AIDS 2020 – UNAIDS: COVID-19 has significantly upended progress toward eliminating HIV in sub-Saharan Africa


  • Conference Reports
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Takeaway

  • People with HIV (PWH) and/or with tuberculosis (TB) living in sub-Saharan African countries are at a higher risk for COVID-19-related morbidity and mortality because of significant disruptions to health/HIV services.
  • Progress toward ending AIDS by 2030 has been derailed further by COVID-19.

Why this matters

  • Continue to strengthen HIV clinic-patient communications and safeguard logistics and supply chains for HIV medicines and test kits.
  • Implement multimonth dispensing policies.
  • Consider PWH a high-risk group for COVID-19 responses.

Key points

  • Modeling-based estimates suggest that 6-month disruptions of antiretroviral therapy (ART) might result in >500,000 (range, 471,000-673,000) additional deaths from AIDS-related illnesses (e.g. TB) between 2020 and 2021.
  • COVID-19-related interruptions to prevent mother-to-child HIV transmissions may result in increases in new child infections totaling >50% in Malawi, Uganda, and Zimbabwe and by 83% in Mozambique.
  • Interruptions in ART for 20% of PWH for 6 months is expected to result in 110,000 additional AIDS-related deaths.
  • Significant effect seen among people who are socioeconomically disadvantaged and marginalized and people with underlying medical conditions.
  • Preliminary health survey data analysis (Angola, Haiti, Malawi, Mozambique, Rwanda, South Africa, Zambia, and Zimbabwe) demonstrates that PWH have difficulties meeting social distancing guidelines because of significantly higher odds of living in a household with a shared toilet and without a radio.
  • Voluntary medical male circumcision, condom production/distribution, preexposure prophylaxis, HIV testing/treatment, and other programs have all been negatively affected.
  • Some countries are using criminal law to sanction COVID-19 exposure and transmission, affecting HIV health-seeking behavior and disclosure.
  • Large proportions of migrants living in camps are also at a significant risk.

Commentary

“Our progress towards ending AIDS as a public health threat by 2030 was already off track before the COVID-19 outbreak. Now this crisis has the potential to blow us even further off course,” said UNAIDS Executive Director Winnie Byanyima in the Report’s Foreword.