(Q29482)
Statements
Key populations (KP), including men who have sex with men (MSM), female sex workers (FSW), and transgender women (TGW), experience a disproportionate burden of HIV, even in generalized epidemics like South Africa. (English)
BACKGROUND (English)
© 2024. The Author(s). (English)
2024
Given this disproportionate burden and unique barriers to accessing health services, sustained provision of care is particularly relevant. (English)
BACKGROUND (English)
© 2024. The Author(s). (English)
2024
It is unclear how the COVID-19 pandemic and its associated restrictions may have impacted this delivery. (English)
BACKGROUND (English)
© 2024. The Author(s). (English)
2024
In this study, we aimed to describe patterns of engagement in HIV prevention and treatment services among KP in South Africa and assess the impact of different COVID-19 restriction levels on service delivery. (English)
BACKGROUND (English)
© 2024. The Author(s). (English)
2024
We leveraged programmatic data collected by the US President's Emergency Plan for AIDS Relief (PEPFAR)-supported KP partners in South Africa. (English)
METHODS (English)
© 2024. The Author(s). (English)
2024
We divided data into three discrete time periods based on national COVID-19 restriction periods: (i) Pre-restriction period, (ii) High-level restriction period, and (iii) After-high level restriction period. (English)
METHODS (English)
© 2024. The Author(s). (English)
2024
Primary outcomes included monthly total HIV tests, new HIV cases identified, new initiations of pre-exposure prophylaxis (PrEP), and new enrollments in antiretroviral therapy (ART). (English)
METHODS (English)
© 2024. The Author(s). (English)
2024
We conducted interrupted time series segmented regression analyses to estimate the impact of COVID-19 restrictions on HIV prevention and treatment service utilization. (English)
METHODS (English)
© 2024. The Author(s). (English)
2024
Between January 2018 and June 2022, there were a total of 231,086 HIV tests, 27,051 HIV positive cases, 27,656 pre-exposure prophylaxis (PrEP) initiations, and 15,949 antiretroviral therapy initiations among MSM, FSW and TGW in PEPFAR-supported KP programs in South Africa. (English)
RESULTS (English)
© 2024. The Author(s). (English)
2024
We recorded 90,457 total HIV tests during the 'pre-restriction' period, with 13,593 confirmed new HIV diagnoses; 26,134 total HIV tests with 2,771 new diagnoses during the 'high-level restriction' period; and 114,495 HIV tests with 10,687 new diagnoses during the after high-level restriction period. (English)
RESULTS (English)
© 2024. The Author(s). (English)
2024
Our Poisson regression model estimates indicate an immediate and significant decrease in service engagement at the onset of COVID-19 restrictions, including declines in HIV testing, treatment, and PrEP use, which persisted. (English)
RESULTS (English)
© 2024. The Author(s). (English)
2024
As programs adjusted to the new restrictions, there was a gradual rebound in service engagement, particularly among MSM and FSW. (English)
RESULTS (English)
© 2024. The Author(s). (English)
2024
Towards the end of the high-level restriction period, with some aspects of daily life returning to normal but others still restricted, there was more variability. (English)
RESULTS (English)
© 2024. The Author(s). (English)
2024
Some indicators continued to improve, while others stagnated or decreased. (English)
RESULTS (English)
© 2024. The Author(s). (English)
2024
Service provision rebounded from the initial shock created by pandemic-related restrictions, and HIV services were largely maintained for KP in South Africa. (English)
CONCLUSION (English)
© 2024. The Author(s). (English)
2024
These results suggest that HIV service delivery among programs designed for KP was able to be flexible and resilient to the evolving restrictions. (English)
CONCLUSION (English)
© 2024. The Author(s). (English)
2024
The results of this study can inform plans for future pandemics and large-scale disruptions to the delivery of HIV services. (English)
CONCLUSION (English)
© 2024. The Author(s). (English)
2024
Danwei (English)
Yao (English)
D
Naomi (English)
Hill (English)
N
Ben (English)
Brown (English)
B
Dorian (English)
Gule (English)
D
Matshidiso (English)
Chabane (English)
M
Mfezi (English)
Mcingana (English)
M
Kalai (English)
Willis (English)
K
Vusi (English)
Shiba (English)
V
Oluwasolape (English)
Olawore (English)
O
Dawie (English)
Nel (English)
D
Jacqueline (English)
Pienaar (English)
J
Johanna (English)
Theunissen (English)
J
Katherine (English)
Rucinski (English)
K
Katie (English)
Reichert (English)
K
Lauren (English)
Parmley (English)
L
J Joseph (English)
Lawrence (English)
JJ
Stefan (English)
Baral (English)
S
Amrita (English)
Rao (English)
A
5 September 2024
3 September 2024