Abstract:
BACKGROUND : The coronavirus disease 2019 (COVID-19) pandemic disrupted paediatric HIV
services across South Africa. Shortly before COVID-19, updated national HIV guidelines were
released.
OBJECTIVES : This study describes COVID-19’s impact on paediatric HIV services in Tshwane
District, South Africa.
METHOD : A retrospective review of National Institute for Communicable Diseases and District
Health Information System data for Tshwane District from April 2019 to March 2022. Data
included: Early Infant Diagnosis (EID), HIV viral load (VL) and CD4 monitoring and HIV
management among children (< 15 years) living with HIV (CLHIV). Pre-pandemic (2019/2020)
and pandemic periods (2020/2021, 2021/2022) were compared.
RESULTS : Year-on-year, HIV testing improved at 10 weeks, 6 months, and 18 months, whereas
birth testing decreased. HIV EID case rates were 485 (2019/2020), 410 (2020/2021) and 454
(2021/2022). HIV EID test positivity was 0.77% – 1.2%. Antiretroviral treatment initiation
declined from 2019/2020 to 2020/2021, but improved in 2021/2022.
Initial HIV VL and CD4 testing declined, with HIV VL testing increasing in 2021/2022, and CD4
testing further declining. HIV VL suppression rate among CLHIV ranged from 69% to 73%.
CONCLUSION : Initially, COVID-19 resulted in reduced paediatric HIV services as children
disengaged from care. Indicators eventually recovered to proximate pre-pandemic levels;
however, compensatory increases did not occur. Thus, some children may not have returned
to care.
