HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo

Authors

Gulzar H. Shah, Georgia Southern University, Jiann-Ping Hsu College of Public HealthFollow
Gina D. Etheredge, FHI 360, Washington, DCFollow
Stacy Smallwood, Georgia Southern University, Jiann Ping Hsu College of Public HealthFollow
Lievain Maluantesa, FHI 360Follow
Kristie C. Waterfield, Georgia Southern University, Jiann-Ping Hsu College of Public HealthFollow
Osaremhen Ikhile, Georgia Southern University, Jiann-Ping Hsu College of Public HealthFollow
John Ditekemena, FHI 360
Elodie Engetele, FHI 360Follow
Elizabeth Ayangunna, Georgia Southern University, Jiann-Ping Hsu College of Public HealthFollow
Astrid Mulenga, FHI 360Follow
Bernard Bossiky, 5National Multisectoral HIV/AIDS program (PNMLS)

Document Type

Article

Publication Date

10-28-2022

Publication Title

Southern African Journal of HIV Medicine

DOI

10.1097/QAI.0000000000003201

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible.

Objectives: To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL.

Method: Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021.

Results: After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55–4.01; P < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02–1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47–2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07–2.11).

Conclusion: Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals.

What this study adds: This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.

Comments

Georgia Southern University faculty members, Gulzar H. Shah, Stacy W. Smallwood, and Kristie C. Waterfield co-authored HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo.

Recommended Citation

Shah, Gulzar H., Gina D. Etheredge, Stacy Smallwood, Lievain Maluantesa, Kristie C. Waterfield, Osaremhen Ikhile, John Ditekemena, Elodie Engetele, Elizabeth Ayangunna, Astrid Mulenga, Bernard Bossiky. 2022. "HIV viral load suppression before and after COVID-19 in Kinshasa and Haut Katanga, Democratic Republic of the Congo." Southern African Journal of HIV Medicine, 23 (1). doi: 10.1097/QAI.0000000000003201
https://digitalcommons.georgiasouthern.edu/hpmb-facpubs/316

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.