This archive report was first published on 7 June 2020.
Coronavirus Disrupts HIV Prevention Efforts in Africa ¶
As the COVID-19 pandemic spread across Africa, it brought with it a devastating impact on HIV prevention efforts. In Uganda, sex worker Lillian Namiiro, who worked on the Tanzanian border, saw her work come to a grinding halt. She would remind government workers to send antiretroviral drugs to nearby health centers and check on whether sex workers needed drug refills. But now, she says, “All that ended. The sex workers who want drugs can’t get them. Everything ended.”
Uganda’s ban on public gatherings ruled out health talks for sex workers, and when transport was prohibited, except for cargo trucks, Namiiro knew that the health outreach teams could no longer reach her community. Across Africa, countries rolled out similar measures, causing major health systems disruptions, with people being unable or afraid to visit hospitals for regular care like antenatal services, childbirth, and immunizations.
According to 24 interviews across five countries, the most disrupted HIV-related services were those meant to prevent new infections, especially among populations considered most at risk of HIV. Health workers and sex workers in Uganda, Kenya, South Africa, Nigeria, and Mozambique came up with creative ways to ensure registered HIV patients continue receiving drugs, but HIV testing, PrEP, drop-in centers for vulnerable groups, and medical male circumcision were scaled back and sometimes closed completely.
“We expect many more new cases of HIV to be reported in the coming months and weeks,” says Thomas Abol, executive director of Keeping Alive Society’s Hope (KASH), a Kenyan organization that serves sex workers and men who have sex with men. UNAIDS and WHO have sounded similar alarms.
Under the Nairobi government’s COVID-19 restrictions, KASH closed its drop-in center, a safe space in Kisumu for people who may not feel safe going to a regular clinic, including sex workers. In South Africa, Megan Lessing, spokesperson for the NGO Sex Workers Education and Advocacy Taskforce, said their outreach work and walk-in HIV clinic stopped for the first five weeks of lockdown.
Even before the pandemic, the five countries were in total registering nearly 620,000 new HIV infections a year, according to WHO data. In 10 other countries, similar HIV service reductions were reported to an International Planned Parenthood Federation survey of its network of sexual and reproductive health clinics, in March.
