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Covid-19 impacts HIV testing and treatment 

31 Jan 2021

The number of people coming in for human immunodeficiency virus (HIV) testing and to obtain related treatment services has significantly decreased due to the Covid-19 pandemic, The Sunday Morning learnt.  Speaking to The Sunday Morning, National Sexually Transmitted Diseases (STD)/Acquired Immunodeficiency Syndrome (AIDS) Control Programme Consultant Venereologist, Dr. Chandrika Jayakody said that there is growing concern that Covid-19 will result in service provision disruptions in the case of HIV testing and treatment.  “In 2019 alone, 439 new HIV infections were reported. Of these, 359 were males. However, we see a decrease in cases being reported in 2020 due to the Covid-19 pandemic where only 340 new HIV infections were reported,” noted Dr. Jayakody.  Meanwhile, according to the Joint United Nations (UN) Programme on HIV and AIDS, large and sustained decreases in HIV testing services have been seen across all countries except Rwanda, with reduced services being reported for most countries starting in April 2020. Five countries – Myanmar, Mozambique, Madagascar, Rwanda, and Armenia – have rebounded to pre-Covid-19 testing levels, while in other countries, such as Guyana and Peru, testing remains low. As of August 2020, the Joint UN Programme, the World Health Organisation (WHO), and the UN Children's Fund (UNICEF) data collection exercise to identify national, regional, and global disruptions of routine HIV services caused by Covid-19 had collected data on the prevention of vertical transmission (from mother to child) of HIV from 43 countries, of which 17 countries reported data that enabled the identification of trends.  According to Dr. Jayakody, there has been a gradual increase in the number of new diagnoses of HIV-infected persons reported in Sri Lanka in recent times.  “In 2011, 144 new HIV infections were reported and the numbers gradually increased. Sri Lanka is still a low-risk country for the spread of HIV, and HIV prevalence is less than 0.01% in the general population,” added Dr. Jayakody.  Since 2016, there has been an increase in the number of HIV infections among young people aged 15-24 years, corresponding to the total increase of HIV infections during this period. In 2019, 54 (12%) of new HIV infections were in this age group, and 89% of them were males, Dr. Jayakody further said.  According to Dr. Jayakody, Sri Lanka sees less sexually risky behaviour among females when compared to males.  “HIV can be transmitted from one person to another, by unprotected sex with an infected partner, by infected blood and blood-related fluids, and from an infected mother to her child. Out of these three ways, 86% of HIV transmissions in Sri Lanka occur through unprotected sex and most frequently by unprotected same-sex relationships among males,” she further added.  According to the WHO, Sri Lanka having already eliminated mother-to-child transmission of HIV and syphilis demonstrates the country’s commitment to public health. High-quality maternal and child health (MCH) services, multi-sectoral support, strong community engagement, and concerted efforts by partners such as the WHO, UNICEF, Joint UN Programme, the UN Population Fund (UNFPA), and civil society organisations have contributed towards this achievement. Screening for HIV and the management of infected women during pregnancy is fully integrated within MCH services at every level.  Many factors make young people vulnerable to getting infected by HIV. Their knowledge on sexually transmitted infections (STIs) including HIV is inadequate and they lack the necessary life skills to avoid risky behaviour in order to ensure prevention from being infected with STIs and HIV, Dr. Jayakody explained.  “Other important factors which make young people vulnerable are the misuse of modern technology, forming instant relationships with unknown partners, childhood sexual abuse, and peer pressure. In the current context of the Covid-19 pandemic, young people study or work from home and are isolated from their peers. This further exacerbates their use of technology including mobile phones, and they form new relationships through the internet,” elaborated Dr. Jayakody.  They also become addicted to drugs frequently, when compared to older people, Dr. Jayakody explained.  She further added that these factors may lead them to engage in high-risk sexual behaviour. In addition, young people still face substantive challenges to access HIV and sexual and reproductive health services due to stigma.  According to Dr. Jayakody, young people should be the principal beneficiaries of HIV prevention strategies such as comprehensive sexual health education and life skills development. Through increased access to sexual health education, STIs including HIV, unintended pregnancies, gender-based violence (GBV), and gender inequality can be minimised.  To prevent the transmission of this infection among youths, it is important to follow steps like delaying sexual intercourse until marriage, limiting sexual intercourse to one faithful partner, and using a condom correctly and consistently when having sex, she further explained.  Blood tests to detect HIV are performed free of charge while maintaining confidentiality at STI clinics throughout the country, Dr. Jayakody said. These tests can now detect the infection at an early stage, and it is possible for people living with HIV to receive antiviral drugs and lead a normal life.  Young people are also provided with risk reduction counselling and behavioural change counselling to maintain their positive behaviours, said Dr. Jayakody.   


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