Within BPH, Jihane Ben Farhat analyzed the impact of COVID-19 on the care of people living with HIV.
Jihane Ben Farhat, chercheur·e au sein de BPH (Université de Bordeaux).
Thèse soutenue en 2024 à l'école doctorale École doctorale Sociétés, politique, santé publique (Talence, Gironde ; 2011-....).
Référencée dans le réseau ABES/STAR, cette thèse répond aux critères de rigueur de l'enseignement supérieur français.
The COVID-19 pandemic has revealed deep vulnerabilities in health systems worldwide, but it has had particularly severe repercussions on at-risk populations, including people living with HIV (PLHIV). This thesis by Jihane Ben Farhat highlights the challenges faced by these patients during the health crisis, examining the direct and indirect effects of the pandemic on their care. Public health measures, while essential to contain the spread of the virus, often had disastrous consequences on the continuity of HIV care, thereby exacerbating existing inequalities in access to treatment.
The study's results show that, despite significant obstacles, some initiatives have managed to maintain access to treatment. For example, in countries like Benin, non-governmental organizations have implemented innovative strategies to ensure the distribution of antiretrovirals, even during lockdown periods. However, disparities persist depending on local contexts. In some African countries, access to HIV treatment has improved due to concerted efforts, while in others, such as certain regions of Nigeria, patients have been left behind, suffering from interruptions in essential health services.
It is crucial to ask how health systems can adapt to better meet the needs of PLHIV, especially in times of crisis. The thesis proposes several recommendations, including accelerating the implementation of differentiated service delivery models. For instance, telemedicine could play a key role in managing HIV care, allowing patients to consult healthcare professionals without having to travel, which is particularly relevant in rural areas where access to care is limited. This could not only improve access to care but also strengthen the resilience of health systems in the face of future pandemics.
Policymakers must take these lessons into account to avoid repeating past mistakes. Public health cannot be a matter of choosing between fighting a pandemic and treating chronic diseases. Both must coexist, and health systems must be prepared for this duality. For example, HIV prevention programs should be integrated into emergency health responses, ensuring that PLHIV are not neglected.
In summary, this research underscores the importance of an integrated and adaptable approach to managing HIV care. This involves not only considering the challenges posed by COVID-19 but also building on the lessons learned to create a more resilient future. Health systems in West Africa, in particular, must be strengthened to face future crises by investing in robust health infrastructures and training medical staff in care management in crisis contexts.
It is also essential to involve communities in responding to health crises. PLHIV must be at the center of decisions that affect them, and their voices must be heard in discussions about public health. This can translate into regular consultations with patient advocacy groups, ensuring that health policies genuinely meet the needs of people living with HIV.
Finally, the COVID-19 pandemic has highlighted the importance of international solidarity. Countries must collaborate to share resources, information, and best practices in the fight against HIV and other diseases. By joining forces, nations can better prepare to face future challenges, ensuring that PLHIV are not left behind in health crises. In conclusion, it is imperative to learn from this crisis to build more inclusive, resilient health systems that meet the needs of all, especially vulnerable populations.
Données clés
- Amélioration de l'accès au traitement VIH : Mesure de l'impact des initiatives mises en place durant la pandémie.
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Sources et accès
Jihane Ben Farhat. Impact de la pandémie de COVID-19 sur la prise en charge des personnes vivant avec le VIH dans différents contextes de soins. Médecine humaine et pathologie. Université de Bordeaux, 2024. Français. ⟨NNT : 2024BORD0348⟩. ⟨tel-05553786⟩