The influence of the COVID-19 pandemic on identifying HIV/AIDS cases in China: an interrupted time series study

Zhao, Tianming; Liu, Haixia; Bulloch, Gabriella; Jiang, Zhen; Cao, Zhaobing; Wu, Zunyou

doi:10.1016/j.lanwpc.2023.100755

Cited by 6 publications

(9 citation statements)

References 35 publications

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“…Future efforts will likely concentrate on improving the convenience and privacy of VCT services. The number of HIV tests in 2020 and 2022 was significantly lower than in surrounding years, possibly related to the coronavirus disease 2019 (COVID-19) pandemic ( 6 ).…”

Section: Discussionmentioning

confidence: 96%

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics — China, 2015–2022

Liu,

Su,

et al. 2024

China CDC Weekly

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Introduction Human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) clinics play a critical role in identifying and diagnosing HIV cases. This study aimed to describe the trend of HIV positivity rate (HPR) among Chinese VCT clinics between 2015 and 2022. Methods This study utilized data from the China Information System for Disease Control and Prevention to analyze the trend in the HPR for VCT clinics from 2015 to 2022. The HPR was calculated by dividing the number of newly-reported HIV cases by the number of HIV tests, multiplied by 100%. To identify temporal and spatial trends in the HPR, we employed joinpoint regression analysis and the Getis-Ord hotspot analysis. Results From 2015 to 2022, VCT clinics in China performed a total of 22,075,386 HIV tests, leading to the identification of 260,353 HIV cases, resulting in a HPR of 1.18%. The HPR consistently declined over the study period, with an average annual percent change (AAPC) of −7.5% (95% confidence interval: −12.6%, −2.2%, P <0.05). The number of HPR hotspots also decreased from 41 in 2015 to 23 in 2022. These HPR hotspots were primarily located in Yunnan, Sichuan, Guangdong, and Guangxi provincial-level administrative divisions (PLADs). Among the 31 PLADs, 16 showed a significant decrease in HPR during the study period (AAPC<0, P AAPC <0.05). Conclusions VCT clinics in China have played a significant role in identifying HIV cases. The declining HPR observed in these clinics may indicates the progress has been made in some degree in mitigating HIV among high-risk populations. Therefore, it is crucial to further improving the utilization of VCT clinics for HIV testing.

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Section: Discussionmentioning

confidence: 96%

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics — China, 2015–2022

Liu,

Su,

et al. 2024

China CDC Weekly

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“…Simultaneously, these measures may have deterred individuals from seeking resources for gonorrhea testing. China’s experience has shown that COVID-19 lockdowns resulted in insufficient and delayed opportunities for individuals with HIV/AIDS and tuberculosis to receive diagnosis and testing [ 26 , 27 ]. The gonorrhea cases varied at different stages of the pandemic response, linked to differing levels of containment and closure policies [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Interruption time series analysis using autoregressive integrated moving average model: evaluating the impact of COVID-19 on the epidemic trend of gonorrhea in China

Li,

Liu,

et al. 2023

BMC Public Health

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Background Interrupted time series (ITS) analysis is a growing method for assessing intervention impacts on diseases. However, it remains unstudied how the COVID-19 outbreak impacts gonorrhea. This study aimed to evaluate the effect of COVID-19 on gonorrhea and predict gonorrhea epidemics using the ITS-autoregressive integrated moving average (ARIMA) model. Methods The number of gonorrhea cases reported in China from January 2005 to September 2022 was collected. Statistical descriptions were applied to indicate the overall epidemiological characteristics of the data, and then the ITS-ARIMA was established. Additionally, we compared the forecasting abilities of ITS-ARIMA with Bayesian structural time series (BSTS), and discussed the model selection process, transfer function, check model fitting, and interpretation of results. Result During 2005–2022, the total cases of gonorrhea were 2,165,048, with an annual average incidence rate of 8.99 per 100,000 people. The highest incidence rate was 14.2 per 100,000 people in 2005 and the lowest was 6.9 per 100,000 people in 2012. The optimal model was ARIMA (0,1, (1,3)) (0,1,1)12 (Akaike’s information criterion = 3293.93). When predicting the gonorrhea incidence, the mean absolute percentage error under the ARIMA (16.45%) was smaller than that under the BSTS (22.48%). The study found a 62.4% reduction in gonorrhea during the first-level response, a 46.47% reduction during the second-level response, and an increase of 3.6% during the third-level response. The final model estimated a step change of − 2171 (95% confidence interval [CI] − 3698 to − 644) cases and an impulse change of − 1359 (95% CI − 2381 to − 338) cases. Using the ITS-ARIMA to evaluate the effect of COVID-19 on gonorrhea, the gonorrhea incidence showed a temporary decline before rebounding to pre-COVID-19 levels in China. Conclusion ITS analysis is a valuable tool for gauging intervention effectiveness, providing flexibility in modelling various impacts. The ITS-ARIMA model can adeptly explain potential trends, autocorrelation, and seasonality. Gonorrhea, marked by periodicity and seasonality, exhibited a downward trend under the influence of COVID-19 intervention. The ITS-ARIMA outperformed the BSTS, offering superior predictive capabilities for the gonorrhea incidence trend in China.

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“…During the COVID-19 pandemic, medical resources were mainly focused on COVID-19 prevention and treatment, leaving HIV/AIDS-related healthcare services and research in the “neglected corner”. 1 Zhao et al 2 used time series models to quantitatively evaluate the impact of the pandemic on reported HIV/AIDS cases in China, revealing that over a quarter of HIV/AIDS cases may not have been identified during the pandemic, which might lead to a potential rebound in the HIV/AIDS epidemic. Globally, not only in China, the pandemic and economic crises have had an increasing impact on HIV/AIDS prevention and control.…”

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confidence: 99%

“…Studies have shown that the monthly number of HIV cases decreased suddenly after February 2020. 2 , 4 There are two possible reasons for this. One reason is that, stricter lockdown and COVID-19 polices increased the difficulty for key populations (e.g., men who have sex with men [MSM] and sex workers) to meet and date in some leisure and entertainment places, which could indeed reduce the chance of HIV transmission and the number of infections.…”

mentioning

confidence: 99%

“…Represented by HIV self-testing (HIVST) service, e-health services could provide contactless, individualized service delivery during the lockdown period, and increase security, convenience and privacy protection. 1 , 2 However, simply carrying out HIVST services is insufficient. We should also consider implementing HIV monitoring by using HIVST services to identify cases and manage subsequent treatment.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Take action to mitigate the impact of the COVID-19 pandemic on HIV prevention and control

Yan¹,

Qin²,

Zhang³

2023

The Lancet Regional Health - Western Pacific

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The influence of the COVID-19 pandemic on identifying HIV/AIDS cases in China: an interrupted time series study

Cited by 6 publications

References 35 publications

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics — China, 2015–2022

Temporal and Spatial Trends in HIV Positivity Rate for VCT Clinics — China, 2015–2022

Interruption time series analysis using autoregressive integrated moving average model: evaluating the impact of COVID-19 on the epidemic trend of gonorrhea in China

Take action to mitigate the impact of the COVID-19 pandemic on HIV prevention and control

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