How paediatric HIV services weathered the COVID-19 storm in Tshwane District, South Africa

Michael Christie; Ahmad Haeri Mazanderani; Gayle Sherman; Ute Feucht

doi:10.4102/sajhivmed.v25i1.1557

How paediatric HIV services weathered the COVID-19 storm in Tshwane District, South Africa

South Afr J HIV Med. 2024 May 20;25(1):1557. doi: 10.4102/sajhivmed.v25i1.1557. eCollection 2024.

Authors

Michael Christie^{1

2

3}, Ahmad Haeri Mazanderani^{4

5}, Gayle Sherman^{4

5}, Ute Feucht^{1

2

3}

Affiliations

¹ Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
² Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
³ Research Unit for Maternal and Infant Health Care Strategies, South African Medical Research Council, Pretoria, South Africa.
⁴ Centre for HIV and STIs, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.
⁵ Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic disrupted paediatric HIV services across South Africa. Shortly before COVID-19, updated national HIV guidelines were released.

Objectives: This study describes COVID-19's impact on paediatric HIV services in Tshwane District, South Africa.

Method: A retrospective review of National Institute for Communicable Diseases and District Health Information System data for Tshwane District from April 2019 to March 2022. Data included: Early Infant Diagnosis (EID), HIV viral load (VL) and CD4 monitoring and HIV management among children (< 15 years) living with HIV (CLHIV). Pre-pandemic (2019/2020) and pandemic periods (2020/2021, 2021/2022) were compared.

Results: Year-on-year, HIV testing improved at 10 weeks, 6 months, and 18 months, whereas birth testing decreased. HIV EID case rates were 485 (2019/2020), 410 (2020/2021) and 454 (2021/2022). HIV EID test positivity was 0.77% - 1.2%. Antiretroviral treatment initiation declined from 2019/2020 to 2020/2021, but improved in 2021/2022.Initial HIV VL and CD4 testing declined, with HIV VL testing increasing in 2021/2022, and CD4 testing further declining. HIV VL suppression rate among CLHIV ranged from 69% to 73%.

Conclusion: Initially, COVID-19 resulted in reduced paediatric HIV services as children disengaged from care. Indicators eventually recovered to proximate pre-pandemic levels; however, compensatory increases did not occur. Thus, some children may not have returned to care.

Keywords: COVID-19; HIV management; HIV services; children living with HIV; paediatric HIV; public health.

Grants and funding

Funding information UNICEF partially funded this research: Grant number 43307635.