Preliminary Exploration of Risk Factors for COVID-19-Related Mortality among People Living with HIV in Taiwan

Hsun-Yin Huang^1*, Hsiu-Yun Lo¹, Shih-Yang Tsao¹, Pin-Hui Lee¹, Pei-Chun Chan¹², Chia-Chi Lee¹

2024 Vol.40 No.23

Correspondence Author： Hsun-Yin Huang^1*

Abstract：

        To reduce the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and death among individuals with human immunodeficiency virus (HIV), active efforts are being made to educate and encourage HIV-infected individuals to receive COVID-19 vaccinations. Health bureaus and designated HIV healthcare facilities are actively promoting vaccination and reaching out to HIV-infected individuals who might have lost contact to ensure they return for medical care, medication adherence, and vaccination. The goal was to maintain immunity and achieve an undetectable viral load status in HIV patients. Community organizations involved in HIV prevention and treatment are also actively promoting and advocating for COVID-19 vaccination.
        In this retrospective study, the research subjects consisted of 36,404 HIV-infected individuals reported as of December 31, 2022, excluding those who died before July 2021. The multivariate analysis results showed that the odds of COVID-19-related death were 5.5 times higher among those who were not vaccinated (95% CI: 2.3–13.1). Other significant factors influencing COVID-19-related death among HIV-infected individuals included age over 40 (41-49 years old, OR: 9.3, 95% CI: 1.1–75.9; ≥50 years old, OR: 11.3, 95% CI: 1.4–92.2), and risk factors of infecting with HIV was others (unspecified cause and pending, OR: 27.1, 95% CI: 7.0–104.9).
        To minimize the risk of severe complications or death from COVID-19 among HIV-infected individuals, it is recommended that they complete the COVID-19 vaccination series.

Keywords：People living with HIV, COVID-19, vaccine

Investigation of the Relationship Between Accessibility to HIV Medical Care and Medication Adherence in Eastern Taiwan, 2022–2023

Ling-Li Huang, Jui-Nien Hsi, Ya-Wen Teng, Pei-Ching Huang^* 

2024 Vol.40 No.23

Correspondence Author： Pei-Ching Huang^* 

Abstract：

        In recent years, Taiwan has achieved internationally recognized results in the prevention and control of HIV through multi-faceted strategies, including collaborating with non-governmental organizations to provide friendly services and health education, diversifying HIV testing and counseling services, offering free antiretroviral therapy, and promoting pre-exposure prophylaxis (PrEP). However, in Eastern Taiwan (Hualien and Taitung counties), the rate of viral suppression among People Living with HIV (PLWH) was 88.8%, below the national average of 92.9%. To explore the reasons for poor treatment adherence, in this study we analyzed data from the HIV/AIDS Management System of the Taiwan Centers for Disease Control to conduct quantitative and qualitative analyses. Statistical data and visitation records in the system were examined, and HIV case managers in designated HIV/AIDS hospitals and local health centers were interviewed.
        Analyses revealed that there was a clear insufficiency of HIV-related medical resources in Eastern Taiwan, and inaccessibility to medical services negatively affected medication adherence among patients living in rural and mountainous areas. Using telehealth to provide medical services to patients living in remote areas and those who have difficulty accessing care through traditional means is recommended to prevent the continued spread of viruses, decrease the healthcare burden following opportunistic infections, and minimize the development of drug resistance, thereby maximizing the effectiveness of prevention and treatment.

Keywords：Accessibility to HIV Medical Care, Medication Adherence, Telehealth