Impact of COVID-19 on HIV Care and Services

The COVID-19 pandemic has exerted widespread and multifaceted effects on HIV care and services across diverse settings. Public health measures such as lockdowns, travel restrictions and facility repurposing led to substantial declines in HIV testing and initiation of antiretroviral therapy (ART), particularly in high-burden and resource-limited regions. Although medication refills and differentiated service delivery models mitigated some interruptions, many people living with HIV (PLWH) encountered barriers in accessing routine clinical appointments, counselling and laboratory monitoring. Social and economic disruptions heightened psychosocial stressors, with reports of increased anxiety, depression and substance use among PLWH, adversely affecting adherence and engagement in care. Mathematical modelling has underscored the critical importance of maintaining uninterrupted ART supply to avoid excess HIV-related morbidity and mortality. In response, service adaptations—such as multi-month dispensing, telemedicine and community-based ART delivery—have been scaled up, revealing the potential for more resilient and patient-centred HIV programmes beyond the acute phase of the pandemic.

Research from Nature Portfolio

A multicentre observational survey conducted across eleven antiretroviral therapy sites in northern Vietnam between mid-2021 and early 2022 assessed SARS-CoV-2 seroprevalence, access to HIV treatment and psychosocial outcomes among over 7 800 PLWH. Findings revealed very low COVID-19 infection rates among participants and stable ART adherence without increases in risky health behaviours. Nevertheless, significant economic hardship was reported, marked by unemployment and food insecurity, which correlated with elevated depressive symptoms. Notably, depression prevalence declined by over ten per cent compared with pre-pandemic levels, suggesting the positive impact of strengthened social support networks and targeted financial assistance on mental health and treatment retention.

Impact of COVID-19 on HIV Care and Services publication trend

The graph below shows the total number of articles in impact of covid-19 on hiv care and services across all publications each year (not limited to Nature Index journals).

Technical terms

Antiretroviral therapy (ART): A combination of medicines used to suppress HIV replication and restore immune function.

Interrupted time series analysis: A statistical technique that evaluates the impact of an intervention or event on longitudinal outcome data.

Differentiated service delivery: Person-centred HIV care models that tailor the type, intensity and location of services to individual needs.

Seroprevalence: The proportion of a population with detectable antibodies to a specific pathogen, indicating prior infection or exposure.

Telemedicine: The remote provision of healthcare services via telecommunications technology, often employed to reduce in-person visits.

References

1. Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple mathematical models. The Lancet HIV (2020).
2. Multicenter observational survey on psychosocial and behavioral impacts of COVID-19 in people living with HIV in Northern Vietnam. Scientific Reports (2023).
3. The impact of the COVID‐19 pandemic on mental health, associated factors and coping strategies in people living with HIV: a scoping review. Journal of the International AIDS Society (2023).
4. The impact of the COVID-19 lockdown on HIV care in 65 South African primary care clinics: an interrupted time series analysis. The Lancet HIV (2021).
5. The impacts of COVID-19 pandemic on service delivery and treatment outcomes in people living with HIV: a systematic review. AIDS Research and Therapy (2023).