HIV Testing Services Outcomes in CDC-Funded Health Departments During COVID-19
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HIV Testing Services Outcomes in CDC-Funded Health Departments During COVID-19

Filetype[PDF-156.22 KB]

  • English

  • Details:

    • Alternative Title:
      J Acquir Immune Defic Syndr
    • Description:

      Organizations offering HIV prevention services have reported interruptions during the COVID-19 pandemic. The national extent of these interruptions and their public health impact remain largely unexplored.


      Using data from 60 state and local health departments, we compared HIV testing services outcomes in calendar years 2019 and 2020, including the number of CDC-funded HIV tests conducted, the percentage of persons with newly diagnosed HIV infection (i.e., HIV positivity), and the percentage linked to HIV medical care within 30 days after new diagnoses (i.e., linkage to care) using Chi-square and robust Poisson models. We also assessed the independent associations between the pandemic period (i.e., March—December 2020) and the number of COVID-19 cases with monthly HIV testing services outcomes using multivariable robust Poisson models.


      There was a 46.0% (p<0.001) reduction in the number of CDC-funded HIV tests conducted in 2020 (n=1,255,895) compared with 2019 (n=2,324,421). Although there were fewer persons with newly diagnosed HIV in 2020 (n=5,581 vs. n=7,739 in 2019), HIV positivity was greater in 2020 (0.4% vs. 0.3% in 2019; aPR=1.33, 95% CI: 1.05-1.69). When adjusting for the monthly number of COVID-19 cases, the pandemic period was associated with a 56% reduction in the number of monthly CDC-funded HIV tests (aRR=0.44, 95% CI: 0.37-0.52) but 28% higher monthly HIV positivity (aPR=1.28 95% CI: 1.16-1.41) and 10% higher linkage to care (aPR=1.10, 95% CI: 1.02-1.18).


      Despite increased HIV positivity, a drastic reduction in the number of CDC-funded HIV tests was observed in 2020, impacting the ability to identify persons with newly diagnosed HIV. CDC and health departments will need to expand testing strategies to cover tests not conducted in 2020 while adapting to the continuing pandemic.

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