Challenges to HIV service delivery and the impacts on patient care during COVID-19: perspective of HIV care providers in Guangxi, China

ABSTRACT

The COVID-19 pandemic has brought immense challenges on the health system including HIV care service. Based on online survey data of 1,029 HIV care providers in Guangxi, China, we assessed their perspectives on the challenges for HIV service delivery and perceived impacts of such challenges on patient care during the COVID-19 outbreak. Multivariate regression analysis was conducted to test the association between specific challenges and patient care outcomes controlling for socio-demographics of HIV care providers. The prominent impacts of COVID-19 on patient care outcomes included “not being able to make follow-up visits on time”, “not being able to get ARV refills timely”, and “compromised ART adherence”. Patient care outcome was significantly associated with “not being able to go to work due to quarantine and traffic restriction”, “no overall arrangement”, “no guideline for HIV service”, “conflicts between HIV care and response to COVID-19”, and “clinics were overwhelmed by COVID-19 care”. In response to dual epidemics of COVID-19 and HIV, policy makers may consider the potential impact of large-scale preventive strategies (e.g., lockdowns) on HIV care, assist healthcare providers to navigate shifting tasks and resetting priorities effectively, and develop clear guidelines and clinic-level arrangements to best serve both COVID-19 and HIV patients.

KEYWORDS:

• Challenges to HIV service delivery
• patient care outcomes
• COVID-19
• HIV care provider
• China

Acknowledgements

We thank Dr. Cheuk Chi Tam for his work in online survey development. We appreciate Ms. Shuaifeng Liu for her assistance in IRB application and project coordination. We also greatly thank all the HIV care providers who responded to the online survey. Thank Joanne Zwemer for proofreading the manuscript.

Disclosure statement

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

Additional information

Funding

Research reported in this publication was supported by the National Institute of Mental Health of the National Institutes of Health under Award Number NIH R01MH0112376. The work by Dr. Shufang Sun was supported by National Institute of Health (K23AT011173). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.