{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:01:12Z","timestamp":1790794872136,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,12,11]],"date-time":"2022-12-11T00:00:00Z","timestamp":1670716800000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Interruptions in treatment pose risks for people with HIV (PWH) and threaten progress in ending the HIV epidemic; however, the COVID\u201019 pandemic's impact on HIV service delivery across diverse settings is not broadly documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From September 2020 to March 2021, the International epidemiology Databases to Evaluate AIDS (IeDEA) research consortium surveyed 238 HIV care sites across seven geographic regions to document constraints in HIV service delivery during the first year of the pandemic and strategies for ensuring care continuity for PWH. Descriptive statistics were stratified by national HIV prevalence (&lt;1%, 1\u20134.9% and \u22655%) and country income levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Questions about pandemic\u2010related consequences for HIV care were completed by 225 (95%) sites in 42 countries with low (\n                      <jats:italic>n<\/jats:italic>\n                      = 82), medium (\n                      <jats:italic>n<\/jats:italic>\n                      = 86) and high (\n                      <jats:italic>n<\/jats:italic>\n                      = 57) HIV prevalence, including low\u2010 (\n                      <jats:italic>n<\/jats:italic>\n                      = 57), lower\u2010middle (\n                      <jats:italic>n<\/jats:italic>\n                      = 79), upper\u2010middle (\n                      <jats:italic>n<\/jats:italic>\n                      = 39) and high\u2010 (\n                      <jats:italic>n<\/jats:italic>\n                      = 50) income countries. Most sites reported being subject to pandemic\u2010related restrictions on travel, service provision or other operations (75%), and experiencing negative impacts (76%) on clinic operations, including decreased hours\/days, reduced provider availability, clinic reconfiguration for COVID\u201019 services, record\u2010keeping interruptions and suspension of partner support. Almost all sites in low\u2010prevalence and high\u2010income countries reported increased use of telemedicine (85% and 100%, respectively), compared with less than half of sites in high\u2010prevalence and lower\u2010income settings. Few sites in high\u2010prevalence settings (2%) reported suspending antiretroviral therapy (ART) clinic services, and many reported adopting mitigation strategies to support adherence, including multi\u2010month dispensing of ART (95%) and designating community ART pick\u2010up points (44%). While few sites (5%) reported stockouts of first\u2010line ART regimens, 10\u201311% reported stockouts of second\u2010 and third\u2010line regimens, respectively, primarily in high\u2010prevalence and lower\u2010income settings. Interruptions in HIV viral load (VL) testing included suspension of testing (22%), longer turnaround times (41%) and supply\/reagent stockouts (22%), but did not differ across settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While many sites in high HIV prevalence settings and lower\u2010income countries reported introducing or expanding measures to support treatment adherence and continuity of care, the COVID\u201019 pandemic resulted in disruptions to VL testing and ART supply chains that may negatively affect the quality of HIV care in these settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jia2.26036","type":"journal-article","created":{"date-parts":[[2022,12,11]],"date-time":"2022-12-11T22:51:50Z","timestamp":1670799110000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Service delivery challenges in HIV care during the first year of the COVID\u201019 pandemic: results from a site assessment survey across the global IeDEA consortium"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8514-1958","authenticated-orcid":false,"given":"Ellen","family":"Brazier","sequence":"first","affiliation":[{"name":"Institute for Implementation Science in Population Health City University of New York New York New York USA"},{"name":"Graduate School of Public Health and Health Policy City University of New York New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-5063","authenticated-orcid":false,"given":"Rogers","family":"Ajeh","sequence":"additional","affiliation":[{"name":"Clinical Research Education Networking and Consultancy Yaound\u00e9 Cameroon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"Maruri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases Vanderbilt University Medical Center Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Musick","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Data Science Indiana University School of Medicine Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Bloomberg School of Public Health Johns Hopkins University Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8375-3926","authenticated-orcid":false,"given":"C. 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