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Impact of COVID-19 pandemic on retention in care of native and migrant people with HIV in the ICONA cohort

Gagliardini, Roberta; Giacomelli, Andrea; Bozzi, Giorgio; D'Arminio Monforte, Antonella; Tavelli, Alessandro; Mazzotta, Valentina; Bruzzesi, Elena; ... ICONA Foundation study group; + view all (2024) Impact of COVID-19 pandemic on retention in care of native and migrant people with HIV in the ICONA cohort. Travel Medicine and Infectious Disease , 58 , Article 102691. 10.1016/j.tmaid.2024.102691. Green open access

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Abstract

BACKGROUND: COVID-19 pandemic challenged the UNAIDS 90-90-90 targets. How the COVID-19 pandemic affected HIV retention in care and whether it has disproportionally affected migrant people with HIV (PWH) remained to be investigated. METHODS: PWH in ICONA Cohort in follow-up in each of the study periods were included: 01/09/2019-29/02/2020 (pandemic period) and 01/03/2018-31/08/2018 (historical period, as a control). Risk of temporary loss to follow-up (LTFU, defined as no data recorded for a person for one year) was analyzed by logistic regression, with migrant status as the main exposure variable. Difference in difference (DID) analysis was applied to evaluate the effect of COVID-19 pandemic in the different risk of LTFU between natives and migrants. RESULTS: 8864 (17.1% migrants) and 8071 (16.8% migrants) PWH constituted the pandemic and the historical period population, respectively. Proportion of PWH defined as LTFU in the pandemic period was 10.5% in native and 19.6% in migrant PWH. After controlling for age, sex and geographical location of enrolling site, risk of temporary LTFU was higher for migrants than native PWH [adjusted odds ratio 1.85 (95%CI 1.54-2.22)] in pandemic period. In PWH contributing to both periods, LTFU was 9.0% (95% CI 8.3-9.8) in natives vs 17.0% (95% CI 14.7-19.4) in migrants during the pandemic. Instead, LTFU was 1.2% (95%CI 0.9, 1.5) in natives vs 2.2% (95% CI 1.3-3.1) in migrants during the historical period, with a resulting DID of 7.0% (95% CI 4.4-9.6). CONCLUSIONS: A greater proportion of LTFU in migrant PWH was observed in both periods, which remained unaltered over time. Interventions to reduce LTFU of migrants are necessary.

Type: Article
Title: Impact of COVID-19 pandemic on retention in care of native and migrant people with HIV in the ICONA cohort
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.tmaid.2024.102691
Publisher version: http://dx.doi.org/10.1016/j.tmaid.2024.102691
Language: English
Additional information: This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/bync-nd/4.0/).
Keywords: Loss to follow-up, Retention in care, SARS-CoV-2
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10187522
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