Background The coronavirus disease 2019 (COVID-19) pandemic resulted in unique programmatic opportunities to test hypotheses related to the initiation of antiretroviral treatment (ART) and viral load (VL) suppression during a global health crisis, which would not otherwise have been possible. Objectives To generate practice-relevant evidence on the impact of initiating ART pre-COVID-19 versus during the COVID-19 pandemic on HIV VL. Method Logistic regression was performed on data covering 6596 persons with HIV whose VL data were available, out of 36 585 persons who were initiated on ART between 01 April 2019 and 30 March 2021. Results After controlling for covariates such as age, gender, duration on ART, tuberculosis status at the time of the last visit, and rural vs urban status, the odds of having a VL < 1000 copies/mL were significantly higher for clients who started ART during the COVID-19 pandemic than the year before COVID-19 (adjusted odds ratio [AOR]: 2.50; confidence interval [CI]: 1.55-4.01; P < 0.001). Odds of having a VL < 1000 copies/mL were also significantly higher among female participants than male (AOR: 1.23; CI: 1.02-1.48), among patients attending rural clinics compared to those attending urban clinics (AOR: 1.83; CI: 1.47-2.28), and in clients who were 15 years or older at the time of their last visit (AOR: 1.50; CI: 1.07-2.11). Conclusion Viral loads did not deteriorate despite pandemic-induced changes in HIV services such as the expansion of multi-month dispensing (MMD), which may have played a protective role regardless of the general negative impacts of response to the COVID-19 crises on communities and individuals. What this study adds This research capitalises on the natural experiment of COVID-19-related changes in HIV services and provides new practice-relevant research evidence.

中文翻译：

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刚果民主共和国金沙萨和上加丹加 COVID-19 前后的 HIV 病毒载量抑制。

背景 2019 年冠状病毒病 (COVID-19) 大流行带来了独特的计划机会，可以检验与在全球健康危机期间启动抗逆转录病毒治疗 (ART) 和病毒载量 (VL) 抑制相关的假设，否则这是不可能的。目的 生成与实践相关的证据，证明在 COVID-19 之前启动 ART 与 COVID-19 大流行期间对 HIV VL 的影响。方法 对 2019 年 4 月 1 日至 2021 年 3 月 30 日期间开始接受 ART 的 36 585 人中的 6 596 名 VL 数据可用的 HIV 感染者的数据进行逻辑回归。结果ART、上次就诊时的结核病状况、农村与城市状况、VL < 对于在 COVID-19 大流行期间开始 ART 的客户，1000 份/mL 明显高于 COVID-19 之前的一年（调整后的优势比 [AOR]：2.50；置信区间 [CI]：1.55-4.01；P < 0.001）。VL < 1000 拷贝/mL 的几率在女性参与者中也显着高于男性参与者 (AOR: 1.23; CI: 1.02-1.48)，与在城市诊所就诊的患者相比 (AOR: 1.83; CI: 1.47) -2.28)，以及上次就诊时年满 15 岁的客户 (AOR：1.50；CI：1.07-2.11)。结论 尽管大流行引起艾滋病毒服务发生变化，例如扩大多月分发 (MMD)，但病毒载量并未恶化，尽管应对 COVID-19 危机对社区的总体负面影响如何，这可能起到了保护作用和个人。