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.
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].