Effect of first three months of COVID pandemic on HIV services in Greece: A short survey among HIV physicians

Background/purpose: The first wave of the COVID-19 pandemic was successfully contained in Greece with a low infection attack rate Strict lockdown measures were implemented from March to May 2020 ID physicians were amongst the frontline healthcare workers The purpose of this survey was to assess the operational effect of COVID-19 on HIV clinics in Greece Materials/methods: Information was gathered in June 2020, after the lockdown lift, via an anonymous questionnaire distributed to an expert panel of HIV/ID physicians (n = 9) Results: Participants' clinics provided care in total for 4335 PLWHIV Of the nine panelists, 80% worked in a COVID-19 reference hospital, 90% had direct involvement in COVID-19 patient care, devoting an average of 90% of their working time on COVID-19 Four COVID-19 cases in PLWHIV were reported (approx 0 1%);one was hospitalised and all recovered without complications During lockdown all clinics had to cancel scheduled visits (25% completely, 50% covering only emergencies and prescriptions) All centres stopped routine checks for cardiovascular and other comorbidities and 75% also stopped routine laboratory testing as well as mental health services Overall there was an 82% drop in routine appointments during lockdown compared to Jan-Feb Significantly fewer PEP cases were recorded, and there was an approximate 50% drop in new HIV cases (34% were late presenters) compared to the monthly average of Jan-Feb For 62 5% of the panel there was no concern about poorer adherence to ART or higher risk sexual behaviour for their patients during lockdown;however, all were concerned either moderately (87 5%) or seriously (12 5%) about an increase in substance use After the first wave some centres limited scheduled appointments to avoid overcrowded clinics, while others considered adding extra ones to compensate for lost visits Policy was also dictated by the local epidemic situation Conclusions: This short survey demonstrates that in Greece, in the context of a successful early containment of the COVID-19 pandemic, there was a major disruption in HIV services, mainly due to the low number of HIV/ID physicians having to cover multiple roles (including HIV care) and the healthcare system's insufficient capacity to deal with routine care under pressure