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The impact of the COVID-19 pandemic on HIV treatment gap lengths and viremia among people living with HIV British Columbia, Canada, during the COVID-19 pandemic: Are we ready for the next pandemic?

Author

Listed:
  • Munasinghe, Lalani L.
  • Yin, Weijia
  • Nathani, Hasan
  • Toy, Junine
  • Sereda, Paul
  • Barrios, Rolando
  • Montaner, Julio S.G.
  • Lima, Viviane D.

Abstract

The SARS-CoV-2 (COVID-19) pandemic has impacted the care of people living with HIV (PLWH). This study aims to characterize the impact of the pandemic on the length of HIV treatment gap lengths and viral loads among people living with HIV (PLWH) in British Columbia (BC), Canada, with a focus on Downtown Eastside (DTES), which is one of the most impoverished neighbourhoods in Canada. We analyzed data from the HIV/AIDS Drug Treatment Program from January 2019 to February 2022. The study had three phases: Pre-COVID, Early-COVID, and Late-COVID. We compared results for individuals residing in DTES, those not residing in DTES, and those with no fixed address. Treatment gap lengths and viral loads were analyzed using a zero-inflated negative binomial model and a two-part model, respectively, adjusting for demographic factors. Among the 8982 individuals, 93% were non-DTES residents, 6% were DTES residents, and 1% had no fixed address during each phase. DTES residents were more likely to be female, with Indigenous Ancestry, and have a history of injection drug use. Initially, the mean number of viral load measurements decreased for all PLWH during the Early-COVID, then remained constant. Treatment gap lengths increased for all three groups during Early-COVID. However, by Late-COVID, those with no fixed address approached pre-COVID levels, while the other two groups did not reach Early-COVID levels. Viral loads improved across each phase from Pre- to Early- to Late-COVID among people residing and not residing in DTES, while those with no fixed address experienced consistently worsening levels. Despite pandemic disruptions, both DTES and non-DTES areas enhanced HIV control, whereas individuals with no fixed address encountered challenges. This study offers insights into healthcare system preparedness for delivering HIV care during future pandemics, emphasizing community-driven interventions with a particular consideration of housing stability.

Suggested Citation

  • Munasinghe, Lalani L. & Yin, Weijia & Nathani, Hasan & Toy, Junine & Sereda, Paul & Barrios, Rolando & Montaner, Julio S.G. & Lima, Viviane D., 2024. "The impact of the COVID-19 pandemic on HIV treatment gap lengths and viremia among people living with HIV British Columbia, Canada, during the COVID-19 pandemic: Are we ready for the next pandemic?," Social Science & Medicine, Elsevier, vol. 350(C).
    • Handle: RePEc:eee:socmed:v:350:y:2024:i:c:s0277953624003642
    DOI: 10.1016/j.socscimed.2024.116920
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    References listed on IDEAS

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    1. Khansa Ahmad & Sebhat Erqou & Nishant Shah & Umair Nazir & Alan R Morrison & Gaurav Choudhary & Wen-Chih Wu, 2020. "Association of poor housing conditions with COVID-19 incidence and mortality across US counties," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-13, November.
    2. Glenn-Milo Santos & Benjamin Ackerman & Amrita Rao & Sara Wallach & George Ayala & Erik Lamontagne & Alex Garner & Ian Holloway & Sonya Arreola & Vince Silenzio & Susanne Strömdahl & Louis Yu & Carol , 2021. "Economic, Mental Health, HIV Prevention and HIV Treatment Impacts of COVID-19 and the COVID-19 Response on a Global Sample of Cisgender Gay Men and Other Men Who Have Sex with Men," Post-Print hal-02909813, HAL.
    3. Federico Belotti & Partha Deb & Willard G. Manning & Edward C. Norton, 2015. "twopm: Two-part models," Stata Journal, StataCorp LLC, vol. 15(1), pages 3-20, March.
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