Client and provider experiences with, and approaches to sustain HIV care during the COVID-19 pandemic restrictions at two public hospitals in southwestern Uganda

• DOI: 10.1007/s44155-024-00069-1
• Publication Date: 2024-03-18T23:01:32Z
• Authors: Cecilia Akatukwasa; Brian Beesiga; Asiphas Owaraganise; Joan Nangendo; Elijah Kakande; Florence Mwangwa; Susan Nayiga; Fred C. Semitala; Moses R. Kamya; Jane Kabami
• Keywords: Pandemic; 2019-20 coronavirus outbreak

Abstract Introduction The COVID-19 pandemic had far-reaching consequences on global health systems, disrupting the delivery of routine healthcare services, and posing new challenges to ongoing disease control efforts. In Uganda, where HIV is endemic, threatened reverse gains in country’s response over past decade. this study, we explored effects cascade, focusing impact pandemic-related disruptions retention care among Persons with (PWH). We further highlighted key opportunities for mitigating adverse effects. Methods Qualitative data were collected from January 2022 March using in-depth interviews PWH (n = 20) workers 4) informant 6) managers. current previous experiences including providers managers delivering receiving amidst restrictions recovery period, strategies implemented ensure continuity services barriers implementing these strategies. coded Dedoose software analyzed thematic analysis. Results qualitative findings highlight pandemic, restricted access points, sub-optimal clinical management persons HIV, loss livelihoods, interruptions adherence. Adaptations included leveraging community-based drug strategies, phone call consultations, modification clinic workspaces, linkages nearby facilities. Barriers adaptations increased cost psychological challenges, fear anxiety surrounding COVID infection, treatment, survival, follow-up no information patient referral, infection workers, depletion stocks due multi-month scripting, shortage Personal protective equipment (PPE) supplies other drugs. Conclusion a significant reduced support ART adherence, changes delivery. Our enablers during lockdown provide valuable lessons efforts mitigate future periods pandemics/lockdowns.