Abstract
The impacts of COVID-19 among men who have sex with men (MSM), who
face limited access to HIV services due to stigma, discrimination, and violence, need
to be assessed and quantified in terms of HIV treatment outcomes for future pandemic
preparedness. This study aimed to evaluate the effects of the COVID-19 lockdown on the
HIV treatment cascade among MSM in selected provinces of South Africa using routine
programme data after the implementation of differentiated service delivery (DSD) models.
An interrupted time series analysis was employed to observe the trends and patterns of
HIV treatment outcomes among MSM in Gauteng, Mpumalanga, and KwaZulu-Natal
from 1 January 2018 to 31 December 2022. Interrupted time series analysis was applied to
quantify changes in the accessibility and utilisation of HIV treatment services using the R
software version 4.4.1. The segmented regression models showed a decrease followed by an
upward trend in all HIV treatment outcomes. After the implementation of the DSD model,
significant increases in positive HIV tests (estimate = 0.001572; p < 0.001), linkage to HIV
care (estimate = 0.001486; p < 0.001), ART initiations (estimate = 0.001003; p = 0.004), ART
collection (estimate = 0.001748; p < 0.001), and taking viral load tests (estimate = 0.001109;
p = 0.001) were observed. There was an overall increase in all HIV treatment outcomes
during the COVID-19 lockdown in light of the DSD model.