New Delhi: Gilead Sciences, Inc. and the AIDS Society of India has announced findings from a pulse survey conducted to evaluate the impact of the COVID-19 pandemic on access and delivery of HIV care in Asia Pacific. In this region, there are more than 5.8 million people living with HIV (PLHIV) and in 2019, 300,000 were newly infected and about 160,000 deaths were AIDS-related. According to 2017 data for India, there are 2.1 million PLHIV; that year, 88,000 people were newly infected with HIV while 69,000 died from AIDS-related illnesses. According to a recent UNAIDS report, disruption to HIV care could lead to thousands more deaths. The data collected from this regional survey on HIV testing, treatment and prevention, aims to provide insights into current gaps and barriers to care, and action that can be taken to sustain critical healthcare services for HIV.
Commenting on the survey, Dr I. S. Gilada, President, AIDS Society of India, said, “The COVID-19 pandemic has had serious implications on the delivery of healthcare services in HIV across the region, whether in low or high-income countries. Despite proactive efforts by the National AIDS Control Organisation (NACO) to minimise the impact of disruption in medical services and delivery of ART, PLHIV and at-risk populations suffered a severe blow. Interruptions to access and delivery of care can negatively impact PLHIV and those at-risk of HIV, putting them at a higher risk of health complications. This survey is an indication of the critical gaps in access to testing, treatment and preventive care, and shines a light on areas that need to be strengthened to prepare for future public health emergencies or disruptions.”
The survey included PLHIV, people at-risk of HIV and HIV care prescribers across 10 countries in the region, including India. Over 82% of prescribers in India reported that there was a decrease in the frequency or delay of visits of PLHIV. An analysis of the responses in the survey provides additional insights into the disruptions caused by the COVID-19 pandemic:
COVID-19 has had a big impact on the uptake of HIV tests, especially amongst the at-risk population. About 46% of at-risk population reported a decrease in the frequency of taking HIV tests during COVID-19. The main reasons for reduced testing were concerns of getting infected with COVID-19 (62%) and travel restrictions imposed during the pandemic (46%), as HIV tests were mostly only accessible at point-of-care.
COVID-19 has also had a substantial impact on the dispensing or uptake of medicines. About 80% of HIV care prescribers reported a decline in preventive prescriptions for at-risk population while more than 1 in 3 amongst the at-risk population reported that they had either decreased or stopped taking HIV preventive medicine. About 50% of prescribers also reported a decline in prescribing refill antiretroviral medication to PLHIV. Travel restrictions and a change in high-risk behaviour emerged as some of the main reasons for the disruption in treatment.
Long-term ability to access anti-HIV medications is a major concern. Almost 47% of PLHIV and 37% of those at-risk reported that they are concerned about getting antiretroviral medicines and preventive medication during the ongoing COVID-19 pandemic.
Telehealth is becoming a mode of delivery for HIV care during the COVID-19 pandemic. Amongst HIV care prescribers, almost 97% use telehealth to consult with patients via telephone (85%) or video (50%), or to provide refill prescriptions (67%). A majority of prescribers surveyed (76%) expect an increase in telehealth adoption in the future as it offers convenience, allows them to reach more patients and reduces spread of illness. Amongst PLHIV and those at-risk, the most frequent type of telehealth service received from the doctor were phone consultations (58%).