| Title | The impact of COVID-19 non-pharmaceutical interventions on HIV care continuum in China: An interrupted time series analysis |
| Authors | Wu, Xinsheng Wu, Guohui Ma, Yanmin Huang, Xiaojie Yang, Yuecheng Cai, Yanshan Luo, Ganfeng Ma, Ping Qiao, Ying Chen, Yuanyi Lin, Yi-Fan Gao, Yanxiao Zhan, Yuewei Song, Wei Wang, Yingying Wang, Rugang Yang, Xuejuan Sun, Lijun Wei, Hongxia Li, Quanmin Xin, Xiaoli Wang, Lijing Wang, Xicheng Xie, Ronghui Yang, Lijuan Meng, Xiaojun Zhao, Jin Li, Linghua Zhang, Tong Xu, Junjie Fu, Gengfeng Zou, Huachun |
| Affiliation | Sun Yat Sen Univ, Sch Publ Hlth Shenzhen, Shenzhen, Peoples R China Chongqing Ctr Dis Control & Prevent, Inst AIDS STD Control & Prevent, Chongqing, Peoples R China Henan Prov Ctr Dis, Inst AIDS STD Control & Prevent, Zhengzhou, Peoples R China Capital Med Univ, Beijing Youan Hosp, Clin & Res Ctr Infect Dis, Beijing, Peoples R China Dehong Prefecture Ctr Dis Control & Prevent, Dehong, Peoples R China Guangzhou Ctr Dis Control & Prevent, Dept AIDS Control & Prevent, Guangzhou, Peoples R China Tianjin Second Peoples Hosp, Dept Infect Dis, Tianjin, Peoples R China Tianjin Assoc STD AIDS Prevent & Control, Tianjin, Peoples R China 2 Hosp Huhhot, Hohhot, Peoples R China Shenzhen Peoples Hosp, Talents & Discipline Off, Shenzhen, Peoples R China Shenyang Ctr Dis Control & Prevent, Shenyang, Peoples R China Shijiazhuang Ctr Dis Control & Prevent, Dept STD AIDS Control & Prevent, Shijiazhuang, Peoples R China Dalian Publ Hlth Clin Ctr, Dalian, Peoples R China Yunnan Prov Infect Dis Hosp, Yunnan AIDS Care Ctr, Dept Infect Dis, Kunming, Peoples R China Nanjing Univ Chinese Med, Hosp Nanjing 2, Dept Infect Dis, Peo, Nanjing, Peoples R China Guangzhou Med Univ, Guangzhou Peoples Hosp 8, Infect Dis Ctr, Guangzhou, Peoples R China 6 Peoples Hosp Shenyang, Shenyang, Peoples R China Shijiazhuang Fifth Hosp, Shijiazhuang, Peoples R China Wuxi Municipal Ctr Dis Control & Prevent, Emergency Management Off, Wuxi, Peoples R China Shenzhen Ctr Dis Control & Prevent, Shenzhen, Peoples R China Peking Univ, Shenzhen Hosp, Clin Res Acad, Shenzhen, Peoples R China Jiangsu Prov Ctr Dis Control & Prevent, Dept STD AIDS Control & Prevent, Nanjing, Peoples R China 66 Gongchang Rd, Shenzhen 518107, Guangdong, Peoples R China 8 Longyuan First Rd, Shenzhen, Guangdong, Peoples R China 627 Dongfeng East Rd, Guangzhou, Guangdong, Peoples R China 8 Xitoutiao, Beijing, Peoples R China Lianhua Rd 1120, Shenzhen, Guangdong, Peoples R China 172 Jiangsu Rd, Nanjing, Jiangsu, Peoples R China |
| Keywords | REGRESSION |
| Issue Date | Dec-2022 |
| Publisher | LANCET REGIONAL HEALTH-WESTERN PACIFIC |
| Abstract | Background China implemented strict non-pharmaceutical interventions to contain COVID-19 at the early stage. We aimed to evaluate the impact of COVID-19 on HIV care continuum in China. Methods Aggregated data on HIV care continuum between 1 January 2017 and 31 December 2020 were collected from centers for disease control and prevention at different levels and major infectious disease hospitals in various regions in China. We used interrupted time series analysis to characterize temporal trend in weekly numbers of HIV post-exposure prophylaxis (PEP) prescriptions, HIV tests, HIV diagnoses, median time intervals between HIV diagnosis and antiretroviral therapy (ART) initiation (time intervals, days), ART initiations, mean CD4+ T cell counts at ART initiation (CD4 counts, cells/mu L), ART collections, and missed visits for ART collection, before and after the implementation of massive NPIs (23 January to 7 April 2020). We used Poisson segmented regression models to estimate the immediate and long-term impact of NPIs on these outcomes. Findings A total of 16,780 PEP prescriptions, 1,101,686 HIV tests, 69,659 HIV diagnoses, 63,409 time intervals and ART initiations, 61,518 CD4 counts, 1,528,802 ART collections, and 6656 missed visits were recorded during the study period. The majority of outcomes occurred in males (55.3-87.4%), 21-50 year olds (51.7-90.5%), Southwestern China (38.2-82.0%) and heterosexual transmission (47.9-66.1%). NPIs was associated with 71.5% decrease in PEP prescriptions (IRR 0.285; 95% CI 0.192-0.423), 36.1% decrease in HIV tests (0.639, 0.497-0.822), 32.0% decrease in HIV diagnoses (0.680, 0.511-0.904), 59.3% increase in time intervals (1.593, 1.270-1.997) and 17.4% decrease in CD4 counts (0.826, 0.746-0.915) in the first week during NPIs. There was no marked change in the number of ART initiations, ART collections and missed visits during the NPIs. By the end of 2020, the number of HIV tests, HIV diagnoses, time intervals, ART initiations, and CD4 counts reached expected levels, but the number of PEP prescriptions (0.523, 0.394-0.696), ART collections (0.720, 0.595-0.872), and missed visits (0.137, 0.086-0.220) were still below expected levels. With the ease of restrictions, PEP prescriptions (slope change 1.024/week, 1.012-1.037), HIV tests (1.016/week, 1.008-1.026), and CD4 counts (1.005/week, 1.001-1.009) showed a significant increasing trend. Interpretation HIV care continuum in China was affected by the COVID-19 NPIs at various levels. Preparedness and efforts to maintain the HIV care continuum during public health emergencies should leverage collaborations between stakeholders. Copyright (C) 2022 The Authors. Published by Elsevier Ltd. |
| URI | http://hdl.handle.net/20.500.11897/652430 |
| DOI | 10.1016/j.lanwpc.2022.100569 |
| Indexed | SCI(E) SSCI |
| Appears in Collections: | 深圳医院 |
