Impact of the COVID-19 Pandemic on HIV Care in a Paediatric and Adolescent ARV Clinic in Johannesburg: A Retrospective Cohort Study

Abstract

Background: The co-existence of the HIV/AIDS epidemic and the COVID-19 pandemic in South Africa challenged the healthcare sector and negatively impacted healthcare service delivery, including through impeding access to primary healthcare services which include HIV care services for children and adolescents. Objectives: We describe the impact of the COVID-19 pandemic on paediatric and adolescent HIV care at an HIV clinic in Johannesburg, South Africa. Method: A retrospective cohort study was conducted on data from the Empilweni Services and Research Unit (ESRU) database, and a secondary data analysis was performed by comparing data of children and adolescents aged 0-18 years who had their first visit during the two study periods; March 2018- February 2019 (pre-COVID era) and March 2020- February 2021 (COVID era). Results: During the COVID era, a total of 113 children and adolescents were enrolled into HIV care, reflecting a 27% decline from the pre-COVID era where 154 enrolments occurred. Additionally, there was a significant decrease in the number of neonates referred via the Vertical Transmission Prevention (VTP) program, previously known as the ‘Prevention of Mother-to-Child Transmission (PMTCT) program’ (45 pre- COVID compared to 20 in the COVID era). However, no significant difference was observed in adherence patterns and treatment outcomes between the two study periods. Conclusion: The COVID-19 pandemic negatively impacted the enrolment of children and adolescents into HIV care and affected the VTP program negatively. This is evidenced by a decline in the total number of children and adolescents enrolled in XI care during this period. However, there was no significant impact on the outcomes of HIV care.