https://orcid.org/0000-0003-2616-9894
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ABSTRACT
Background
Coronavirus disease 2019 (COVID-19) is caused by a virus called severe acute respiratory syndrome coronavirus. As countries struggled to control the spread of the virus through among other measures closure of health facilities, repurposing of health care workers, and restrictions on people’s movement, HIV service delivery was affected.
Objectives
To assess the impact of COVID-19 on HIV service delivery in Zambia by comparing uptake of HIV services before and during COVID-19.
Methods
We used repeated cross-sectional quarterly and monthly data on HIV testing, HIV positivity rate, people living with HIV initiating ART and use of essential hospital services from July 2018 to December 2020. We assessed quarterly trends and measured proportionate changes comparing periods before and during COVID-19 divided into three different comparison time frames: (1) annual comparison 2019 versus 2020; (2) April to December 2019 versus same period in 2020; and (3) Quarter 1 of 2020 as base period versus each of the other quarters of year 2020.
Results
Annual HIV testing dropped by 43.7% (95%CI 43.6–43.7) in 2020 compared to 2019 and was similar by sex. Overall, annual recorded number of newly diagnosed PLHIV fell by 26.5% (95% CI 26.37–26.73) in 2020 compared to 2019, but HIV positivity rate was higher in 2020, 6.44% (95%CI 6.41–6.47) compared to 4.94% (95% CI 4.92–4.96) in 2019. Annual ART initiation dropped by 19.9% (95%CI 19.7–20.0) in 2020 compared to 2019 while use of essential hospital services dropped during the early months of COVID-19 April to August 2020 but picked up later in the year.
Conclusion
While COVID-19 had a negative impact on health service delivery, its impact on HIV service delivery was not huge. HIV policies that were implemented before COVID-19 on testing made it easier to adopt COVID-19 control measures and to continue providing HIV testing services without much disruption.
Responsible Editor Stig Wall
Responsible Editor Stig Wall
Author contributions
All authors contributed to writing the manuscript, interpreting the results critically reviewing it and approval of the final manuscript for submission.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Ethics and consent
The study received ethics approval from Excellence in Research Ethics and Science (ERES) Converge Ethical review Board in Zambia. Since the study used routinely corrected aggregated data, the study was not required to seek another consent from the study participants.
Paper context
The COVID-19 pandemic disrupted delivery of many services in many countries across the world. One area that was greatly affected is health service delivery especially HIV testing and care services in high-burdened countries. This article presents how Zambia’s HIV policies on testing that had been adopted and implemented before COVID-19 helped the country withstand the COVID-19 disruptive effects on HIV testing services and care.