Assessing the impact of COVID-19 on people living with HIV, including pregnant women and children

The purpose of this study is to provide an assessment and analysis of the situation of people living with HIV/AIDS (PLWH) in the Republic of Moldova in the context of the COVID-19 pandemic, including COVID-19 awareness and concern, socioeconomic status, quality of life, mental health and social support, access to medical care/treatment (including digital methods), and stigma and develop recommendations for key government stakeholders to address the identified challenges and mitigate the negative impacts of COVID-19.

 This study considers available statistics and latest trends, including an analysis of the data before and during the pandemic, as well as quantitative and qualitative data collected in the field. The study also highlights the situation of pregnant women and children of caretakers with HIV or with HIV themselves.

Key findings: The COVID-19 pandemic has had widespread implications on the health and well-being of PLWH in the Republic of Moldova. One-fifth of PLWH in the national survey reported being severely affected by the pandemic and one-third reported being moderately affected. The multifaceted dimensions of PLWH’s vulnerabilities, compounded with restrictions during COVID-19 lockdowns, resulted in job loss, limited access to treatment, and continued stigma.

COVID-19 awareness and concern: 

  • PLWH received the bulk of COVID-19-related information from online news sources and TV. Less than half of all respondents felt family doctors were a good source of information.
  • Over one-third of PLWH said they were “definitely willing” to get the COVID-19 vaccine. A slightly smaller portion, reported no intention of receiving the vaccine at all.Socioeconomic indicators

Socioeconomic indicators: 

  • 1 in 10 PLWH experienced job loss.
  • Decrease in income was reported by half of all PLWH. Pandemic-induced income reduction was more frequent among urban dwellers.
  • More than half of PLWH expressed concerns regarding financial sustainability and ability to pay daily expenses (utilities, food, drugs).
  • Half of households spent savings, borrowed money, and bought cheaper food to cope with economic hardships during the COVID-19 pandemic. 2 in 5 limited their personal food consumption.
  • More than half of PLWH reported anxieties tied to not being able to pay utilities and buy medication.
  • Out-of-pocket expenses related to HIV care were reported by 56% of PLWH.

Quality of life: 

  • Self-reported quality of life during the COVID-19 pandemic was very poor to poor among over a quarter of PLWH.
  • Self-reported deterioration in health during the COVID-19 pandemic was reported by 17% of PLWH. Deterioration was expressed at a higher rate among the male population.

Access to medical care/treatment: 

  • Nearly 1 in 10 respondents had a lack of knowledge regarding existing HIV/AIDS programs offered by healthcare facilities during the COVID-19 pandemic and therefore had not accessed them.
  • 1 in 10 PLWH reported cancelled medical visits between July 2020 – July 2021. 
  • A quarter of PLWH indicated that the frequency of their visits to healthcare facilities had decreased during the COVID-19 pandemic period when compared to pre-pandemic periods. 
  • Fear of contracting COVID-19 was the most cited barrier in accessing healthcare facilities, reported by 41% of PLWH. 

Find the recommendations in the report.

HIV & SRHR SBC Toolkit for Adolescents and Young People in ESA Region: Question & answer resource documents

As part of the 2gether 4 SRHR joint UN programme, UNICEF ESARO in collaboration with Y+ Global and UNFPA ESARO, developed six key question and answer (Q&A) resource documents on HIV and SRH for adolescents and young people in ESA. The toolkit has been developed to assist country teams in improving knowledge and understanding, driving adolescent and youth engagement and behaviour change,​ and promoting uptake of services in ESA. The content has been developed with adolescents and young people. Part of a broader toolkit, the content is intended for adaptation and use across multiple SBC platforms, including digital approaches scripts for radio shows and peer counselling sessions.

Each Q&A has approximately 10 questions, and links to the other topic areas:

  • Healthy relationships
  • Staying safe
  • Sex and other stuff
  • All about HIV
  • Living with HIV
  • Being a young parent
  • Understanding Puberty
  • The HPV Vaccine
  • Talking with Your Children

Click and watch on how to access and use the toolkit

Care and Support for Adolescents Living with HIV/AIDS in School Settings: Perspectives of Teachers and Administrators in the Southern Highlands of Tanzania

Adolescents living with HIV (ALHIV) encounter diverse challenges in school settings that impact their well-being and academic performance. This UNICEF-supported study sought to delve into the viewpoints of teachers and administrators regarding the care and support accessible to ALHIV in schools in the Southern Highlands of Tanzania. 

Various forms of support for ALHIV in schools were identified. Schools had designated health teachers/matrons/ patrons responsible for addressing health-related issues, including those affecting ALHIV. Assistance for clinic visits and medication adherence was readily available. Peer clubs were established to combat stigma and discrimination while providing additional support. Nevertheless, challenges such as staff members’ limited knowledge and skills, reluctance to disclose, inadequate nutritional support, and insufficient backing from regional and district administrators persist.

The study also pinpointed areas for enhancement, such as capacity building for teachers and staff, bolstering support for disclosure, offering nutritious dietary options, reinforcing peer clubs, and fostering collaboration between the education and health sectors. These findings can inform the development of comprehensive interventions to support ALHIV in school settings better, ultimately advancing their well-being and academic achievements. 

