The impact of the COVID-19 pandemic on HIV healthcare delivery for females in sub-Saharan Africa: A scoping review
Bibliographic record
Abstract
Throughout sub-Saharan Africa (SSA), females are disproportionately impacted by HIV and face generalized but also gendered social and economic barriers to accessing HIV healthcare and services. At the outset of the pandemic, many anticipated COVID-19 would represent a major set-back for HIV care in the region. The impact of COVID-19 on HIV health services and HIV-affected populations has been reported in specific populations but has not been synthesized for females in the SSA region. The objective of this scoping review is to investigate the impact of COVID-19 on HIV healthcare delivery and services for females in SSA. Four databases were searched to identify relevant studies. Studies included were limited to English primary research articles reporting on the interactions between COVID-19 and HIV healthcare delivery and services amongst females in SSA. Two pairs of reviewers each screened 1390 articles via abstract and full-text screening, and data extraction was facilitated with a standardized protocol. A total of 39 studies were included in this review. Through thematic analysis of the articles, we identified five major themes-accessibility, availability, affordability, clinical barriers, and psychosocial barriers-which complicated the provision of HIV care during the COVID-19 pandemic and facilitators of HIV care during the pandemic. The literature highlighted two special populations, female sex workers and pregnant females, as having unique challenges in accessing HIV care due to societal stigma and their personalized health needs. Reviewed articles indicate that the COVID-19 pandemic introduced and exacerbated barriers to the accessibility, availability, and affordability of HIV healthcare and services for females in SSA. This review should be used by healthcare workers, healthcare administrators, policymakers, and the government to better understand the current gaps in HIV service provision to females during the COVID-19 pandemic, which can support the delivery of HIV care to females for future public health emergencies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.038 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.013 | 0.016 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.004 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".