Loss of follow-up of HIV patients from an HIV clinic during COVID-19 outbreak period: what are the reasons?

Dear Editor, HIV infection remains a major global public health issue. At the moment, the standard disease management strategy is continuous antiretroviral drug therapy. HIV infection typically necessitates a closed follow-up at an HIV clinic [1]. The failure to follow-up is a serious issue that could lead to the failure of HIV management. The most common reason for loss of follow-up (disengagement from care for more than 12 months) is a financial problem [2]. The authors present their findings from an HIV clinic in Indochina, where HIV infection is common. The situation is concentrated during the COVID-19 outbreak period. The authors analyzed local data from an HIV clinic (GPS 13.651440, 100.258881) with a special focus on HIV cases who lost follow-up during 2021, when the setting is experiencing a serious COVID-19 outbreak. There are 2445 registered cases in the clinic during the study period. There are 320 HIV patients (119 females and 201 males) who have not been followed up on. . After excluding cases that are not actual cases of loss of follow-up (such as changing to receive care from another medical center due to change of medical care rights, 193 cases, and registering to home delivery program of antiretroviral drug during COVID-19 outbreak period, 10 cases), there are only 17 actual cases of actual loss of follow-up. The determined reasons from these 17 cases are being imprisoned in two cases, being admitted to a psychiatric hospital in two cases, death (not due to COVID-19) in two cases, and moving to rural areas to avoid COVID-19 in ten cases. As can be seen, there are numerous reasons for the loss of follow-up. An interesting reason is the fear of COVID-19 and the loss of attachment to antiretroviral drugs. Indeed, during the COVID-19 period, there is a system in place to assist patients who have difficulty accessing medical care and to reduce unnecessary transportation by using a home medication system. However, some patients continue to be afraid and flee the city. Other reasons identified are also intriguing. The death occurred during the course of care in an HIV clinic, and the cousin may not have reported it to the medical center during the COVID-19 period. Furthermore, the cousin fails to report antiretroviral drug medication in specific cases that develop psychiatric problems and are admitted to psychiatric medical centers. This could be because the cousin does not have access to information about the patient's HIV infection. Indeed, it is the rule that the patient's HIV infection is kept private, and if the patient refuses, the information will not be disclosed to others. Acknowledgements Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.