COVID- 19 Containment Policy Measures and Their Effect on Access to HIV Services for Persons Living With HIV in Ruaraka Sub-County

Abstract

The spread of the novel coronavirus disease 2019 (COVID-19) globally led to the introduction of mitigation and containment responses designed to stem the heightened transmission of the virus. These measures hindered face-to-face provision of healthcare, which has traditionally formed the foundation for HIV treatment, testing, and prevention services. Research evidence demonstrates that the mitigation guidelines disproportionately affected people living with HIV. Although the containment policy guidelines might have been effective in limiting infections, they caused serious economic ramifications, which indirectly caused fear and anxiety among people living with HIV. Accordingly, the rationale of this study was to determine the effect of COVID-19 containment policy measures on access to HIV services for persons living with HIV. In so doing, the study explored containment policy measures that affected access to HIV services and the impact of these guidelines on psychological health of people living with HIV. Moreover, knowledge on the novel coronavirus as well as coping strategies used by People living with HIV to enable access to HIV services amidst COVID-19 were also explored to inform future responses to epidemics. The study adopted a cross-sectional research design. The study population for the study encompassed of 914 people living with HIV. The sample size constituted of 298 people living with HIV. Proportionate stratified, purposive, and systematic random sampling approaches were used to select respondents, while semi-structured questionnaire was used for data collection. The study used a self-reported questionnaire (SRQ-20) to screen for existence of psychological distress. The validity and reliability of the questionnaire was established through pretesting. Based on the overall results of the study, COVID-19 containment policy guidelines, such as closure of public transport (p=0.00), cessation of movement (p=0.00), stay at home requirement (p=0.00), curfew (p=0.00), public transportation limitation on passenger capacity (p=0.00), quarantine (p=0.00), and reduction of service hours in clinics (p=0.00), negatively affected access to HIV. The prevalence of psychological distress among people living with HIV was 20.2% (95 % CI: 15.2%, 25.1%). The study concluded that the outcomes of COVID-19 containment policy measures contributed significantly to psychological distress; people living with HIV used various coping strategies to enable them access HIV services under the COVID-19 control measures; and

people living with HIV had knowledge on the symptoms and high risk factors of COVID- 19. The study recommends that enhanced investment in psychological counseling be

made at every health centre to provide support mechanism to PLHIV during the COVID- 19 outbreak period. The study recommends the Ministry of Health to adopt multi-month

dispensing of ART, including mailing, home delivery, and integration of digital health into the delivery platforms of HIV services to ensure minimal interruption. The study recommends sensitization campaigns by the Government on COVID-19 given the evolving nature of the symptoms of the virus.