HIV Care Continuum During the COVID-19 Pandemic
Summary
The continuum of HIV care spans testing and diagnosis, linkage to services, initiation and adherence to antiretroviral therapy (ART), and achievement of sustained viral suppression. The COVID-19 pandemic posed unprecedented challenges at every stage of this pathway. Lockdowns and the reallocation of healthcare resources disrupted routine testing and delayed new diagnoses, particularly among marginalised and hard-to-reach populations. Social distancing measures and fear of exposure prompted many clinics to reduce in-person consultations, threatening timely linkage to care and adherence support. Supply-chain disturbances and border closures hindered the distribution of ART in regions dependent on international procurement. In response, healthcare systems accelerated remote delivery models, including telemedicine, community-based ART delivery and multimonth prescribing, which mitigated some disruptions and provided alternative routes to maintain continuity. Modelling studies have suggested that even brief interruptions to critical services can result in substantial increases in new HIV infections and HIV-related mortality over both short- and mid-term horizons. Despite these risks, emerging data indicate that adaptations like differentiated service delivery, expanded virtual consultations and policy flexibilities are helping to preserve virological outcomes for those already in care. Global experience underscores the need for resilient health systems capable of protecting the HIV care continuum in the face of large-scale emergencies, ensuring that progress towards epidemic control is not reversed.
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HIV Care Continuum During the COVID-19 Pandemic publication trend
The graph below shows the total number of articles in hiv care continuum during the covid-19 pandemic across all publications each year (not limited to Nature Index journals).
Technical terms
Antiretroviral therapy (ART): A combination of medications used to suppress HIV replication and preserve immune function.
Viral suppression: The reduction of HIV RNA in the blood to undetectable levels, indicating effective treatment.
Linkage to care: The process of connecting individuals diagnosed with HIV to medical and support services without delay.
Telemedicine: The remote delivery of healthcare services via digital platforms, including video and phone consultations.
CD4 cell count: A laboratory measure of immune system strength, reflecting the number of CD4+ T lymphocytes per cubic millimetre of blood.
References
- Consequences of the COVID-19 pandemic on the continuum of care in a cohort of people living with HIV followed in a single center of Northern Italy. AIDS Research and Therapy (2020).
- The impact of COVID-19 pandemic on HIV care continuum in Jiangsu, China. BMC Infectious Diseases (2021).
- The impact of disruptions due to COVID‐19 on HIV transmission and control among men who have sex with men in China. Journal of the International AIDS Society (2021).
- HIV care using differentiated service delivery during the COVID‐19 pandemic: a nationwide cohort study in the US Department of Veterans Affairs. Journal of the International AIDS Society (2021).
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