Impact of the COVID-19 pandemic on HIV care in Guatemala

Medina, Narda; Alastruey-Izquierdo, Ana; Bonilla, Oscar; Ortíz, Brenan; Gamboa, Osmar; Salazar, Luis Roberto; Mercado, Danicela; Pérez, Juan C.; Denning, David W.; Arathoon, Eduardo; Rodriguez-Tudela, Juan Luis

OBJETIVES: To describe the impact of the COVID-19 pandemic on the diagnosis of HIV and opportunistic infections mortality in Guatemala. METHODS: A retrospective study was conducted to describe the impact of COVID-19 pandemic on people living with HIV in a referral HIV clinic as well as the disruption of the services of a diagnostic laboratory hub (DLH), which provides diagnosis for opportunistic infections to a network of 13 HIV health care facilities. March to August months from two different time periods were used for comparative analysis. These periods included months from March to August: : (i) the pre COVID-19 (2017–2019) and (ii) the COVID-19 period (2020). RESULTS: In the COVID-19 period 7,360 HIV tests were performed at CFLAG in comparison with 16,218 tests performed on average in the pre COVID-19 period, a 54.7% reduction (95% CI, 53.8%-55.4%). OI mortality at 90 days was 10.7% higher in 2020 than observed in 2019 (27.3% vs 16.6%, P = 0.05). Clinical samples for opportunistic infections diagnosis sent to the DLH decreased by 43.7% (95% CI, 41%-46.2%). CONCLUSION: The COVID-19 pandemic is having a substantial impact on HIV care in Guatemala. Diagnostic services for HIV were severely affected and OI mortality increased. Lessons learned must guide the introduction of strategies to reduce the impact of the pandemic.