COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in Eswatini

Background: Oral pre-exposure prophylaxis (PrEP) uses antiretroviral medication to reduce HIV risk in HIV-negative individuals. Despite its effectiveness, global uptake faces policy and accessibility challenges. In Eswatini, PrEP introduction in 2017 showed promise despite stigma and COVID-19 disrup...

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Main Authors: Musa B. Ginindza, Nondumiso Ncube, Renier Coetzee
Format: Article
Language:English
Published: AOSIS 2024-12-01
Series:African Journal of Primary Health Care & Family Medicine
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Online Access:https://phcfm.org/index.php/phcfm/article/view/4685
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author Musa B. Ginindza
Nondumiso Ncube
Renier Coetzee
author_facet Musa B. Ginindza
Nondumiso Ncube
Renier Coetzee
author_sort Musa B. Ginindza
collection DOAJ
description Background: Oral pre-exposure prophylaxis (PrEP) uses antiretroviral medication to reduce HIV risk in HIV-negative individuals. Despite its effectiveness, global uptake faces policy and accessibility challenges. In Eswatini, PrEP introduction in 2017 showed promise despite stigma and COVID-19 disruptions. Aim: This study compared PrEP uptake and retention during and after COVID-19. Setting and Methods: An analytical cross-sectional study was conducted among clients accessing HIV testing services in selected Eswatini facilities. Data from the HIV testing register, PrEP register, and Client Management Information System (CMIS) were analysed. Uptake, retention, and client outcomes were measured during COVID-19 (March 2020–March 2021) and post-COVID-19 (April 2021–April 2022). Results: Of 5286 clients, 45% (n = 2380) initiated PrEP during COVID-19, while 55% (n = 2906) initiated post-pandemic. Facility 3 had the highest initiations during COVID-19 (844), while Facility 5 had the lowest (7). Retention was lower among clients aged 15–29 years. Females initially showed higher retention odds (odds ratio [OR]: 1.50), but this was insignificant after adjusting for confounders. Clients initiated post-COVID-19 had higher retention odds (OR: 2.96). Conclusion: COVID-19 impacted PrEP uptake in Eswatini, emphasising the need for flexible healthcare delivery. Targeted campaigns and tailored interventions are crucial for sustaining HIV prevention efforts and addressing demographic shifts. Contribution: This study highlights the importance of responsive healthcare systems and tailored approaches to maintaining HIV prevention during public health crises.
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spelling doaj-art-87a47dff02c14d61b738aa6473d2e4cd2025-01-14T12:13:43ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362024-12-01161e1e610.4102/phcfm.v16i1.46851214COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in EswatiniMusa B. Ginindza0Nondumiso Ncube1Renier Coetzee2School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape TownSchool of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape TownSchool of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape TownBackground: Oral pre-exposure prophylaxis (PrEP) uses antiretroviral medication to reduce HIV risk in HIV-negative individuals. Despite its effectiveness, global uptake faces policy and accessibility challenges. In Eswatini, PrEP introduction in 2017 showed promise despite stigma and COVID-19 disruptions. Aim: This study compared PrEP uptake and retention during and after COVID-19. Setting and Methods: An analytical cross-sectional study was conducted among clients accessing HIV testing services in selected Eswatini facilities. Data from the HIV testing register, PrEP register, and Client Management Information System (CMIS) were analysed. Uptake, retention, and client outcomes were measured during COVID-19 (March 2020–March 2021) and post-COVID-19 (April 2021–April 2022). Results: Of 5286 clients, 45% (n = 2380) initiated PrEP during COVID-19, while 55% (n = 2906) initiated post-pandemic. Facility 3 had the highest initiations during COVID-19 (844), while Facility 5 had the lowest (7). Retention was lower among clients aged 15–29 years. Females initially showed higher retention odds (odds ratio [OR]: 1.50), but this was insignificant after adjusting for confounders. Clients initiated post-COVID-19 had higher retention odds (OR: 2.96). Conclusion: COVID-19 impacted PrEP uptake in Eswatini, emphasising the need for flexible healthcare delivery. Targeted campaigns and tailored interventions are crucial for sustaining HIV prevention efforts and addressing demographic shifts. Contribution: This study highlights the importance of responsive healthcare systems and tailored approaches to maintaining HIV prevention during public health crises.https://phcfm.org/index.php/phcfm/article/view/4685primary carehivpre-exposure prophylaxiscovid-19eswatiniretentionpandemicpublic healthprevention.
spellingShingle Musa B. Ginindza
Nondumiso Ncube
Renier Coetzee
COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in Eswatini
African Journal of Primary Health Care & Family Medicine
primary care
hiv
pre-exposure prophylaxis
covid-19
eswatini
retention
pandemic
public health
prevention.
title COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in Eswatini
title_full COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in Eswatini
title_fullStr COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in Eswatini
title_full_unstemmed COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in Eswatini
title_short COVID-19 impact on HIV PrEP uptake and retention at selected health facilities in Eswatini
title_sort covid 19 impact on hiv prep uptake and retention at selected health facilities in eswatini
topic primary care
hiv
pre-exposure prophylaxis
covid-19
eswatini
retention
pandemic
public health
prevention.
url https://phcfm.org/index.php/phcfm/article/view/4685
work_keys_str_mv AT musabginindza covid19impactonhivprepuptakeandretentionatselectedhealthfacilitiesineswatini
AT nondumisoncube covid19impactonhivprepuptakeandretentionatselectedhealthfacilitiesineswatini
AT reniercoetzee covid19impactonhivprepuptakeandretentionatselectedhealthfacilitiesineswatini