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Survey Highlights Disruption of HIV Care During COVID-19 Pandemic
Pulse survey conducted by Gilead Sciences found that majority of people living with HIV, individuals at risk and HIV care prescribers in Asia Pacific experienced disruptions in HIV care during the COVID-19 pandemic.

Gilead Sciences conducted a pulse survey to evaluate the impact of the COVID-19 pandemic on the access and delivery of care in HIV, which includes testing, treatment and prevention, in Asia Pacific. The survey revealed that people living with HIV and individuals at-risk have halted or delayed essential care, such as testing and taking medications, to manage their health during the pandemic. In a region that has more than 5.8 million people living with HIV, 300,000 new infections and about 160,000 AIDS-related mortality, disruptions to HIV care can have serious consequences in terms of HIV transmissions and lead to thousands more deaths. The data collected from this regional survey is therefore significant in providing insights into the current gaps and barriers to care, and actions that can be taken to sustain critical healthcare services for HIV.

The survey results were based on responses from 1,265 respondents across 10 countries and territories in the region, which include 667 people living with HIV (PLHIV), 455 individuals at-risk of HIV and 143 HIV care prescribers. Close to 50 percent of all respondents reported a disruption in visits to hospitals or point-of-care to receive HIV care, whether for testing, treatment or preventive care.

An analysis into the responses found that the COVID-19 pandemic has the biggest impact on the uptake of HIV tests, especially amongst those individuals at-risk. Close to half (47%) of the individual at-risk respondents reported a decrease in frequency of taking HIV tests during COVID-19. Travel restrictions imposed during the pandemic (35%) and concerns of getting infected with COVID-19 (42%) were the main barriers to actively accessing tests, as HIV tests were mostly only accessible at point-of-care.

The pandemic also had a substantial impact on the dispensing or uptake of medicines. About 60 percent of prescribers reported a decline in preventive prescriptions for at-risk population while about 42 percent of individual at-risk respondents reported that they had either decreased or stopped taking HIV preventive medicine during COVID-19 pandemic. At the same time, about 43 percent of prescribers also reported a decline in prescribing refill antiretroviral medication to PLHIV. Travel restrictions were also cited as one of the main reasons for the disruption.

Long-term ability to access anti-HIV medications is also a major concern. With 51 percent of PLHIV and 44 percent of individuals at-risk reported that they are concerned about accessing anti-retroviral medicines and prevention medications with the ongoing COVID-19 pandemic.

“The COVID-19 pandemic has had serious implications on the delivery of healthcare services in HIV across the region, whether it is in a low or high-income country. Interruptions to access and delivery of care can negatively impact PLHIV and those at-risk of HIV, putting them at a higher risk of health complications,” said Professor Dr. Adeeba Kamarulzaman, Dean of the Faculty of Medicine, Universiti Malaya & President of the International AIDS Society.

“This survey is an indication of the critical gaps in access to testing, treatment and preventive care and shines a light on areas that can be strengthened, such as the implementation of telehealth to decentralize and reduce the burden on health systems, to prepare for future potential public health emergencies or disruptions.”

Telehealth had increasingly become a mode of care delivery during the COVID-19 pandemic, and a majority of prescribers interviewed (72%) expect an increase in telehealth adoption in the future as it offers convenience, improved workflow efficiencies, and allows them to reach more patients and individuals at-risk. About 85% of them used telehealth during the pandemic to consult with patients or individuals at-risk via telephone (60%) or video (32%), and more than half use it to provide refill prescriptions (57%). Conversely, about 34% of PLHIV and individuals at-risk shared that remote access to medications is the most preferred telehealth service, followed by phone (33%) and video (28%) consultations.

“This pulse survey shows that ensuring access to critical HIV care services is an important public health priority especially when an end in sight to the pandemic remains uncertain. Gilead is committed to collaborating with the HIV community from public health authorities to prescribers, patient groups and civil societies across the region to identify strategies that can close the gaps to care to ensure the continuity of vital HIV care services during these challenging times and beyond,” said Betty Chiang, Vice President of Medical Affairs, International, Gilead Sciences.

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