Oran: Coexistence with AIDS in the time of Covid-19

The investigation, whose report has not been published because it has not yet been presented to the public (reserve required) but we were able to obtain a copy of it, was conducted under the leadership of Dr. Qadduri Sharifa, a physician specializing in epidemiology and prevention. Medicine. In this report, it was a matter of evaluating the impact of Covid-19 on people living with human immunodeficiency virus (PLHIV) in Algeria, during the month of December of the year 2020.

Le rapport indique que l’urgence sanitaire et la mobilisation des services de santé pour faire face à la demande «ont engendré des répercussions majeurs sur l’offre de soins qui se retrouve souvent altérée, voire insuffisante», les ciser visure que pérés à limiter la propagation du coronavirus, (distanciation sociale, confinement, couvre-feu, etc.), ont entraîné a contrario «de grandes difficultés en termes d’accès aux soins et aux médicaments, mais aussi sur d’autres psycho-sociaux aspects from life”.

Needless to say, these repercussions can be even more significant in populations with special needs, particularly people living with HIV, “who constitute vulnerable populations, sometimes live in precarious conditions and require regular access to care and medication, but also Other psychosocial support measures. This situation was exacerbated by the emergence of Covid-19, as all health structures and health care personnel were mobilized in the fight against the epidemic, which created additional difficulties in the fight against HIV.

This is confirmed by the report of Dr. Bukhari Youssef, Director of Prevention at the Directorate of Health and Population in Oran, which testifies to the unprecedented crisis experienced by health workers and in health care structures, which mobilized all their resources in order to respond to the urgent need of the epidemic, “which led to the saturation of health care services and transcend it.”

Zaoui Farouk, a doctor specializing in infectious diseases and first assistant in the infectious diseases department at Oran University Hospital Center (the headquarters of the CDR Oran Referral Treatment Center), who was also interviewed in the report, exaggerates in this sense by denouncing the closure of Oran University Hospital. care units for people living with HIV, “as CDR referral treatment centers were designated for Covid-19 care, which led to difficulties in monitoring HIV and AIDS patients and delays in their appointments.”

Moreover, Bourouba Othman, president of the “Aids Algeria” association, adds, “This situation has been exacerbated by the measures to restrict and limit the movement of the population, which have been established on the national territory.” It also emphasizes the inability of people living with HIV/AIDS to move during this period to go to reference centers for the management of HIV/AIDS infection (CDRs which are mostly regional), “in order to ensure their medical follow-up and antiretroviral therapy ( ARV supply ‘.

As a result, we can see that the measures to combat HIV are facing great difficulties during this period of the epidemic, especially since the National Committee for Combating HIV / AIDS and Protection from it was not working during this period, adds Bourouba Othman, stressing that the associations that are fighting HIV “found itself having to adapt to this very context, by devising and deploying personalized initiatives with its own resources in order to meet the needs of the target population”.

In this study, the report states that a total of 100 HIV-positive volunteers were interviewed. The majority were female (55% vs 45%) with a mean age of approximately 36 years. The people questioned lived in different cities of the country with a predominance in Oran, but also in Camp Ouellezane and Tissemsilt, and most of them were treated at the referral treatment center in Oran or Algiers.

Also, regarding access to antiretroviral therapy since the COVID-19 health crisis, the report notes that “only 59% of respondents declared that they had no difficulty in obtaining antiretrovirals,” explaining that these numbers are “below the target rates.” Through the National Strategic Plan to Combat Sexually Transmitted Diseases / HIV / AIDS 2020-2024, “where 90% of people living with HIV should be under treatment” in order to join the WHO global strategy and program Joint United Nations on HIV/AIDS with the goal of ending the AIDS epidemic by 2030”

However, the report adds, “It is worth noting that in nearly 89% of cases this service has been provided by associations in the field, ensuring regular provision of antiretroviral treatment to people living with HIV/AIDS who have difficulty in Mobility, despite the limitations of the moment.” According to those interviewed, it will be known, the report says, that the main obstacles to accessing antiretroviral treatment were primarily the “difficulty of confinement, distance and curfews”; but also to the “inaccessibility of the reference treatment center for CDR”, “the fear of Covid”; And finally, “lack of treatment”. “It should also be noted that only 30% of participants had their own check-out records in their city of residence, which explains the above findings, where difficulty with booking, distance, and curfews were cited as the main obstacle to accessing antiretrovirals.” , the report that adds that “this factor has a direct impact on the movement and mobility of individuals to receive treatment or to ensure regular monitoring at the level of the Council for Development and Reconstruction since the circulation and transportation within the states were reduced during the implementation of containment and curfews.”

We will also know that during the lead-up to the pandemic, in the majority of cases CDR was visited every 3 months, and only 2% of people living with HIV/AIDS had any CDR testing. This delay, the report laments, “has been disrupted and prolonged since the Covid-19 pandemic in 34% of cases, reflecting the negative impact of the Covid-19 crisis on clinical follow-up of HIV infection, in terms of access to completion and registration reports and for follow-up and care needed.” optimum”.

During this study, we will learn that 26% of those questioned declared themselves infected with Covid-19, “of which only 46% have benefited from free diagnosis, 27% have found help from associations, 15% have used fee-based diagnoses and 12% have Diagnostic tests cannot be accessed.”

The report also stated that 23% of these patients could not be cared for “either for lack of means or for lack of places in healthy structures”, before concluding that these aspects would “win. They must be corrected in order to support. HIV-positive people who form a group populations that are more vulnerable and immunocompromised than the general population, and therefore require special attention with regard to the risks associated with coronavirus.”

In conclusion, the report notes that “access to care and medication remains by far the number one concern of people living with HIV during this particular period (89.1%) and represents a focal point that must be ensured and strengthened”, before noting a positive point in terms of effort and initiative The union environment: “The provision of ART during this particular period was by associations in the field that were engaged in advocacy with the supervisory authorities in order to meet their needs. The target population during this crisis.

These organizations will need to be strengthened in order to improve their actions towards people living with HIV, in terms of peer support, provision of a helpline for people living with HIV, psychosocial support and other accompanying measures. This is part of the overall goal of improving the care and quality of life for people living with HIV, which requires collaboration between these organizations, but also with health structures and nursing staff.”

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