Pre-Exposure Prophylaxis and Adolescent Girls and Young Women in Eastern and Southern Africa: The latest insights

Eastern and southern Africa (ESA) is the world’s most heavily HIV-impacted region, with adolescent girls and young women (AGYW) disproportionately affected. To support the scale-up of PrEP amongst AGYW in ESA, in September 2021 UNICEF and partners released the implementation brief “Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa,” highlighting considerations to help improve the quality and coverage of AGYW PrEP programming.

The PrEP landscape has evolved significantly in the three years since the original brief was released, both in scale and variety. This updated brief summarises the most recent evidence on AGYW PrEP provision, serving as a supplement to the original 2021 implementation brief.

Ending HIV for Every Child, Every Adolescent: An investment opportunity for the public and private sectors

This document highlights opportunities for both public and private sectors to engage in the global HIV response for infants, children, and adolescents in partnership with UNICEF. 

UNICEF is a key partner and leader in the AIDS response for children, adolescents, and women. It collaborates with governments and partners worldwide, offering innovation, technical expertise, data and evidence, programme excellence, coordination, and convening power.

UNICEF is 100 per cent voluntarily funded, and is seeking support to deliver ambitious HIV results for children and to ensure the world can reach Sustainable Development Goal Target 3.3, to end the epidemic of HIV by 2030. 

Spotlight on the UNICEF HIV/AIDS Fund: Results achieved in 2022 to achieve an AIDS-free future for children and adolescents

UNICEF’s HIV/AIDS Thematic Fund is a global flexible funding pool. It enables us to strengthen systems to ensure an AIDS-free future for children and adolescents. This offers donors an exciting opportunity to target funding specifically to HIV/AIDS outcomes, while also giving UNICEF the flexibility to allocate funds based on where the need is greatest for children, including critically underfunded priorities at the country level, humanitarian response activities, and where funds will have the greatest impact. Thanks to our generous donors UNICEF’s Global HIV/ AIDS Thematic Fund income in 2022 reached over $5.7 million.

This document features the results achieved in 2022, when supporters of the HIV/AIDS Thematic Fund enabled UNICEF to allocate resources to 45 countries and territories. Funds were allocated to countries based on several measures determining the burden of HIV/AIDS on the population. These included the number of AIDS-related deaths in the country and the number of new infections among children and adolescents in the country. Funds were also allocated to UNICEF’s regional and global headquarters, supporting the vital work that allows thematic funding to unlock wide-scale results and impact the world over.

Global standards for quality health-care services for adolescents: Standards and criteria

Global initiatives are urging countries to prioritize quality as a way of reinforcing human rights-based approaches to health. Yet evidence from both high- and low-income countries shows that services for adolescents are highly fragmented, poorly coordinated and uneven in quality. Pockets of excellent practice exist, but, overall, services need significant improvement and should be brought into conformity with existing guidelines.

The WHO/UNAIDS global standards for quality health-care services for adolescents aim to assist policy-makers and health service planners to improve the quality of health-care services, so that adolescents find it easier to obtain the health services that they need to promote, protect, and improve their health and well-being, according to their needs. 

This publication presents global standards for quality health-care services for adolescents, as well as an implementation guide and monitoring tools.

The adolescent health indicators recommended by the Global Action for Measurement of Adolescent Health

This document is an interactive guide for the uniform collection, compilation, reporting, and use of adolescent health data.

Adolescence is a critical stage in life for physical, cognitive and emotional development, shaping future health and well-being. Comprehensive measurement of adolescent health is essential to prioritize health issues, guide interventions and track progress. However, global, regional and national adolescent health measurement has historically been inconsistent and incomplete.

The Global Action for Measurement of Adolescent health (GAMA) Advisory Group has been established by the World Health Organization (WHO) in collaboration with United Nations partners to support efforts to focus adolescent health measurement on the most important issues and to improve alignment across different measurement initiatives.

The indicators are intended to guide policy and programming for adolescents, and to assist in identifying topics in which more detailed health assessments and additional programming are needed. The last chapter in this guidance document describes how this can be done, based on the approach suggested in the Accelerated Action for the Health of Adolescents (AA-HA!) guidance.

This document presents a list of 47 indicators recommended by GAMA for measurement of adolescent health, which are applicable to all adolescent population subgroups and span Well-being Outcomes. 

Ending the AIDS Epidemic Among Young People in the Middle East and North Africa

This advocacy report discusses the HIV epidemic among young people in the Middle East and North Africa (MENA) region, particularly among key populations. The report emphasizes the challenges faced in collecting HIV-related data and the need for comprehensive efforts to address the epidemic, including targeted prevention programmes, improved access to testing and treatment, and addressing social and structural factors. It also discusses the presence of punitive and obstructive laws that contribute to stigma and discrimination and calls for their removal or reform. The report advocates for increased investment in HIV programmes, improved access to sexual and reproductive health services, comprehensive sexuality education, and community engagement. It highlights the importance of community health systems, data collection, and involving young people in the development of HIV and other health programmes.  ​