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.

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.