Caribbean countries should ensure that people living with HIV have reliable access to treatment, healthcare and human rights-based social support services during the covid19 pandemic.
The call is being made by the Joint UN Programme on HIV and AIDS (UNAIDS), Pan American Health Organization (PAHO) and Pan Caribbean Partnership against HIV and AIDS (PANCAP).
In a release, the organisations said regular access to essential care and treatment for people living with HIV may be challenged at this time because of the burden of covid19 response on health facilities.
They said it is therefore vital that HIV programmes develop contingency plans to meet demand for the care and treatment of people living with HIV, as well as HIV testing, antenatal care and other essential sexual and reproductive health services. They said alternatives for remote or virtual clinical care may be explored during the implementation of quarantine, social distancing measures and stay-at-home orders.
They said it was critical for countries to implement World Health Organisation (WHO) guidelines for multi-month dispensing (MMD), ensuring that people living with HIV who are stable on antiretroviral treatment are given three to six months of their medications at once. They said this would lessen the burden on health facilities and allow people to maintain uninterrupted treatment regimens without risking exposure to covid19 when collecting their medicines. They said this should also apply in countries with HIV Pre-Exposure Prophylaxis (PrEP) programmes. Alternative treatment access options such as community pharmacy dispensing, community-based pick-up points or home delivery may be considered.
The organisations said health services should also prioritise ongoing care for people living with HIV, who have a higher covid19 risk due to low CD4 counts, tuberculosis and other underlying conditions, as well as people recently diagnosed with HIV infection who need to start treatment as soon as possible.
They said community organisations, including those of people living with HIV, will play a key role in supporting people keeping up their treatment and mental health. These organisations should be included in contingency planning and implementation processes to ensure continuity of treatment and care.
The organisations said the HIV response has learned many lessons that can be used in the covid19 response, including complying with a human-rights-based approach that puts communities at the centre and respects the rights and dignity of all. A primary lesson from the AIDS response is that stigma and discrimination are counterproductive to ensuring good individual and public health outcomes.