The Covid-19 pandemic prompted the public health authorities to concentrate their work on the fight against the disease and become relatively loose on managing HIV infections under control.

In dealing with HIV, it is best to find as many infected cases as possible and to provide antiviral treatment and prevent new infections as quickly as possible.

Community public health centers are one of the institutions that can do the job. Disruptions at public health centers could undermine efforts to manage new HIV cases and provide timely treatment.

After the first outbreak of Covid-19 on Jan. 20, the disease spread rapidly in Daegu and the surrounding area. In early May, when community infections grew larger after a night club-linked infection spread, public health centers across the nation began to work for Covid-19 control.

Critics said such disease control put patients with other infectious diseases on the blind spot.

An online community of HIV patients had many postings complaining about how difficult to get timely treatment due to the Covid-19 pandemic.

One HIV patient, who recently moved to a new home, said he could not visit the public health center because of the worries over Covid-19. He called an official at the public health center in charge of HIV management, but the official did not answer the phone, the patient said.

In the posting, he asked other community members how to contact the right official to get out-of-the-pocket payment for medications refunded.

Kim Yeon-jae, an infectious disease specialist at the Infectious Disease Department of the National Medical Center, said relatively vulnerable patients who need support such as HIV patients seemed to suffer a setback amid Covid-19.

“The longer the pandemic gets, the bigger the damage. We need to build an alternative system for proper diagnosis (of HIV),” he said.

Kim emphasized that HIV patients need a separate medical examination space for the authorities to keep track of them and provide safe medical care.

In managing HIV infection, it is essential to protect patients’ anonymity. Because of the social stigma of the disease, HIV patients are extremely reluctant to reveal their condition. If anonymity is not guaranteed, patients avoid treatment, leading to failure in HIVE infection control.

An HIV patient who had to get tested for Covid-19 after a visit to Itaewon said he had to write down the names of the medication, the name of the company, and his address. “I’m worried people might find out that I’m an HIV patient. I’m so afraid that I could suffer disadvantages,” he wrote in the online community.

Experts are paying attention to “online diagnosis” as an alternative to continue HIV patient control with patients’ anonymity guaranteed during a pandemic. Some advanced countries are already pushing for an online HIV diagnosis project.

An overseas site allows patients to purchase an HIV diagnostic kit. After a self-test, the patient can submit the results and get a significant portion of the purchasing cost refunded by the government.

Such a program makes it easy for a suspected HIV patient can check the test result. Recently developed HIV diagnostic kits have over 90 percent sensitivity, which builds a case for the necessity of online diagnosis.

However, getting a positive result from a diagnostic kit means the patient has to receive a blood test to have the final diagnosis.

“There was some discussion over online HIV diagnosis among experts in the past. But some raised concerns for exposure of private information in the process of kit distribution and result collection,” Kim said.

If these issues are resolved, online HIV diagnosis will be an excellent alternative to detect HIV infections early, he added.

kym@docdocdoc.co.kr

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