COVID-19 and HIV Treatment Interruption: A Case Study of the AIDS Support Organization (TASO) Mbale Clinic

Introduction: COVID-19 pandemic caught many HIV programs completely unprepared, leading to massive interruptions in HIV treatment. Fear and anxiety caused by another infectious and potentially deadly virus kept many PLHIV away from accessing ART services. Besides, the COVID-19 control measures imposed by the Government of Uganda, such as restrictions on movement due to the ban on both private and public transport, shortened travel hours due to the curfew imposed from 7 p.m. local time and limited resources at The AIDS Support Organization (TASO) Mbale clinic further frustrated access to ART services. The actual burden of treatment interruption in Uganda remains unclear. As such, this paper provides the magnitude of treatment interruption in TASO Mbale clinic during the April-June 2020 quarter—the COVID-19 pandemic peak period in Uganda. Methodology: We analyzed secondary and routine program data for all PLHIV on scheduled appointment in the quarters of January-March 2020 and April 2020-June 2020. We abstracted data from Uganda Electronic Medical Records (EMR) and linked with that from TASO Management Information system to make one dataset. This was then exported for final analysis in STATA version 15. Results: Out of 6744 PLHIV scheduled on appointment during April-June 2020 quarter, 1710 (25.3%) individuals missed their appointments, with the facility-based clients more affected than community-based (56.1% vs 43.9%) (p < 0.001), individuals with up-to-date viral load (VL) status were less likely to miss their appointment (p < 0.001) while sex was not associated with missed appointment (p-value = 0.269). Overall, there was a 356% increase in rate of missed appointment compared with that of January-March 2020 quarter (25.3% vs 7.1%) before COVID-19 pandemic hit Uganda. Moreover, PLHIV who received six-month’s drug refills were less likely to miss their appointment (p < 0.001) compared to those who received less. Conclusions: The COVID-19 pandemic significantly disrupted provision of ART services, leading to increased rate of missed appointment from 7.1% in the pre-COVID-19 quarter to 25.3%.