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/S2352-3018(20)30211-3,
author = {Jewell, B and Mudimu, E and Stover, J and Ten, Brink D and Phillips, A and Smith, J and Martin-Hughes, R and Teng, Y and Glaubius, R and Mahiane, SG and Bansi-Matharu, L and Taramusi, I and Chagoma, N and Morrison, M and Doherty, M and Marsh, K and Bershteyn, A and Hallett, T and Kelly, S},
doi = {10.1016/S2352-3018(20)30211-3},
journal = {The Lancet HIV},
pages = {e629--e640},
title = {Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple mathematical models},
url = {http://dx.doi.org/10.1016/S2352-3018(20)30211-3},
volume = {7},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: The COVID-19 epidemic could lead to the disruptions to provision of HIV services for people living with HIV and those  at risk of acquiring HIV in sub-Saharan Africa, where UNAIDS estimates that more than two thirds of the 37.9 million (32.7-44.0 million) people living with HIV reside in 2018.  We set out to predict the potential effects of such disruptions on HIV-related deaths and new infections.Methods: Five well-described models of HIV epidemics (Goals, Optima HIV, HIV Synthesis, Imperial College model, EMOD) were each used to estimate the effect of various potential disruptions to HIV prevention, testing and treatment services on HIV-related deaths and new infections in sub-Saharan Africa lasting 6 months from 1 April 2020.  Disruptions affecting 20%, 50% and 100% of the population were considered.  In further analyses shorter term disruptions and the possibility of reductions in sexual activity during disruptions were considered. Findings: A six-month interruption of supply of antiretroviral  (ARV) drugs across 50% of the  population of people living with HIV on treatment would be expected to lead to a 1.63-fold (median across models; range 1.39 to 1.87) increase in HIV-related deaths over a one year period compared to  with no disruption.  In sub-Saharan Africa this amounts to an excess of  296,000  (median over model estimates, range 229,000 – 420,000)  HIV deaths should such a high level of disruption occur.   There would also be an approximately 1.6-fold increase in mother to child transmission of HIV.  While an interruption of supply of ARV drug would have by far the largest impact of any potential disruptions, effects of poorer clinical care due to over-stretched health facilities, interruptions of supply of other drugs such as cotrimoxazole and suspension of HIV testing would all have significant population-level impact on mortality.  Interruption to condom supplies and peer education would make populations more vulnerable to increases
AU  - Jewell,B
AU  - Mudimu,E
AU  - Stover,J
AU  - Ten,Brink D
AU  - Phillips,A
AU  - Smith,J
AU  - Martin-Hughes,R
AU  - Teng,Y
AU  - Glaubius,R
AU  - Mahiane,SG
AU  - Bansi-Matharu,L
AU  - Taramusi,I
AU  - Chagoma,N
AU  - Morrison,M
AU  - Doherty,M
AU  - Marsh,K
AU  - Bershteyn,A
AU  - Hallett,T
AU  - Kelly,S
DO  - 10.1016/S2352-3018(20)30211-3
EP  - 640
PY  - 2020///
SN  - 2405-4704
SP  - 629
TI  - Potential effects of disruption to HIV programmes in sub-Saharan Africa caused by COVID-19: results from multiple mathematical models
T2  - The Lancet HIV
UR  - http://dx.doi.org/10.1016/S2352-3018(20)30211-3
UR  - https://www.sciencedirect.com/science/article/pii/S2352301820302113?via%3Dihub
UR  - http://hdl.handle.net/10044/1/80445
VL  - 7
ER  -
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