National AIDS Programmes continue to be challenged by the ongoing COVID-19 pandemic. Despite these challenges, they continue to deliver services to ensure the continuity of care. The delivery of services at this critical time requires reshaping the way that services are traditionally delivered. COVID-19 presents an opportunity to explore innovative solutions and new methods for service delivery.

Amongst the services significantly impacted by the pandemic disruptions is HIV testing. Persons requiring testing must access care at a health facility. Countries are now exploring the possibility of implementing HIV self-testing. HIV self-testing has the potential to rapidly increase uptake of HIV testing services, especially for populations with low access and those at higher risk that would otherwise not get tested. In areas where COVID-19 disruptions are high, self-testing is an ideal alternative to scale-up testing.

The pandemic has also opened up new avenues for the care of those who are stable and require fewer clinical interactions. By doing so, stable patients do not need to visit clinics as frequently as they did for medication and routine follow-up. Many programmes have implemented multi-month drug dispensing of antiretroviral therapy or ART for about three to six months. This has allowed care providers to devote more time to those with more urgent needs. It has also reduced the frequency that clients visit pharmacies to fill their prescriptions.

Many HIV programmes have also been embracing the use of digital technology. In some cases, clients are now able to book appointments online to avoid overcrowding in waiting rooms, especially in small clinics where physical distancing may not be possible. Also, some services, such as counselling and patient follow-up, are being conducted virtually.

Despite the disruptions from the pandemic, these new approaches are reshaping the way services are delivered. Most of these interventions still require close monitoring and evaluation to know if they are effective. Notwithstanding this, these interventions have the potential to reach more people and to deliver services in a quick, efficient and safe manner. They can change the way that care is provided beyond COVID-19.