ArticleBMJ global health2022
Mitigating the effects of COVID-19 on HIV treatment and care in Lusaka, Zambia: a before-after cohort study using mixed effects regression.
Article in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impacts of COVID-19 pandemic on service delivery and treatment outcomes in people living with HIV: a systematic review.AIDS research and therapy · 2023Pooled it
- Longitudinal challenges faced by perinatally-infected young people with HIV in Kenya during the COVID-19 pandemic.AIDS (London, England) · 2026Article
- Identifying care gaps along the HIV treatment failure cascade: A multistate analysis of viral load monitoring, re-suppression, and regimen switches in Zambia.PLoS medicine · 2025Article
- Patterns of engagement in care during clients' first 12 months after HIV treatment initiation in Zambia: a retrospective cohort analysis using routinely collected data.BMJ global health · 2025Article
- Assessing the impact of the COVID-19 pandemic on uptake of HIV treatment in Bandung and Yogyakarta, Indonesia: A retrospective cohort study.PLOS global public health · 2025Article
- Health crisis within a crisis: Effect of COVID-19 on STI services for young adults in Lusaka, Zambia.PLOS global public health · 2025Article
- Temporal dynamics and drivers of durable HIV viral load suppression and persistent high- and low-level viraemia during Universal Test and Treat scale-up in Uganda: a population-based study.Journal of the International AIDS Society · 2024Article
- Impact of COVID-19 on people living with HIV and HIV care: A qualitative study in the Volta Region of Ghana.PLOS global public health · 2024Article
- Patterns of person-centred communications in public HIV clinics: a latent class analysis using the Roter interaction analysis system.Journal of the International AIDS Society · 2023Article
- Provider perspectives on service delivery modifications to maintain access to HIV pre-exposure prophylaxis during the COVID-19 pandemic: qualitative results from a PrEP implementation project in Kenya.Journal of the International AIDS Society · 2023Article
- Task shifting healthcare services in the post-COVID world: A scoping review.PLOS global public health · 2023Article
- COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview.The journal of venomous animals and toxins including tropical diseases · 2023Article
- Poor adherence to antiretroviral therapy among adult people living with HIV initiated during the COVID-19 epidemic waves - observations at the University Teaching Hospital in Lusaka, Zambia.Frontiers in public health · 2023Article
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18 authors.
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Abstract
introductionThe Zambian Ministry of Health (MoH) issued COVID-19 mitigation guidance for HIV care immediately after the first COVID-19 case was confirmed in Zambia on 18 March 2020. The Centre for Infectious Disease Research in Zambia implemented MoH guidance by: 1) extending antiretroviral therapy (ART) refill duration to 6 multi-month dispensation (6MMD) and 2) task-shifting communication and mobilisation of those in HIV care to collect their next ART refill early. We assessed the impact of COVID-19 mitigation guidance on HIV care 3 months before and after guidance implementation.
methodsWe reviewed all ART pharmacy visit data in the national HIV medical record for PLHIV in care having ≥1 visit between 1 January-30 June 2020 at 59 HIV care facilities in Lusaka Province, Zambia. We undertook a before-after evaluation using mixed-effects Poisson regression to examine predictors and marginal probability of early clinic return (pharmacy visit >7 days before next appointment), proportion of late visit (>7 days late for next appointment) and probability of receiving a 6MMD ART refill.
resultsA total of 101 371 individuals (64% female, median age 39) with 130 486 pharmacy visits were included in the analysis. We observed a significant increase in the adjusted prevalence ratio (4.63; 95% CI 4.45 to 4.82) of early return before compared with after guidance implementation. Receipt of 6MMD increased from a weekly mean of 47.9% (95% CI 46.6% to 49.2%) before to 73.4% (95% CI 72.0% to 74.9%) after guidance implementation. The proportion of late visits (8-89 days late) was significantly higher before (18.8%, 95% CI17.2%to20.2%) compared with after (15.1%, 95% CI13.8%to16.4%) guidance implementation .
conclusionsTimely issuance and implementation of COVID-19 mitigation guidance involving task-shifted patient communication and mobilisation alongside 6MMD significantly increased early return to ART clinic, potentially reducing interruptions in HIV care during a global public health emergency.
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