A systematic review and meta-analysis of the impact of the COVID-19 pandemic on access to HIV pre-exposure prophylaxis: Lessons for future public health crises.
Issued Date
2024-01-01
Resource Type
ISSN
15254135
eISSN
19447884
Scopus ID
2-s2.0-85198717843
Journal Title
Journal of Acquired Immune Deficiency Syndromes
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Acquired Immune Deficiency Syndromes (2024)
Suggested Citation
Lila Wulandari L.P., Salita Negara S.N., Mashuri Y.A., Wahyuningtias S.D., Cahyadi Surya Distira Putra I.W., Subronto Y.W., Ahmad R.A., Thabrany H., Guy R., Law M., Hammoud M., Bavinton B.B., Kaldor J., Medland N., Liverani M., Probandari A., Boettiger D., Wiseman V. A systematic review and meta-analysis of the impact of the COVID-19 pandemic on access to HIV pre-exposure prophylaxis: Lessons for future public health crises.. Journal of Acquired Immune Deficiency Syndromes (2024). doi:10.1097/QAI.0000000000003488 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/99777
Title
A systematic review and meta-analysis of the impact of the COVID-19 pandemic on access to HIV pre-exposure prophylaxis: Lessons for future public health crises.
Corresponding Author(s)
Other Contributor(s)
Abstract
Background:The WHO is committed to strengthening access to pre-exposure prophylaxis (PrEP) for HIV prevention and its integration into primary care services. Unfortunately, the COVID-19 pandemic has disrupted the delivery of primary care, including HIV-related services. To determine the extent of this disruption, we conducted a systematic review and meta-analysis of the changes in access to PrEP services during the pandemic and the reasons for these changes.Methods:A search was conducted using Pubmed, Scopus, Embase, PsycINFO, and Cinahl for studies published between January 2020 and January 2023. Selected articles described self-reported disruptions to PrEP service access associated with the COVID-19 pandemic or its responses. Pooled effect sizes were computed using a random-effects model.Results:Thirteen studies involving 12,652 PrEP users were included in our analysis. The proportion of participants reporting a disruption in access to PrEP services during the COVID-19 pandemic ranged from 3% to 56%, with a pooled proportion of 21% (95%CI: 8 - 38%). Social restrictions, financial constraints, and limited health insurance coverage were key factors impacting access to PrEP services during the pandemic.Conclusions:To our knowledge, this is the first meta-analysis to quantify the extent of disruptions to accessing PrEP services due to the COVID-19 pandemic. To increase the ability of primary care services to maintain PrEP services during public health crises, a mixture of strategies is worth considering. These include multi-month PrEP prescriptions, telehealth services, deployment of peer support groups to provide a community-based service or home delivery, and provision of financial support interventions.