The COVID-19 pandemic slowed previous gains made in controlling HIV blood levels and worsened health disparities. This is even if the world had been making progress on its goals to reduce HIV before COVID-19, with the pandemic compromising those gains by leveling off improvements in the overall population and worsening outcomes particularly among minority patients and people who inject illicit drugs.
This is according to a study – “Viral Suppression Trajectories Destabilized After Coronavirus Disease 2019 Among US People With Human Immunodeficiency Virus: An Interrupted Time Series Analysis” by Matthew A. Spinelli, Katerina A. Christopoulos, Carlos V. Moreira, et al – that was published in Clinical Infectious Diseases, the journal of the Infectious Diseases Society of America.
“Equity in HIV outcomes likely worsened during the pandemic, with decreased access to necessary care and increased socioeconomic impacts disproportionately affecting (specific) populations,” said the paper’s first author, Spinelli.
The researchers used data from 17,999 participants from Jan. 1, 2018 to Jan. 1, 2022 at eight large HIV clinics in the US (particularly: Baltimore, Birmingham, Boston, Chapel Hill, Cleveland, San Diego, San Francisco and Seattle). They compared results from Jan.1, 2018 to March 21, 2020, tracking outcomes as the pandemic progressed.
Past progress in controlling the virus came to a virtual standstill during the pandemic for the general population. But for certain subsets, mainly Black patients as well as those with a history of injection drug use, the pandemic worsened their outcomes. The percentage of Black patients who kept their viral loads suppressed decreased from 87% to 85%, and for people who inject drugs their level dropped from 84% to 81%.
The shelter-in-place orders around the world limited access to care for patients, especially those who were already experiencing health disparities. Factors included the shift to telemedicine to provide HIV services as well as reduced in-person medical visits. Increased isolation also led to worsening substance use, loneliness and mental health issues for some individuals.
The Philippines fared no better, with various issues affecting HIV-related efforts – e.g. no access to testing for those at risk for HIV infection, and problems with accessing antiretroviral medicines for PLHIVs.
With this, many countries – including the US, and particularly the Philippines – may not reach the global goals to eliminate HIV by 2030.
“We will need to redouble our efforts in responding to the HIV epidemic to regain our momentum, with a focus on improving health equity so that no one is left behind,” Spinelli ended.