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Arnold School of Public Health

Pandemic hurts HIV care, management for South Carolinians

March 30, 2023 | Erin

Researchers at the South Carolina SmartState Center for Healthcare Quality (CHQ), located at the Arnold School of Public Health, have revealed further negative impacts from the COVID-19 pandemic on South Carolina’s HIV population. In a statewide examination of electronic health records, the authors found that people living with HIV were less likely to engage with their health care providers and maintain adequate viral suppression during the pandemic when compared to before the pandemic.

“In addition to the direct health impacts of COVID-19, the pandemic may also have detrimental impact on health care services for vulnerable populations, including people with HIV, whose conditions put them at greater risk for additional health complications and adverse outcomes,” says Xueying Yang, a research assistant professor with CHQ and the Department of Health Promotion, Education, and Behavior. “Previous studies have provided us with snapshots of the pandemic’s impact on HIV care – particularly the challenges in accessing health care – but none have taken a longitudinal view of the dynamic changes in HIV care engagement behaviors such as retention in care prior to and during the pandemic.”

To better understand these changes, the team analyzed data from more than 7,300 people living with HIV in South Carolina. Their findings, which were published in AIDS, showed not only lower rates of retention in care and viral suppression overall, but also revealed disparities for different groups.

Decreased continuation of care was more severe among people living with HIV who already had pre-existing chronic conditions, such as diabetes and hypertension. Meanwhile, viral load suppression – which is accomplished through prescription medications and serves to halt the progression of the disease and limit its spread – was much more pronounced among South Carolinians living in urban areas.

“These negative effects of the pandemic could be due to the structural barriers resulting from COVID-19 mitigation measures, such as lockdowns and social distancing, and the subsequent underutilization of HIV care services through patients’ personal decisions to avoid accessing in-person health care or the service interruption of HIV clinics,” Yang says. “This pandemic has created an opportunity for accelerating effective strategies like ensuring the safety net of adequate health care providers or telemedicine. Decentralizing HIV care in low-resource settings and incorporating telemedicine in high-resource settings in an effective manner might mitigate shocks to health care systems in the future.”

The research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (R01AI127203, R01AI164947, and R21AI170159-01A1) and the USC Office of the Vice President for Research (ASPIRE-1, TRACK 2, Grant #: 115400-22-60028).


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