Top 5 Takeaways

1. Overall Gains in HIV Services: Despite the COVID-19 pandemic, PEPFAR-supported countries saw a 5% increase in HIV treatment and a 2% increase in viral load suppression in 2020.
2. Effective Strategies: Key strategies included enhanced index testing, community- and home-based testing, multimonth dispensing of medications, streamlined clinic visits, and improved data use.
3. Public Health Insights: The successes in these countries provide valuable strategies for maintaining and improving HIV services during global health crises.
4. Country-Level Variations: While 88% of countries reported increases in HIV treatment, only 39% saw increases in identifying new HIV-positive cases, highlighting the focus on retaining known PLHIV on treatment.
5. Data and Monitoring: Improvements in data systems and patient tracking were crucial for programmatic gains, emphasizing the importance of robust data management in health service delivery.

Original Article Author and Citation

Corresponding Author

Kiva A. Fisher, okm1@cdc.gov

Suggested Citation

Fisher KA, Patel SV, Mehta N, et al. Lessons Learned from Programmatic Gains in HIV Service Delivery During the COVID-19 Pandemic — 41 PEPFAR-Supported Countries, 2020. MMWR Morb Mortal Wkly Rep 2022;71:447–452. DOI: http://dx.doi.org/10.15585/mmwr.mm7112a2

Summary

The COVID-19 pandemic posed significant challenges to health care systems globally. However, in 41 PEPFAR-supported countries, there were notable gains in HIV treatment and viral load suppression during 2020. Strategies such as enhanced index testing, community- and home-based testing, multimonth medication dispensing, and improved data use were key to these successes. These findings offer valuable insights for maintaining essential health services during global health crises.

Methods

CDC used Monitoring, Evaluation, and Reporting (MER) data to assess the impact of COVID-19 mitigation strategies on HIV service delivery across 41 PEPFAR-supported countries. The analysis compared data from January–March 2020 (pre-COVID-19) with October–December 2020. Indicators included the number of HIV-positive test results, the number of PLHIV receiving antiretroviral therapy (ART), and HIV viral load suppression rates. Qualitative data from countries in the upper quartile for each indicator were also reviewed to identify successful strategies.

Discussion

The report highlights the adaptability of PEPFAR-supported countries in maintaining and improving HIV services during the COVID-19 pandemic. Key strategies included reducing facility visits through community-based approaches, enhancing data systems, and using telecommunications for client services. These strategies not only helped mitigate the impact of the pandemic on HIV services but also provided a framework for future health crises.

Conclusion

The study demonstrates that with adaptive strategies, significant gains in HIV service delivery can be achieved even during a global health crisis. The lessons learned from PEPFAR-supported countries can inform future efforts to maintain essential health services during pandemics and other emergencies.

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