Abstract
AbstractGlobally, Botswana has one of the highest burdens of HIV. This study estimated the impact of the COVID-19 pandemic on the HIV cascade of care in Sub-Saharan Africa. We conducted an interrupted time series analysis on national-level data to estimate the effect of COVID-19 on the numbers of HIV tests, positive HIV tests and ART initiations from April 2019 until March 2021. In multivariable Poisson interrupted time series regression, the COVID-19 lockdown was associated with a 27% decrease in the monthly numbers of HIV tests (IRR 0.73, 95%CI 0.72–0.73), a 25% decrease in HIV positive tests (IRR 0.75, 95%CI 0.71–0.79), and a 43% reduction in ART initiations (IRR 0.57, 95%CI 0.55–0.60). The impact of the pandemic on all three outcomes was worse in males and those aged ≥ 50 years. In conclusion, COVID-19 had a strong negative impact on HIV screening, diagnosis and ART initiation in Botswana.
Publisher
Springer Science and Business Media LLC
Reference28 articles.
1. Joint United Nations Programme on HIV/AIDS (UNAIDS. )-Fact sheet 2022. https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf. Accessed 26 Nov 2022.
2. Kay ES, Batey DS, Mugavero MJ. The HIV treatment cascade and care continuum: updates, goals, and recommendations for the future. AIDS Res Therapy. 2016;13(1):35.
3. Center for Disease Control and Prevention. Understanding the HIV care continuum. 2014. http://www.cdc.gov/hiv/pdf/dhap_continuum.pdf. Accessed 30 Nov 2022.
4. Joint United Nations Programme on HIV/AIDS (UNAIDS). Understanding fast-track-Accelerating action to end the AIDS epidemic by 2030. https://www.unaids.org/sites/default/files/media_asset/201506_JC2743_Understanding_FastTrack_en.pdf. Accessed 01 Dec 2022.
5. Nah K, Nishiura H, Tsuchiya N, Sun X, Asai Y, Imamura A. Test-and-treat approach to HIV/AIDS: a primer for mathematical modeling. Theor Biol Med Model. 2017;14(1):16. Epub 20170905.