A little more than a month after World AIDS Day 2019, COVID-19 started to impact our HIV programs in Asia as countries like Cambodia, Thailand and Vietnam began quarantine. Community testing ground to a halt. People living with HIV worried about access to their medications. HIV pre-exposure prophylaxis (PrEP) enrollment slowed. COVID-19 testing diverted laboratories from HIV services. By March 2020, the rest of the world was equally impacted. FHI 360’s HIV programs were determined to continue serving people, but there were deep concerns. We were not alone, of course; the global HIV community was facing COVID-19 together. But with so much uncertainty, we wondered: Would COVID-19 substantially set back hard-won gains toward epidemic control? Did we have the tools in hand, or could we develop the tools, to weather this crisis?
As the COVID-19 pandemic swept over the United States, the stark observation that African-American, Hispanic and Native American populations were disproportionately affected was met with justified shock and anger. After all, the United States has the world’s largest economy, a high standard of living and a sophisticated health care system and is often held up as a model for many countries.
The increased pressure on public health systems to respond to the COVID-19 pandemic affects all routine health care, including the provision of essential HIV services. People living with HIV require regular access to treatment, but crowded public health facilities carry increased risk of exposure to COVID-19. Routine treatment sites also may be harder to reach because of stay-at-home orders, curfews and public transportation shutdowns. To maintain gains in HIV epidemic control, we must ensure that people needing antiretroviral therapy (ART) continue to receive medication uninterrupted.