Benefits of continuing to provide HIV services outweigh the risk of COVID-19 transmission by 100-to-1, say WHO

The World Health Organisation (WHO) has said that disruption to HIV services, which has been as high as 75% in some regions, must stop so that people can continue to access life-saving HIV treatment.

Working with UNAIDS, the WHO have been using mathematical modelling to establish and highlight the benefits of continuing HIV services compared to the potential harm of additional COVID-19 transmissions.

The team’s analysis looked at disruptions to four key HIV services:

• Voluntary medical male circumcision
• HIV diagnostic testing
• Viral load testing
• Programmes to prevent mother-to-child transmission of HIV.

The analysis showed that returning to full provision of HIV services would avoid between 190 to 1,460 AIDS-related deaths per 100,000 people over a 50-year time horizon, whilst the additional COVID-19 related deaths from exposures related to accessing HIV services would be 0.02 to 1.5 per 100,000 people for the same time period. The WHO says that their analysis “demonstrates that the benefits of continuing to provide HIV services during the COVID-19 pandemic far outweigh the risk of additional COVID-19-related deaths”.

“The world should make investments now that don’t leave it with such stark trade-offs in the future,” said Peter Ghys, Director, Strategic Information and Evaluation, UNAIDS. “We need to build robust future systems for health that recognize community-led contributions as part and parcel of a resilient system, not as an afterthought.”

“This work shows that taking the longer view, the benefits of continuing key HIV services are far larger than the risks of additional COVID-19 transmission; innovative and safe delivery of services must continue as the pandemic is brought under control” said Meg Doherty, Director of WHO’s Global HIV, Hepatitis and Sexually Transmitted Infections Programmes.

The WHO and UNAIDS say that their modelling shows that whilst there is some short-term risk of COVID-19 transmission associated with providing HIV services, the risk of a COVID-19 associated death is 100 times less that of an AIDS-related death due to inability to access treatment and care.

The full analysis can be accessed here: https://doi.org/10.1101/2021.03.01.21252663