HIV care in times of the COVID-19 crisis - where are we now in Central and Eastern Europe?

Abstract Introduction The SARS-CoV-2 pandemic hit disproportionately European region. Many HIV clinics share staff and logistics with infectious disease facilities, which are now on the frontline of COVID-19. Therefore, we investigated the impact of current pandemic situation on HIV care and continuity of antiretroviral treatment (ART) supplies in CEE countries. Methods Euroguidelines in Central and Eastern Europe (ECEE) Network Group was established in February 2016 to review standards of care for HIV in the region. The group consists of professionals actively involved in HIV care. On 19th March we decided to review the status of HIV care sustainability in the face of emerging SARS-CoV-2 pandemic in Europe. For this purpose, we constructed an on-line survey consisting of 23 questions. Respondents were recruited from the ECEE members in 22 countries, based on their involvement in HIV care and contacted through e-mails. Results In total 19 countries responded: Albania, Armenia, Belarus, Bosnia and Herzegovina, Bulgaria, Croatia, Czech Republic, Estonia, Georgia, Greece, Hungary, Lithuania, Macedonia, Poland, Republic of Moldova, Russia, Serbia, Turkey, Ukraine. Most of the respondents were infectious disease physicians directly involved in HIV care (17/19). No country reported HIV clinic closure. HIV clinics were operating normally in only six countries (31.6%). In 11 (57.9%) countries physicians were sharing HIV care and COVID-19 care duties. None of the countries expect shortage of ART in the next two weeks; however five physicians expressed uncertainty about the next two months. At the time of providing responses ten (52.6%) countries had HIV-positive persons under quarantine. Conclusions The shortage of resources is evident and the impact on HIV care inevitable. We need to prepare for operating under minimal medical resources with the aim to secure retention on ART. Non-governmental organizations should re-validate their earlier objectives and second medical efforts to ascertain the continuity of ART deliverance.