PEOPLE LIVING WITH HIV AND INDIVIDUALS AT-RISK EXPERIENCED DISRUPTION TO HIV CARE IN THAILAND: SURVEY

The survey provides insights on the adoption of telemedicine as the future of HIV care

The COVID-19 pandemic has contributed to a sharp decline in people living with HIV and individuals at-risk visiting the hospital or clinic to receive care, according to a pulse survey conducted by Gilead Sciences and Institute of HIV Research and Innovation. About 82% of HIV care prescribers have indicated that they saw either less frequent or delayed visits from PLHIV, while 45% of them reported less frequent visits from individuals at-risk. This trend may continue to persist as prescriber respondents have cited travel constraints as one of the main hindrances to PLHIV and individuals at-risk seeking care.

According to the latest UNAIDS report, Thailand is one of the three countries in Asia Pacific to have achieved the 90-90-90 HIV targets. While the HIV epidemic has declined in Thailand due to successful early intervention programs, the country remains one of Asia Pacific's highest HIV prevalence, and disruptions in getting HIV care can reverse the progress that has been made in reducing transmissions and ending HIV.

"Even as Thailand has eased lockdown measures and day-to-day life has begun to normalize, we must be cognizant of the need to futureproof for potential disruptions. It is extremely crucial to ensure that we do not undo our past efforts over the years in reducing new HIV incidence and transmission. To achieve our national strategy of ending HIV as a public health threat by 2030, continuous HIV prevention and management is required to achieve this goal," said Dr. Nittaya Phanuphak, Executive Director from Institute of HIV Research and Innovation.

Thailand is one of the 10 countries and territories in Asia Pacific involved in the survey that sought to evaluate the impact of COVID-19 pandemic on the access and delivery of HIV care, which includes testing, treatment and prevention. A total of 1,265 respondents, including people living with HIV (PLHIV), individuals at-risk and HIV care prescribers, were surveyed from the region; 83 of these respondents were from Thailand. An analysis into the responses in the survey provides additional insights into the disruptions caused by the COVID-19 pandemic:

• More than half of PLHIV experienced challenges in accessing HIV treatments. About 55% of PLHIV surveyed reported interruption in access to antiretroviral treatment, with 47% of them saying that they had either decreased or halted medication completely. At the same time, 60% of HIV care prescribers observed that prescriptions for preventive medications had also decreased amongst individuals at-risk during COVID-19 pandemic.

• While respondents experienced interruptions in access to HIV medications, they are not as worried about long-term access to care. About 29% of PLHIV and 31% of individuals at-risk reporting concerns. This reflects positively on the rapid response by Thailand public health authorities, such as the National Health Security Office (NHSO), to ensure vital services are maintained. In October, the NHSO and the Social Security Insurance Scheme unified the medicine prescription guidelines under the Universal Health Coverage Scheme to allow prescription of a six-month supply of antiretroviral therapy for all eligible people living with HIV.

• Telehealth services have been adopted but they have not been fully leveraged in HIV care yet. About 57% of PLHIV and individuals at-risk said they have not utilized telehealth services. For respondents who have received care via telehealth, phone consultation was the most preferred service (56%), followed by refilling medications remotely (24%) and video consultation (17%) in the future. About 73% of prescribers expect an increase in adoption of telehealth in the future as such services offer convenience (88%), reduce spread of infection (63%), enable wider patient reach (50%) as well as reduce operational costs (50%).

"The pandemic has prompted health systems to re-evaluate ways in which patients and individuals at-risk can be served without over-burdening hospitals. Therein lies the opportunity to better leverage digital innovations such as telehealth to deliver care, stem the tide of the HIV epidemic and leave no person behind," said Dr. Nittaya Phanuphak, Executive Director from Institute of HIV Research and Innovation.

"This survey shows that ensuring access to critical HIV care services is an important public health priority especially when an end in sight to the pandemic remains uncertain. Gilead is committed to collaborating with the HIV community from public health authorities to prescribers, patient groups and civil societies in Thailand and across the region to identify strategies that can close the gaps to care to ensure the continuity of vital HIV care services during these challenging times and beyond," said Boon-Leong Neo, Senior Director, Medical Affairs, Asia Pacific, Gilead Sciences.

About the survey

The "Impact of COVID-19 on access and delivery of HIV care in Asia Pacific" was conducted online, from October to mid-November 2020, in 10 countries and territories in Asia Pacific (Hong Kong, India, Japan, Malaysia, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam) by Kantar Health, funded by Gilead Sciences with the provision of guidance and support from the Institute for HIV Research and Innovation. The survey was disseminated to local medical societies, HIV patient groups and care centers across Asia Pacific. 1,265 respondents, comprising of 667 people living with HIV, 455 individuals at-risk and 143 HIV care prescribers, participated in the survey. The purpose of the survey was to assess the current status as well as gaps and barriers to access to HIV care during COVID-19. The findings provide insights on the impact of COVID-19 to the disruptions of HIV care and inform ways in which health systems as well as HIV community can adapt strategies to maintain the provision of HIV care services and mitigate future disruptions.

About Gilead Sciences, Inc.
Gilead Sciences, Inc. is a research-based biopharmaceutical company that discovers, develops and commercializes innovative medicines in areas of unmet medical need. The company strives to transform and simplify care for people with life-threatening illnesses around the world. Gilead has operations in more than 35 countries worldwide, with headquarters in Foster City, California. For more information on Gilead Sciences, please visit the company's website at www.gilead.com.

About Institute of HIV Research and Innovation (IHRI)

Institute of HIV Research and Innovation (IHRI) is a non-profit organization, located in Bangkok, Thailand. With almost two decades of experience working in research and sexual health programs, the organization is recognized for its expertise both at the national and international level. IHRI provides advance clinical and implementation research on HIV and other health-related issues as well as strengthening the capacity of community health workers and health care providers, while fostering partnership with other health sector entities. We collaborate with governments, health networks, international organizations, local and international civil society organizations to address health issues in the region focusing on sexual health. IHRI is also a learning hub to translate evidenced-based, innovative knowledge into improvements of health policies and practices. For more information, visit our website https://ihri.org/.

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