Impact of the COVID-19 Pandemic on HIV Care Continuum in Jiangsu, China

Abstract

Background: The COVID-19 pandemic seriously threatens general public health services globally. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV care continuum in Jiangsu province, China. Methods: Data for analysis was retrieved from the web-based Comprehensive Response Information Management System (CRIMS) for HIV/AIDS in China. Expert modeler in SPSS time series model was used in the forecast model and Chi-square or fisher’s exact tests were performed to assess subgroup differences. Findings: Overall, a 34.2% (898,936) decrease in testing rates was observed when real data was compared with the estimated number of recorded tests from the first quarter of 2020. Although an estimated 1610 confirmatory tests were expected to be recorded in 2020, only 749 (46.5%) of confirmed HIV/AIDS cases in Jiangsu were recorded by CRIMS. Of 982 clients that received confirmatory tests, only 696 (70.9%) were reportedly linked to care. Only 34.2% (238) out of the expected 523 (53.4%) estimated number of clients received CD4 cell count test services. Meanwhile 208 (29.9%) had initiated antiretroviral therapy (ART) which is comparatively lower than the 315 (32.2%) reported in the previous year. PLWHIV who were migrants, infected through homosexual transmission, and tested via key population surveillance were more likely to be influenced by the COVID-19 policies. Interpretation: The COVID-19 pandemic had a negative impact on the HIV healthcare systems in Jiangsu, China. There is a need to scale up HIV testing systems by encouraging HIV self-testing or community-based testing and providing flexible policies to facilitate ART initiation. Funding Statement: National Key Research and Development Program of China (2017YFE0103800); NIMH (R34MH119963), National Science and Technology Major Project (2018ZX10101-001-001-003); National Nature Science Foundation of China (81903371); Special Found on Prevention and Control of New Coronary Pneumonia in Guangdong Universities (2020KZDZX1047). Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: The study process and contents were reviewed and approved by the Institutional Review Board of the National Center for AIDS/STD Control and Prevention (NCAIDS) and Center for Disease Control and Prevention (CDC) in China. The study was carried out in accordance with relevant guidelines.