna Astrid Mulenga Bernard Bossiky |
| author_sort | Gulzar H. Shah |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-12T14:25:48Z |
| format | Article |
| id | doaj.art-f3a189f261f2405cbea98504617f5253 |
| institution | Directory Open Access Journal |
| issn | 1608-9693 2078-6751 |
| language | English |
| last_indexed | 2024-04-12T14:25:48Z |
| publishDate | 2022-10-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of HIV Medicine |
| spelling | doaj.art-f3a189f261f2405cbea98504617f52532022-12-22T03:29:26ZengAOSISSouthern African Journal of HIV Medicine1608-96932078-67512022-10-01231e1e610.4102/sajhivmed.v23i1.1421814HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the CongoGulzar H. Shah0Gina Etheredge1Stacy W. Smallwood2Lievain Maluantesa3Kristie Waterfield4Osaremhen Ikhile5John Ditekemena6Elodie Engetele7Elizabeth Ayangunna8Astrid Mulenga9Bernard Bossiky10Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of AmericaFHI 360, Washington, United States of AmericaJiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of AmericaFHI 360, Kinshasa, Democratic Republic of the CongoDepartment of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of AmericaDepartment of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of AmericaFHI 360, Kinshasa, Democratic Republic of the CongoFHI 360, Washington, United States of AmericaDepartment of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, United States of AmericaFHI 360, Kinshasa, Democratic Republic of the CongoNational Multisectoral HIV/AIDS program (PNMLS), HIV Program, Presidency of DRC, Democratic Republic of the CongoBackground: 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.https://sajhivmed.org.za/index.php/hivmed/article/view/1421hivviral loadantiretroviral treatmentcovid-19democratic republic of congoplhiv |
| spellingShingle | Gulzar H. Shah Gina Etheredge Stacy W. Smallwood Lievain Maluantesa Kristie Waterfield Osaremhen Ikhile John Ditekemena Elodie Engetele Elizabeth Ayangunna Astrid Mulenga Bernard Bossiky 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 hiv viral load antiretroviral treatment covid-19 democratic republic of congo plhiv |
| title | HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo |
| title_full | HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo |
| title_fullStr | HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo |
| title_full_unstemmed | HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo |
| title_short | HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo |
| title_sort | hiv viral load suppression before and after covid 19 in kinshasa and haut katanga democratic republic of the congo |
| topic | hiv viral load antiretroviral treatment covid-19 democratic republic of congo plhiv |
| url | https://sajhivmed.org.za/index.php/hivmed/article/view/1421 |
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