A hospital worker puts on gloves as part of her Personal Protective Equipment (PPE) in the COVID-19 ward at the Somerset Hospital in Cape Town, on July 2 2020. Picture: AFP/RODGER BOSCH
A hospital worker puts on gloves as part of her Personal Protective Equipment (PPE) in the COVID-19 ward at the Somerset Hospital in Cape Town, on July 2 2020. Picture: AFP/RODGER BOSCH

New research on the effect of the lockdown on decentralised antiretroviral (ARV) therapy programmes‚ which was presented at the 23rd International Aids Conference on Wednesday‚ has revealed that mistrust of the government and health sector’s management of Covid-19 has driven many HIV patients underground.

Lead researcher Jana Jarolimova‚ an infectious disease clinical and research fellow at Massachusetts General Hospital in the US‚ said among the 300 participants involved in the study‚ who received their treatment at pharmacies and community facilities as opposed to clinics‚ “the most commonly identified concerns regarding the pandemic were being infected with Covid-19‚ unable to work‚ and money running out”.

All participants were part of the central chronic medicine dispensing and distribution programme in urban KwaZulu-Natal.

Among those who feared infection‚ more than two-thirds or 68% of HIV patients anticipated barriers to the ARV therapy programmes in the future.

While many were worried about the economic effect of the lockdown and contracting Covid-19‚ Jarolimova said the majority, or 51%, who had managed to collect their ARVs “noted an increase in waiting time at pick-up points” — something they considered an inconvenience.

The Gauteng health department is one of the government departments that has spoken openly about the effect of the lockdown on its ARV therapy programme. In May the number of patients who failed to collect their TB medicines in that province was 1‚090‚ while the number of patients who failed to collect their ARV medicines was about 10‚950.

The province measured medication collections for TB at 1.4% and 19.6% for HIV‚ prompting it to implement a track-and-trace plan to locate patients that had not collected their medication.

Meanwhile a randomised controlled trial by Medecins Sans Frontieres in Khayelitsha’s adherence clubs‚ which compared six-month refills of ARVs compared to the standard two-month supply‚ has found that not only does issuing medication over the long term increase convenience to patients‚ but it improves their adherence to treatment. Patients who received the six-month refills reported reduced unintended disclosure and less worry about transport problems.

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