The potential effect of COVID-19-related disruptions on HIV incidence and HIV-related mortality among men who have sex with men in the USA: a modelling study

Mitchell, Kate; Dimitrov, Dobromir; Silhol, Romain; Geidelberg, Lily; Moore, Maggie; Liu, Albert; Beyrer, Chris; Mayer, Kenneth H.; Baral, Stefan; Boily, Marie Claude

doi:10.1016/s2352-3018(21)00022-9

Cited by 79 publications

(51 citation statements)

References 25 publications

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“…Pre-pandemic, 13% of people with HIV in the U.S. were undiagnosed 19 and data showed that individuals who were unaware of their diagnosis accounted for approximately 40% of new HIV infections. 31 As noted by Mitchell and colleagues, 32 despite the possible fluctuations in HIV transmission due to reduced interpersonal contact and engagement in HIV risk related behaviors during the COVID-19 pandemic, the overall impact of reduced testing could lead to delayed antiretroviral treatment initiation, poor viral suppression, increased transmission risk, and ultimately, increased HIV-related deaths. As the pandemic resolves and restrictions ease, the healthcare industry should scale up testing, messaging to publicize the importance of testing, and routine HIV screening.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on HIV testing rates across four geographically diverse urban centres in the United States: An observational study

Moitra

Tao

Olsen³

et al. 2022

The Lancet Regional Health - Americas

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Background Non-emergent clinical services were limited or suspended during the early stages of the coronavirus disease 2019 (COVID-19) pandemic in the United States (U.S.). This could adversely impact epidemics of public health importance, such as HIV, and access to testing, which is a cornerstone of prevention efforts. Methods In this observational study, we collected HIV testing and positivity rate clinical data from four geographically diverse U.S. healthcare systems in New Orleans, Louisiana; Minneapolis, Minnesota; Providence, Rhode Island; and, Seattle, Washington. Data from 2019 to 2020 were examined to assess changes in HIV testing in community-based, emergency department, and outpatient settings. Poisson regression was used to explore trends in HIV testing through phases of the COVID-19 pandemic. Findings In outpatient settings, there was a 68-97% reduction in the number of HIV tests per week during each state's stay-at-home order period, compared to during the pre-stay-at-home order period in early 2020. HIV testing remained reduced 11-54% after states transitioned to advisory phases. The HIV positivity rate increased slightly at outpatient settings, except in New Orleans where it fell. Interpretation We found a concerning trend of substantially decreased HIV testing across four geographically diverse sites. These findings suggest that new HIV infections within the U.S. may be undiagnosed and not yet linked to clinical care and services, as a consequence of the COVID-19 pandemic. Thus, augmented efforts to identify patients and link them to HIV services will be needed as healthcare settings return to full operation. Funding U.S. National Institute of Mental Health.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on HIV testing rates across four geographically diverse urban centres in the United States: An observational study

Moitra

Tao

Olsen³

et al. 2022

The Lancet Regional Health - Americas

View full text Add to dashboard Cite

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“…7 However, there is contrasting results and an enormous multinational survey, conducted through an on-line social networking application which gathered responses from over 10 000 MSM across 20 countries, described an association between most stringent government responses to COVID-19 with decreased access to HIV testing, prevention and treatment services. 8,9 Local health departments as well as providers, including HIV providers, are on the front lines of both the HIV and COVID-19 response and addressing both epidemics simultaneously creates new challenges. In fact, some clinical conditions related to both HIV and COVID-19 maybe intertwined.…”

Section: Discussionmentioning

confidence: 99%

Decrease in New Diagnosis of HIV/AIDS in the Two Years Period 2019-2020: Impact of COVID-19 Pandemic

Quiros-Roldan

Izzo

Carriero

et al. 2022

Journal of Public Health Research

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The emergence SARS-CoV-2 in late 2019 and early 2020 has caused a pandemic of unprecedented proportions. Management of COVID-19 became emergent public health priorities, and the impact on other public health initiatives, such as expanded HIV screening and linkage to care, remain largely unknown. In this Single-Center retrospective observational study, we describe the characteristics and circumstance of the new HIV cases during 2020 compared to 2019. We observed a decrease of HIV diagnosis during this period. Interestingly, median age at HIV diagnosis decreased of one decade and percentage of female patients was higher. In addition, more patients received diagnosis during hospitalization and more AIDS-defining conditions, such as Pneumocystis pneumonia, were detected. We express our concern that HIV new diagnoses will increase as a result of people's inability to get tested or treated in this period. More efforts are needed to improve local screening programs both during and after COVID-19 pandemic.

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“…Prior mathematical models have shown the devastating impact that interruptions in care due to COVID-19 can have on mortality for PWH [ 15 , 16 ]. However, few studies have evaluated the real-time impact of the COVID-19 pandemic on the HIV continuum of care in a comprehensive care clinic setting.…”

Section: Introductionmentioning

confidence: 99%

The Impact of COVID-19 on the HIV Care Continuum in a Large Urban Southern Clinic

et al. 2022

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Access to care is essential for people with HIV (PWH) but may have been affected during the COVID-19 pandemic. We conducted a retrospective cross-sectional study of adult PWH receiving care in a large southeastern comprehensive care clinic in the United States. Patients in care between January 1, 2017, and July 30, 2020, were included. Race/ethnicity, sex, HIV-1 RNA, CD4 + lymphocyte count were included as baseline covariates. Outcomes included clinic attendance, receipt of HIV-1 RNA PCR testing, and virologic suppression (HIV-1 RNA < 200 copies/mL); outpatient encounters included new patient encounters, follow-up visits, and mental health encounters. Total medical encounters, including telemedicine, decreased by 827 visits (33%) when comparing the second quarters of 2019 and 2020. New patient encounters decreased by 23.5% from 81 to 62 during this period. The second quarter of 2020 saw the lowest number of new patient visits since 2017. HIV-1 RNA testing and the proportion of patients with virologic suppression decreased during the pandemic ( p < 0.001 for both). Total mental health encounters, on the other hand, increased by 14% during April-June 2020 compared to April-June 2019. Mental health electronic communications increased by 60% from 312 to 500 during the same period, with a 20% increase in medication refills. The COVID-19 pandemic affected outpatient visits, viral load surveillance, and virologic suppression but led to an increase in mental health encounters in a comprehensive care clinic setting.

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The potential effect of COVID-19-related disruptions on HIV incidence and HIV-related mortality among men who have sex with men in the USA: a modelling study

Cited by 79 publications

References 25 publications

Impact of the COVID-19 pandemic on HIV testing rates across four geographically diverse urban centres in the United States: An observational study

Impact of the COVID-19 pandemic on HIV testing rates across four geographically diverse urban centres in the United States: An observational study

Decrease in New Diagnosis of HIV/AIDS in the Two Years Period 2019-2020: Impact of COVID-19 Pandemic

The Impact of COVID-19 on the HIV Care Continuum in a Large Urban Southern Clinic

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