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The impact of COVID-19 pandemic on HIV service provision in Ukraine

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BACKGROUND: The COVID-19 pandemic and public health response continue to have an unprecedented impact across the globe. Lives of people living with HIV (PLWH) may be particularly affected due to socioeconomic disparities, co-morbidities that increase severity of the COVID-19 disease, and disruption in receiving vital health services.
METHODS: A mixed methods study assessed the trends in provision of HIV services in HIV care facilities in Ukraine to verify the impact of COVID-19 and identify service gaps. Data on key indicators were extracted from official HIV program reports by the Ministry of Health and matched with the COVID-19 epidemiologic data. Three periods (01/2019-03/2020 [pre-COVID], 04-12/2020 [early-COVID], 01-12/2021 [late-COVID]) were compared using descriptive statistics.
RESULTS: The graphic trends in key indicators and COVID-19 epidemic are presented in Figure. The average monthly number of HIV tests in health care facilities was 206,935 in pre-COVID period, decreasing to 154,009 in early- and 160,289 in late-COVID (23% decrease). The proportion of positive tests increased from 0.9% to 1.1% and then decreased to 1%. The average monthly number of new patients on ART also decreased from 1,716 to 1456 to 1373 (20% decrease) in three periods, respectively. The average monthly number of viral load tests increased from 26,862 to 27,963 to 31,211 (16% increase). The percent of viral suppression (<1000cp/ml) increased slightly from 94.5% to 94.8% to 95.4%.


CONCLUSIONS: The pandemic had a substantial impact on the capacity of HIV clinics in Ukraine, leading to decreased number of tests and new patients on ART. The decrease did not correlate with the waves of COVID-19 transmission and was not reversed in late-COVID period. The number of PLWH who are not on ART in Ukraine remains significant (110,000 of the estimated 240,000 PLWH), therefore urgent measures should be taken to mitigate the impact of COVID-19 and restore HIV testing and treatment services.