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The HIV infection healthcare services continuity in the COVID-19 pandemic context: A mixed cross-sectional analysis of associated determinants in Senegal, 2020–2021

Year: 2025

Type: article

Abstract: COVID-19 pandemic favoured concentration on its response to the detriment of routine services, such as people living with HIV (PLHIV) follow-up, hence the major services discontinuity risk. Thus, Senegalese National Epidemic Management Committee aimed to study the HIV healthcare services continuity during the COVID-19 pandemic. A mixed cross-sectional study for analytical purposes conducted in 2020–2021 used a combination of surveys (stratified, elementary random and systematic) on 504 PLHIV. Data was collected by document review and individual telephone interviews for a multivariate (logistic regression) and thematic analysis using Excel 2010® , Stata SE/15.1® and R-IRaMuTeQ® software. Senegalese National Ethics Committee for Health Research’s approval as well as the participants’ free and informed consent was obtained. Findings shows that the average age was 43.2 ± 13 years, with a female predominance (67 %) and 8.28 % of whom were pregnant or had recently delivered, including 85.7 % hospital deliveries, 89.29 % on antiretroviral therapy and 57.14 % with PCR (87.5 % negative). Stage I disease was more common (90. 8 %) than Stage III (2.38 %). Tuberculosis co-infection was screened in 85.4 % of cases (2.33 % positive). Viral load was measured in 67.26 % of cases, 71.68 % of which were undetectable. Findings shown a 2.38 % PLHIV follow-up services continuity gap during the pandemic, and significant links with marital status (p = 0.015 for married), opinion on the cost of the consultation (p = 0.013 for cheap), and source of household (power) energy (p = 0.035 for solar and p = 0.003 for electricity). Finally, the qualitative analysis showed the high cost of care services barriers and the benefit of early awareness-raising. In conclusion, contextualized and adapted services continuity plans can help to better mitigate the COVID-19 impact on supply and demand for PLHIV follow-up services. • Married PLHIV were more retained in follow-up care services during the pandemic. • Reduced direct (consultation) and indirect (transport) costs can favour continuous care. • COVID-19’s socio-economic obstacles need income-generating activities promotion. • PLHIV follow-up continuity was closely linked to the energy source of the household. • Community support was not linked to PLHIV follow-up continuity due to lockdown.

Source: The Microbe

DOI: 10.1016/j.microb.2025.100536