In wake of COVID-19… Appeal made for contingency plans to meet demand for HIV care and treatment

May 06, 2020 News

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It is important for Caribbean countries to ensure that people living with HIV have reliable access to treatment, healthcare and human rights-based social support services during the COVID-19 pandemic. This is according to a call issued by the Joint United Nations Programme on HIV and AIDS (UNAIDS), the Pan American Health Organisation (PAHO) and the Pan Caribbean Partnership against HIV and AIDS (PANCAP).
In a statement, the three organisations outlined that regular access to essential care and treatment for people living with HIV may be challenged at this time due to the burden of COVID-19 response on health facilities. It was noted therefore that it is vital that HIV programmes develop contingency plans to meet demand for the care and treatment of people living with HIV, as well as HIV testing, antenatal care and other essential sexual and reproductive health services.
“During the implementation of quarantine, social distancing measures and stay-at-home orders, alternative modalities for remote or virtual clinical care may be explored, for example via telephone or on-line portals,” the organisations proposed.
It was also stressed that it is critical that countries now implement HIV treatment guidelines from the World Health Organization (WHO) for multi-month dispensing (MMD). “This would ensure that people living with HIV, who are stable on antiretroviral treatment, are given three to six months of their medications at once. Doing so will help alleviate the burden on health facilities and allow people to maintain uninterrupted treatment regimens without risking increased exposure to COVID-19 when retrieving their medicines,” the organisations further stated.
Additionally, it has been recommended that countries with HIV Pre-Exposure Prophylaxis (PrEP) programmes should also dispense a minimum three-month supply for users. Alternative treatment access options, which may be considered, include community pharmacy dispensing, community-based pick-up points or home delivery.
The organisations are also calling on health services to prioritize ongoing care for people living with HIV who have a higher COVID-19 risk due to low CD4 counts, tuberculosis and other underlying conditions, as well as individuals recently diagnosed with HIV infection who need to start treatment as soon as possible.
“Community organizations, including those made up of people living with HIV, will play a key role in supporting treatment adherence and mental health during this time. These organizations should be included in contingency planning and implementation processes to ensure continuity of treatment and care,” the organisations underscored in their joint statement.
Pointing to the fact that the HIV response has many lessons learned that can be utilized in the COVID-19 response, the organisations made reference to moves to comply with a human rights-based approach that puts communities at the centre. The importance of respecting the rights and dignity of all was also amplified. “A primary lesson from the AIDS response is that stigma and discrimination are counter-productive to ensuring good individual and public health outcomes,” the statement added.
Separately, UNAIDS said that, “These are difficult times for all of us. UNAIDS is urging people to act with kindness, not stigma and discrimination—people affected by COVID-19 are part of the solution and must be supported.”
Reiterating that governments must respect the human rights and dignity of people affected by COVID-19, UNAIDS said that the experiences learned from the HIV epidemic can be applied to the fight against COVID-19.
As in the AIDS response, UNAIDS noted that governments should work with communities to find local solutions pointing out that key populations must not bear the brunt of increased stigma and discrimination as a result of the COVID-19 pandemic.
“We know that COVID-19 is a serious disease that is set to hit the countries with the highest burden of HIV very soon. Everyone, including people living with HIV, should take the recommended precautions to reduce exposure to COVID-19,” UNAIDS noted.
Since precautions must be adhered to help reduce the potential far-reaching impact of this disease, UNAIDS reminded what they are. Among them: regular and thorough hand washing with soap and water or alcohol-based hand rub; maintain at least one metre distance between yourself and anyone who is coughing or sneezing; avoid touching your eyes, nose and mouth; make sure that you, and the people around you, follow good respiratory hygiene—cover your mouth and nose with your bent elbow or tissue when you cough or sneeze and dispose of the used tissue immediately; stay home if you feel unwell. If you have a fever, cough and difficulty breathing; seek medical attention and call in advance and follow the directions of your local health authority.
UNAIDS has noted too that it recognizes, however, that in many countries, owing to weaker health-care systems, informal settlements, overcrowded cities and public transportation and a lack of clean water and sanitation, the current approaches to self-protection, social distancing and containment may not be viable.

 

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