Table 1.

Challenges and recommendations for HIV service delivery to priority populations in Seattle, WA during COVID-19

	Challenges	Recommendations
Program operations	∙ Need to reduce clinic flow and prevent spread of COVID-19 ∙ Avoidance of hospital visits (i.e., emergency room visits) for non-emergency care ∙ Ensurance of continued access to a friendly, safe, and comfortable care environment	∙ Identify stable clients/patients eligible for telemedicine/phone visits ∙ Increase outreach support, while maintaining in-person visits for those where telemedicine is not feasible or advisable ∙ Maintain safety of peers providing HIV service provision
Counseling services	∙ Lack of client/patient access to phone/internet (telemedicine) ∙ Loss of personal connection with clients/patients ∙ Shorted counseling sessions ∙ Encouraged social distancing (including sex) ∙ Increased fear and anxiety	∙ Provide counseling services via telemedicine or phone when possible ∙ Maintain counseling from community members when possible ∙ Link clients/patients to online support groups ∙ Avoid finger-wagging of HIV risk-related behaviors during social distancing measures
Testing services	∙ Blood samples must be collected in person ∙ Frequent testing required for routine medical care (e.g., drug refills, disease screening)	∙ Use phone screening prior to in-person testing (for COVID-19 & STI symptoms) ∙ Consider the feasibility of social distancing at testing locations ∙ Enable flexibility in testing requirements for drug refills and non-urgent medical conditions
Pharmacy services	∙ HIV medications only dispensed for 30 days ∙ Drug dispensing and prescribing requires laboratory tests	∙ Tailor pharmacy services to individuals’ risk and medical urgency (e.g., longer drug dispensing, wave testing for drug refills)
Other essential services	∙ Private and consistent housing needed for prolonged social distancing ∙ Maintenance of services clients/patients rely on (e.g., food & transportation vouchers) ∙ Substance use/addiction	∙ Maintain provision of essential social services ∙ Prioritize access to safe private spaces for social isolation ∙ Relax restrictions on allowable activities