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July 18, 2022

Drop in HIV testing and diagnosis during Covid-19 pandemic

Once Covid-19 lockdown restrictions began in March 2020, HIV testing volumes declined by as much as 50% compared with 2019 levels.

By GlobalData Healthcare

Human immunodeficiency virus (HIV) is a virus that damages the cells in an individual’s immune system and weakens their ability to fight everyday infections and disease. HIV is most frequently transmitted through sexual intercourse or by sharing needles or other drug injection equipment. The disease continues to be a major public health threat and has claimed 36.3 million lives to date, according to the World Health Organisation (WHO).

There is currently no cure for HIV, but those with access can seek effective prophylaxis medications that make the disease much more manageable and can prevent the spread of the virus between sexual partners. HIV testing is the first step in HIV awareness and engagement in prevention strategies. But as the Covid-19 pandemic caused the world to halt, healthcare services, and especially preventative services, were no longer a priority. As a result of the ongoing Covid-19 pandemic, GlobalData epidemiologists forecast that the diagnosed incidence of HIV will likely fall below pre-pandemic levels due to limited resources, poor access to and lower engagement with HIV testing.

A 2022 study published by DiNenno and colleagues in the Centres for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report (MMWR) compared the numbers of HIV tests and new diagnoses of HIV in the US from 2019 to 2020. The data used for the analysis were collected from four different HIV testing data sources (as shown in Figures 1 and 2). Throughout 2019, the weekly number of tests remained stable at approximately 200,000 tests, and in early 2020, testing volumes exceeded that of 2019. But as the pandemic hit in March 2020 and Covid-19 lockdown restrictions began, testing volumes declined by as much as 50% when compared with the levels observed during 2019, as reported by the CDC National HIV Prevention Program Monitoring and Evaluation testing regime (Figure 1).

In addition, diagnosed incident cases of HIV in 2020 were significantly lower than in 2019. The CDC National HIV Surveillance System (NHSS) reported that the new diagnoses of HIV in the US reduced by 17% from 36,940 cases in 2019 to 30,635 cases in 2020 (Figure 2). This reduction was mirrored by the reduction in testing shown in Figure 1.

GlobalData epidemiologists initially forecast that the diagnosed incident cases of HIV would be 43,700 in 2019, which would decrease to 43,000 cases in 2020. But considering the impact of the pandemic on HIV testing, GlobalData epidemiologists forecast that cases will likely be lower than expected over the next three to five years until engagement in HIV testing returns to pre-pandemic levels.

To compensate for testing and diagnoses missed during the Covid-19 pandemic, it is essential that state and local health departments focus on increasing access and education regarding HIV testing. It is important that the CDC guidance on annual testing is resumed in a Covid-safe environment, and that there is increased accessibility to self-testing outside of healthcare settings. This will likely increase the diagnosed incident cases of HIV, but will also mean that there is an increased awareness of HIV status and, therefore, reduce the transmission of the disease.

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