Stakeholders’ solutions to antiretroviral therapy interruption during the COVID-19 pandemic in China: a short report

ABSTRACT

Obtaining antiretroviral therapy (ART) was a challenge for people living with HIV (PLHIV) in China during the COVID-19 outbreak. On 26 January 2020, the Chinese Center for AIDS/STD Control and Prevention issued a nationwide directive to relax restrictions on where and when PLHIV could refill ART. This qualitative study explored unexpected barriers under this directive and recommendations to improve future ART delivery. Between February 11 and February 15 2020, in-depth interviews of 4 groups of stake holders related to ART refilling (i.e., PLHIV, community-based organization employees, CDC staff, infectious disease physicians and nurses), were conducted via WeChat. Data were managed by NVivo 11.0 and transcripts were coded using thematic analysis. Sixty-two interviews were conducted. The main barriers to refilling ART included: (1) inconsistent documentation requirements to refill ART, (2) lack of specific protocols on ART refilling, (3) insufficient staffing, and (4) regimen verification and drug shortages. The most common recommendations to improve future ART delivery were: (1) to establish a nationwide system to distribute ART and (2) increase the number of pills delivered with each ART refill. Strengthening protocols and systems to refill ART and improving collaboration is key to preventing interruptions in ART among PLHIV during public health emergencies.

KEYWORDS:

• China
• people living with HIV
• antiretroviral therapy interruption
• COVID-19
• qualitative

Acknowledgements

HZ conceptualized and designed the study. YZ, YS, AF, BL and HL conducted the qualitative study and analysis. YZ and YS drafted the manuscript, with all authors critically reviewing and approving the final version of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics approval

The study was approved by the review board of Sun Yat-sen University (SYSU-SPH2020008).

Author contributions

HZ conceptualized and designed the study. YZ, YS, AF, BL and HL conducted the qualitative study and analysis. YZ and YS drafted the manuscript, with all authors critically reviewing and approving the final version of the manuscript.

Data availability statement

Due to the nature of qualitative data, we are unable to make the data available in a repository. Corresponding author had the full access to the raw data. Date requests could be sent to the corresponding author via [email protected].

Additional information

Funding

This study was supported by the Natural Science Foundation of China Excellent Young Scientists Fund[82022064], Natural Science Foundation of China International/Regional Research Collaboration Project [72061137001], Natural Science Foundation of China Young Scientist Fund[81703278], the National Science and Technology Major Project of China [2018ZX10721102], the Sanming Project of Medicine in Shenzhen [SZSM201811071], the High Level Project of Medicine in Longhua, Shenzhen [HLPM201907020105], the National Key Research and Development Program of China [2020YFC0840900], the Shenzhen Science and Technology Innovation Commission Basic Research Program [JCYJ20190807155409373], Special Support Plan for High-Level Talents of Guangdong Province[2019TQ05Y230], the Fundamental Research Funds for the Central Universities [58000-31620005], Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences [2020]. All funding parties did not have any role in the design of the study or in the explanation of the data.