Comparison of viral load suppression among treatment-initiated HIV positive patients before and during COVID-19 in the Hhohho region, Eswatini 2018-2022: A repeated cross-sectional study

Abstract

Introduction Globally, it is estimated that there are 37.7 million people living - with the Human Immunodeficiency Virus (HIV), and 28.2 million of them have access to antiretroviral therapy (ART) treatment. The 2020 Global Fund report states that Eswatini achieved the 2025 UNAIDS global AIDS programme targets that were aimed at ending the AIDS pandemic by 2030. This translated to each country reporting that they have achieved the target of 95% of people living with HIV, know their HIV status, 95% of people who know their HIV-positive status, are on treatment, and 95% of people on treatment have a suppressed viral load. The COVID-19 pandemic has profoundly affected various aspects of healthcare, particularly for vulnerable populations such as people living with HIV (PLWHIV). The challenges of balancing protection of the populations and maintenance of essential health service provision was a dilemma faced by governments with the emergence of COVID-19. There is limited research on the effects of the pandemic on HIV viral load suppression in Eswatini, including in Hhohho. This research aims to compare ART adherence among PLWHIV before (March 2018 to February 2020) and during (March 2020 to February 2022) COVID-19 period in the Hhohho region, Eswatini.