By Sharon Atieno

The COVID-19 pandemic has had a negative impact on the provision of HIV services in several counties in Kenya, study reveals.

The Amref Health Africa study shows that since the onset of the pandemic in March 2020, HIV testing and ART initiation has decreased by 56% and 48% respectively.

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.

The decrease, as seen in data from Kibera Informal settlement, can be attributed to several factors, the study finds.

These include: 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, the study adds.

According to Dr. Meshack Ndirangu, Country Director, Amref Health Africa in Kenya, the government measures such as imposed partial lockdown within sections of the country and enforced curfew to regulate movement during the height of the pandemic are to blame.

“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,” he said.

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.

“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.

On a positive note, the findings revealed 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.