Impact of COVID-19 on HIV Prevention and Care Services for People Living With HIV in Bukavu City: An Explanatory Sequential Mixed Study
Introduction: Since its appearance in China at the end of 2019, the sanitary response to COVID-19 infection has disrupted the delivery of primary healthcare services, including those related to the human immunodeficiency virus (HIV). In the Democratic Republic of Congo, anti-COVID-19 measures (containment) effect on the use of HIV preventive and care services for people living with HIV (PLHIV) remains poorly described to date. Objective: Compare and understand the effect of anti-COVID measures on the use of HIV prevention and care services for PLHIV in Outpatient treatment centers from Bukavu before (October 2019 to February 2020) and during (March to July 2020) anti-COVID measures. Methods: Multisite mixed study with an explanatory sequential design carried out in Bukavu between July and September 2021. Quantitative phase is observational, descriptive, retrospective and based on programmatic data from Outpatient treatment centers (OTC). Qualitative phase, guided by quantitative results, is based on 31 semi-structured interviews with caregivers and PLHIV. Results: Compared to the pre-COVID-19 period, anti-COVID-19 measures resulted in an 11-20% decrease in HIV preventive and PLHIV’s care services. They also led to stock outs of antiretrovirals and HIV tests, HIV services reorganization, some caregiver’s contamination with COVID-19 and death of others, and a drop in HIV services use. Discussion and conclusion: In Bukavu, anti-COVID-19 measures have had a negative impact on the care of at-risk, HIV-infected people. They have hampered progress towards the objectives of 95% of people tested for HIV, 95% of PLHIV on treatment and 95% of PLHIV with a suppressed viral load.