475. Describing the impact of the COVID-19 pandemic on HIV care in Latin America
2020
Background: The effects of the COVID-19 pandemic on people living with HIV
(PWH) are unknown. Beyond SARS-CoV-2 co-infection, the pandemic may have devastating consequences for HIV care delivery. Understanding these is crucial as reduced
antiretroviral therapy (ART) availability alone could lead to ≥500,000 AIDS-related
deaths in 2020–2021. With Latin America now a focal point in the pandemic, we sought
to describe the impact of COVID-19 on HIV care at Latin American clinical sites.
Methods: Caribbean, Central and South America network for HIV epidemiology (CCASAnet) and additional Brazilian HIV care sites in Argentina, Brazil, Chile,
Haiti, Honduras, Mexico, and Peru were included. An electronic survey of COVID-19
effects on HIV clinic operations was administered in Spanish or English via phone and
email, April 28-June 2, 2020. We also compared national COVID-19 case, mortality,
and policy data from public sources.
Results: Brazil’s and Mexico’s epidemics appear most pronounced, with >10,000
confirmed COVID-19-related deaths (Figure 1); countries implemented “social distancing” policies at different times after initial cases, with Haiti earliest and Mexico
latest (Figure 2). Nearly all 13 sites reported decreased hours and providers for HIV
care. Twelve of 13 reported increased use of telehealth, suspension/postponements of
routine HIV appointments, and/or suspension of HIV research. Eleven of 13 reported
initiation of new COVID-19 research but suspension of community HIV testing, and
nearly half provided additional ART supplies. Nearly 70% reported impacts on HIV
viral load testing and nearly 40% reported personal protective equipment stock-outs
(Table). All 13 sites experienced changes in resources/services in tandem with national
policies; there was wide variation, however, in the number of economic and health
supports implemented thus far (e.g., quarantines, tax deferrals, interest rate reductions,
etc.), from 172 COVID-19-related policies in Brazil to only 30 in Mexico.
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