Did the 2014 Ebola outbreak in Liberia affect HIV testing, linkage to care and ART initiation?

Evaluates individuals who were diagnosed and enrolled into HIV care before, during and after the outbreak

From:: Department for International Development
Published: 21 June 2017

Country:: Liberia
Document Type:: Journal Article
Theme:: Health
Authors:: Jacobs, G.P., Bhat, P, Owiti, P, Edwards, J.K., Tweya, H, Najjemba, R

Abstract

Setting

Health facilities providing human immunodeficiency virus (HIV) testing, care and treatment in Liberia

Objective

To evaluate individuals aged >15 years who were tested, diagnosed and enrolled into HIV care before (2013), during (2014) and after the Ebola outbreak (2015).

Design

A cross-sectional descriptive study.

Results

A median of 6930 individuals aged >15 years per county were tested for HIV before the Ebola outbreak; this number declined by 35% (2444/6930) during the outbreak. HIV positivity remained similar before (7028/207 314, 3.4%) and during the outbreak (4146/121 592, 3.5%). During Ebola, HIV testing declined more in highly affected counties (68 035/127 468, 47%) than in counties that were less affected (16 444/23 955, 31%, P 0.001). Compared to the pre-Ebola period, HIV testing in less-affected counties recovered more quickly during the post-outbreak period, with a 19% increase in testing, while medium and highly affected counties remained at respectively 38% and 48% below pre-outbreak levels. Enrolment for HIV care increased during and after the outbreak compared to the pre-Ebola period.

Conclusion

HIV testing and diagnosis were significantly limited during the Ebola outbreak, with the most severe effects occurring in highly affected counties. However, enrolment for HIV care and treatment were resilient throughout the outbreak. Pro-active measures are needed to sustain HIV testing rates in future epidemics.

This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)

Citation

Jacobs GP, Bhat P, Owiti P, Edwards JK, Tweya H, Najjemba R. Did the 2014 Ebola outbreak in Liberia affect HIV testing, linkage to care and ART initiation? Public Health Action. 2017;7(1):70–5.