Title:
The Impact of Covid-19 Lockdown on Missed Appointments Among HIV-infected Adults in Ekurhuleni District, South Africa, 2019 to 2021: An Interrupted Time Series Analysis

Authors:
Sikhanyiselwe Nkomo ; Mahlatse L Moropeng, South Africa

Abstract:

The coronavirus pandemic disrupted access to routine HIV healthcare services, affecting health systems flow, and PLHIV particularly those in less privileged communities. A quasi-experimental design study with interrupted time series (ITS) was conducted to determine the effects of the COVID-19 shutdown on the follow-up of HIV patients in the Ekurhuleni district. The study setting included Winnie Mandela Clinic, Tembisa HCC, Tembisa Main Clinic, and Esangweni Clinic. The study used a total sampling of eligible patients during the study period in the chosen facilities. Data was extracted from the Tier.net records for patients who were on antiretroviral therapy by 2019 and during the lockdown to December 2021. The hard lockdown in Tembisa HCC resulted in a proportion of 14.3% of missed appointments, which was comparatively higher than in other months. Interrupted time series analysis on the evaluation of missed appointments showed a statistical significance with a p-value of 0.049 <0.05 at Tembisa HCC compared to the other three clinics. The proportion of virally suppressed patients declined by 3.4% during the lockdown. In comparison to clinics, Tembisa HCC showed the most significant decrease (5.9%) in virally suppressed patients. There was a stronger correlation between acquiring an AIDS-defining disease and failing to attend clinic appointments.

DOI: http://dx.doi.org/10.51505/ijmshr.2025.9102