Effects of the Covid-19 pandemic on ART initiation and access to HIV viral load monitoring in adults living with HIV in West Africa: a regression discontinuity analysis.

Publication date: Mar 01, 2024

Efforts to control the COVID-19 pandemic have potentially compromised the availability and/or quality of HIV services. We aimed to assess the pandemic’s impact on ART initiation and HIV viral load (VL) monitoring in three West African countries. We used routinely collected data from five clinics contributing to the IeDEA collaboration in Burkina Faso, CcF4te d’Ivoire and Nigeria. We included ART-nacEFve adults living with HIV (ALWH) initiating ART from 01/01/2018. We conducted regression discontinuity analysis to estimate changes in the number of ART initiations and VL measures per week, before and during the pandemic period in each country. In clinics in Burkina Faso and CcF4te d’Ivoire, ART initiations per week remained constant throughout the studied periods (-0. 24 points (p) of ART initiations/week 95%CI -5. 5, 5. 9, -0. 9 p 95%CI -8. 5,8. 6, respectively), whereas in Nigeria’s clinic, they decreased significantly (-6. 3 p, 95% CI -10. 8, -1. 7) after the beginning of the pandemic. The volume of VL tests performed decreased significantly in all three countries (-17. 0 p 95%CI -25. 3, -8. 6 in Burkina Faso, -118. 4 p 95%CI -171. 1, -65. 8 in CcF4te d’Ivoire and -169. 1p 95%CI-282. 6, -55. 6 in Nigeria). Access to ART was maintained for newly diagnosed ALWH despite pandemic-related physical/social distancing measures. However, VL monitoring was severely disrupted and did not return to pre-pandemic levels approximately one year after the beginning of the pandemic. While HIV services in West Africa appear rather resilient, the impact of disruptions in VL monitoring on virological and clinical outcomes should continue to be monitored.

Concepts Keywords
African Art
Clinics Burkina
Hiv Ci


Type Source Name
disease MESH Covid-19 pandemic
disease IDO quality
disease IDO country
disease VO volume

Original Article

(Visited 1 times, 1 visits today)