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HIV & TB Q4 2020

Locked down, but not out – how COVID-19 has changed HIV services

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Dr Sanjay Bhagani

President-elect, EACS, Infectious Diseases/HIV specialist

Shared knowledge and experience of HIV care during COVID-19 have changed HIV services for the better, and possibly for good.  


Few things have benefitted from the COVID-19 pandemic, but the move online to deliver clinical care in HIV prevention and treatment has been a great innovation, says Dr Sanjay Bhagani, President-elect of the European AIDS Clinical Society (EACS).

Online consultations, coupled with medicines delivery services, have proved popular with patients. Dr Bhagani says: “The vast majority say they can get on with their lives rather than spend three to four hours visiting a clinic. As clinicians our aim is to normalise life for people living with HIV/AIDS and making people take hours out of their day to visit a clinic is far from doing that. We think this new way of doing things is far better for patients and for local healthcare teams.” 

Standardising care

Online networking has also been vital to sharing knowledge amongst specialists across countries in the field of HIV. Innovation of this type has been important, he says, in order to standardise progress across Europe towards attainment of the UN HIV goals – both in terms of practices and provision of care.

Dr Bhagani says, “depending on the country, testing is different, driven by different resources, differences in workforce and their ability to deliver care.” With no ‘standard’ training in HIV, services may be delivered by genitourinary medicine or infectious disease specialists as they are in the UK, or by respiratory or other specialities as happens elsewhere. “But patients should be able to expect at least the same minimum, evidence-based healthcare practices, wherever they are based,” he says.

If anything, COVID-19 has spurred us on to do even better. Where there is determination to succeed, we are finding that we can really make a difference.

Why U = U

A key element of EACS guidelines and messaging is the principle of ‘U = U’ – where an undetectable viral load equals untransmissible virus. The EACS also aims to define standards in HIV treatment as well as providing training and drive public health agenda. Dr Bhagani says: “If we can get people onto treatment early, we can reduce infections, as well as comorbidities, which in turn significantly reduces health costs.”

Being able to share best practice and reach patients easily have been real positives to come out of COVID-19, and Dr Bhagani believes some practices will change permanently as a result of the experiences that have been shared. He says: “If anything, COVID-19 has spurred us on to do even better. Where there is determination to succeed, we are finding that we can really make a difference.”

The European AIDS Clinical Society is a not-for-profit organisation whose mission is to promote excellence in standards of care, research and education in HIV infection and related co-infections, and to actively engage in the formulation of public health policy, with the aim of reducing HIV disease burden across Europe.

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