HIV Testing and Adherence to Anti-Retroviral Therapy Reduces as COVID-19 Takes Toll on Low-Income Patients

Study conducted by Amref Health Africa reveals that HIV testing and ART initiation reduced by 56% and 48% respectively since the onset of COVID-19 in March 2020

Nairobi, December 10^th, 2020: A prospective cohort study conducted by Amref Health Africa to determine the impact of COVID-19 on HIV testing and adherence to antiretroviral therapy (ART) has revealed that the pandemic has had significant impact on HIV service provision among Nairobi’s low-income earners.

The study, titled Impact of COVID-19 on HIV Programming in Kenya: Evidence from Kibera Informal Settlement and COVID-19 Hotspot Counties, was carried out between July and October 2020 in Nairobi, Mombasa, Nakuru, Kajiado, Busia, Kiambu and Machakos. Its findings reveal that HIV testing services reduced by 56% while the number of new people starting antiretroviral therapy (ART) reduced by 48% since the onset of COVID-19 in March 2020. It also found that Pre-exposure prophylaxis (PrEP) usage among discordant couples, general population, men who have sex with men, female sex workers, and people who inject drugs significantly increased by 24% from the onset of the pandemic.

According to the study, as seen in data from Kibera Informal settlement, the dip in HIV testing and ART services can be attributed to several factors such as reduced demand for services as a result of fear of contracting COVID-19 while visiting health facilities; service disruption owing to lack of drugs, shutting down of health facilities occasioned by redeployment of health workers, cancellation of elective care, closure of outpatient services and changes in treatment policy. Insufficient Personal Protective Equipment (PPE) also reduced confidence among beneficiaries and service providers because both felt exposed and vulnerable to transmission and acquisition of COVID-19.

“This study highlights the negative impact of COVID-19 on people living with HIV in resource-constrained settings like Kibera. At the height of the pandemic, the government imposed partial lockdown within sections of the country and enforced curfew to regulate movement. These measures limited access to ARTs for many patients, with 11% of respondents in July saying they were unable to adhere to their ART regimen as a result of inability to travel and unemployment,” said Dr. Meshack Ndirangu, Country Director, Amref Health Africa in Kenya, during the launch of the study.

The researchers also found that the proportion of respondents who missed medication consistently reduced from 14% in July 2020 to 7% in August and 5% in October 2020. The main reason listed for failure to take medication over the four-month period was forgetfulness, followed by running out of medication. This did not however affect the respondents’ viral load, which remained stable throughout the review period.

“Almost all (96%) the respondents surveyed were at high risk of food insecurity and malnutrition because of inability to fend for themselves and their household members. 19% of respondents in July, 21% in August and 23% in October indicated that they went a whole day and night without eating. As a result of this and fear of COVID infection, seeking HIV testing and management was deprioritised during the period,” noted Dr. Ndirangu, adding: “The situation is however improving now. By October, only 5% of the respondents had fears and concerns about seeking health services. This was a reduction from 23% in July and 13% in August.”

While there is insufficient data on the effect of COVID-19 co-infection on People Living with HIV (PLHIV), studies have shown that people with pre-existing conditions who contract COVID-19 are at a higher risk of disease progression including death. Although about 17% of the respondents in July, 20% in August and 14% in October reported at least one of the COVID-19 symptoms, there was no exponential increase in any of the COVID-19 symptoms throughout the four-month period, and about two-thirds (62%) of the respondents sought medical care in case of COVID-19 symptoms.

The launch of this study occurs concurrently with the launch of three other studies led by Amref: COVID-19 Response Governance Mapping Initiative; Impact of Community Led Alternative Rites of Passage on Eradication of FGM/C in Kajiado County, Kenya & The Effects of COVID-19 Pandemic on FGM/C and Child, Early and Forced Marriages in Kenya; and Lived Experiences of Youth During the COVID-19 Pandemic: Implications for Policy and Program Considerations in Kenya.

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Notes to Editors

About Amref Health Africa

Amref Health Africa, headquartered in Kenya, is the largest Africa-based International Non-Governmental Organisation (INGO). With a focus on increasing sustainable health access, Amref runs programmes in over 35 countries in Africa, with lessons learnt over 60 years of engagement with governments, communities and partners. Amref Health Africa also engages in programme development, fundraising, partnership, advocacy, monitoring and evaluation, and has offices in Europe and North America as well as subsidiaries: Amref Flying Doctors, Amref Enterprises and the Amref International University.

For more information contact:

Elizabeth (Lizz) Ntonjira

Global Communication Director

Amref Health Africa
Email: Elizabeth.Ntonjira@amref.org