Among unhoused people enrolled in a low-barrier, high-intensity HIV care program, neither care engagement nor viral suppression levels dropped during COVID-19 restrictions, an interrupted time-series analysis published in AIDS found.
The 85 participants in POP-UP, a program of Ward HIV Clinic in San Francisco, California, continued to access in-person services during the city’s shelter-in-place ordinance. Temporary housing in hotels as part of the city’s COVID-19 emergency program further facilitated service delivery to 15% of participants.
Prior to COVID-19 lockdowns (10/17/2019-3/16/2020), 48% of POP-UP participants were virally suppressed; during the first several months of the pandemic (3/17/2020-8/16/2020), viral suppression rates within POP-UP held steady at 47%. By comparison, in the general Ward 86 clinic, the odds of being viremic rose by 31%.
At POP-UP, mean visits per patient month also remained level: 1.6 in the pre-COVID study period versus 1.7 in the initial months of the U.S. pandemic.
While viral suppression rates did not drop among POP-UP clients, they are generally low, showing the need for additional interventions, study authors noted. Limitations included the non-randomized design and limited sample size.
“Multi-component interventions such as POP-UP may help maintain viral suppression despite introduction of unanticipated structural barriers, such as those associated with COVID-19,” study authors concluded.