The Ripple Effect of COVID-19: How Lockdown Regulations Shaped Antiretroviral Therapy Initiation Among People Living With HIV in Johannesburg.
N Nkadimeng, L Makhado, O P Netshisaulu
PMID 40965003WHAT IT FOUND
During COVID-19 lockdowns, Soweto facilities diagnosed fewer people with HIV and started fewer on treatment, but a higher share of those diagnosed were started on ART.
Facilities recovered unevenly. Some facilities kept high initiation rates, while others lagged.
Key findings
01ART starts at community health centers fell from 6342 in 2019 to 3301 in 2022.
02Initiation rates were lowest before COVID-19, highest during COVID-19 restrictions, then slightly declined after.
03Recovery was uneven across facilities. Some clinics kept high initiation rates, while others struggled.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study used existing service records, so missing or inconsistent entries could affect the counts. It looked at only one part of Johannesburg, so results may not apply to other clinics or townships. It did not control for reasons behind changes, such as staff shortages or drug stockouts. Some initiation rates above 100% happened because patients diagnosed at one clinic started treatment at another, so facility-level rates can be confusing.
Declared interests
The authors declared no conflicts of interest. The study was funded by HWSETA Postgraduate Research Funding.
The easy way to misread this
Do not conclude that lockdown regulations improved HIV treatment uptake because initiation rates rose. The number of people diagnosed and started on treatment fell, and the study cannot separate the effect of lockdown from other changes.