Imperial College London
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ProfessorTimothyHallett

Faculty of Medicine, School of Public Health

Professor of Global Health
 
 
 
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Contact

 

+44 (0)20 7594 1150timothy.hallett

 
 
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Location

 

School of Public HealthWhite City Campus

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Summary

 

Publications

Citation

BibTex format

@article{Jewell:2020:10.1016/j.eclinm.2020.100483,
author = {Jewell, BL and Smith, JA and Hallett, TB},
doi = {10.1016/j.eclinm.2020.100483},
journal = {EClinicalMedicine},
pages = {1--7},
title = {Understanding the impact of interruptions to HIV services during the COVID-19 pandemic: A modelling study},
url = {http://dx.doi.org/10.1016/j.eclinm.2020.100483},
volume = {26},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThere is concern that the COVID-19 pandemic could severely disrupt HIV services in sub-Saharan Africa. However, it is difficult to determine priorities for maintaining different elements of existing HIV services given widespread uncertainty.MethodsWe explore the impact of disruptions on HIV outcomes in South Africa, Malawi, Zimbabwe, and Uganda using a mathematical model, examine how impact is affected by model assumptions, and compare potential HIV deaths to those that may be caused by COVID-19 in the same settings.FindingsThe most important determinant of HIV-related mortality is an interruption to antiretroviral treatment (ART) supply. A three-month interruption for 40% of those on ART could cause a similar number of additional deaths as those that might be saved from COVID-19 through social distancing. An interruption for more than 6–90% of individuals on ART for nine months could cause the number of HIV deaths to exceed the number of COVID-19 deaths, depending on the COVID-19 projection. However, if ART supply is maintained, but new treatment, voluntary medical male circumcision, and pre-exposure prophylaxis initiations cease for 3 months and condom use is reduced, increases in HIV deaths would be limited to <2% over five years, although this could still be accompanied by a 7% increase in new HIV infections.InterpretationHIV deaths could increase substantially during the COVID-19 pandemic under reasonable worst-case assumptions about interruptions to HIV services. It is a priority in high-burden countries to ensure continuity of ART during the pandemic.FundingBill & Melinda Gates Foundation.
AU  - Jewell,BL
AU  - Smith,JA
AU  - Hallett,TB
DO  - 10.1016/j.eclinm.2020.100483
EP  - 7
PY  - 2020///
SN  - 2589-5370
SP  - 1
TI  - Understanding the impact of interruptions to HIV services during the COVID-19 pandemic: A modelling study
T2  - EClinicalMedicine
UR  - http://dx.doi.org/10.1016/j.eclinm.2020.100483
UR  - https://www.sciencedirect.com/science/article/pii/S2589537020302273?via%3Dihub
UR  - http://hdl.handle.net/10044/1/81492
VL  - 26
ER  -
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