The Management of HIV Care Services in Central and Eastern Europe: Data from the Euroguidelines in Central and Eastern Europe Network Group

Agata Skrzat-Klapaczyńska, Justyna D. Kowalska, Larisa Afonina, Svitlana Antonyak, Tatevik Balayan, Josip Begovac, Dominik Bursa, Gordana Dragovic, Deniz Gokengin, Arjan Harxhi, David Jilich, Kerstin Kase, Botond Lakatos, Mariana Mardarescu, Raimonda Matulionyte, Cristiana Oprea, Aleksandr Panteleev, Antonios Papadopoulos, Lubomir Sojak, Janez Tomazic, Anna Vassilenko, Marta Vasylyev, Antonija Verhaz, Nina Yancheva, Oleg Yurin and Andrzej Horban
Additional contact information
Agata Skrzat-Klapaczyńska: Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warszawa, Poland
Justyna D. Kowalska: Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warszawa, Poland
Larisa Afonina: Republic Clinical Hospital for Infections of MoH of the Russian Federation, 101000 Moscow, Russia
Svitlana Antonyak: Viral Hepatitis and AIDS Department, Gromashevsky Institute of Epidemiology and Infectious Diseases, 01001 Kyiv, Ukraine
Tatevik Balayan: National Center for Disease Control and Prevention, Yerevan 0002, Armenia
Josip Begovac: School of Medicine, University Hospital for Infectious Diseases, University of Zagreb, 10000 Zagreb, Croatia
Dominik Bursa: Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warszawa, Poland
Gordana Dragovic: Department of Pharmacology, Clinical Pharmacology and Toxicology, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia
Deniz Gokengin: Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ege University, 35040 Izmir, Turkey
Arjan Harxhi: Infectious Disease Service, University Hospital Center of Tirana, 1001 Tirana, Albania
David Jilich: Department of Infectious Diseases, 1st Faculty of Medicine, Charles University in Prague and Faculty Hospital Bulovka Hospital, 18000 Prague, Czech Republic
Kerstin Kase: West Tallinn Central Hospital, 10111 Tallinn, Estonia
Botond Lakatos: National Institute of Hematology and Infectious Diseases, South-Pest Central Hospital, National Center of HIV, 1007 Budapest, Hungary
Mariana Mardarescu: National Institute for Infectious Diseases Matei Bals Bucharest, 021105 Bucharest, Romania
Raimonda Matulionyte: Faculty of Medicine, Vilnius University, Vilnius University Hospital Santaros Klinikos, 08410 Vilnius, Lithuania
Cristiana Oprea: Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Carol Davila University of Medicine and Pharmacy, 010001 Bucharest, Romania
Aleksandr Panteleev: City TB Dispensary, 101000 Moscow, Russia
Antonios Papadopoulos: University General Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece
Lubomir Sojak: Department of Infectology and Geographical Medicine, Center for Treatment of HIV/AIDS Patients, Academic L. Derer’s University Hospital, 2412 Bratislava, Slovakia
Janez Tomazic: Clinic for Infectious Diseases, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Anna Vassilenko: Global Fund Grant Management Department, Republican Scientific and Practical Center for Medical Technologies, 220004 Minsk, Belarus
Marta Vasylyev: Astar Medical Center, 79007 Lviv, Ukraine
Antonija Verhaz: Department for Infectious Diseases, Faculty of Medicine, University of Banja Luka, 78000 Banja Luka, Republika Srpska, Bosnia and Herzegovina
Nina Yancheva: Department for AIDS, Specialized Hospital for Active Treatment of Infectious and Parasitic Disease Sofia, 1000 Sofia, Bulgaria
Oleg Yurin: Central Research Institute of Epidemiology, Federal AIDS Centre, 101000 Moscow, Russia
Andrzej Horban: Department of Adults’ Infectious Diseases, Hospital for Infectious Diseases, Medical University of Warsaw, 02-091 Warszawa, Poland

IJERPH, 2022, vol. 19, issue 13, 1-9

Abstract: Introduction: The COVID-19 pandemic has been challenging time for medical care, especially in the field of infectious diseases (ID), but it has also provided an opportunity to introduce new solutions in HIV management. Here, we investigated the changes in HIV service provision across Central and Eastern European (CEE) countries before and after the COVID-19 outbreak. Methods: The Euroguidelines in Central and Eastern Europe Network Group consists of experts in the field of ID from 24 countries within the CEE region. Between 11 September and 29 September 2021, the group produced an on-line survey, consisting of 32 questions on models of care among HIV clinics before and after the SARS-CoV-2 outbreak. Results: Twenty-three HIV centers from 19 countries (79.2% of all countries invited) participated in the survey. In 69.5% of the countries, there were more than four HIV centers, in three countries there were four centers (21%), and in four countries there was only one HIV center in each country. HIV care was based in ID hospitals plus out-patient clinics (52%), was centralized in big cities (52%), and was publicly financed (96%). Integrated services were available in 21 clinics (91%) with access to specialists other than ID, including psychologists in 71.5% of the centers, psychiatrists in 43%, gynecologists in 47.5%, dermatologists in 52.5%, and social workers in 62% of all clinics. Patient-centered care was provided in 17 centers (74%), allowing consultations and tests to be planned for the same day. Telehealth tools were used in 11 centers (47%) before the COVID-19 pandemic outbreak, and in 18 (78%) after ( p = 0.36), but were represented mostly by consultations over the telephone or via e-mail. After the COVID-19 outbreak, telehealth was introduced as a new medical tool in nine centers (39%). In five centers (28%), no new services or tools were introduced. Conclusions: As a consequence of the COVID-19 pandemic, tools such as telehealth have become popularized in CEE countries, challenging the traditional approach to HIV care. These implications need to be further evaluated in order to ascertain the best adaptations, especially for HIV medicine.

Keywords: HIV; COVID-19; models of care; Central and Eastern Europe; telehealth (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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