HIV Services and Outcomes During the COVID-19 Pandemic — United States, 2019–2021
Karen W. Hoover, Weiming Zhu, Zanetta C. Gant, Kevin P. Delaney, Jeffrey Wiener, Neal Carnes, Dominique Thomas, John Weiser, Ya-Lin A. Huang, Laura W. Cheever, Athena P. Kourtis
Abstract
Increasing HIV testing, preexposure prophylaxis (PrEP), and antiretroviral therapy (ART) are pillars of the federal Ending the HIV Epidemic in the U.S. (EHE) initiative, with a goal of decreasing new HIV infections by 90% by 2030.* In response to the COVID-19 pandemic, a national emergency was declared in the United States on March 13, 2020, resulting in the closure of nonessential businesses and most nonemergency health care venues; stay-at-home orders also limited movement within communities (1). As unemployment increased during the pandemic (2), many persons lost employer-sponsored health insurance (3). HIV testing and PrEP prescriptions declined early in the COVID-19 pandemic (4-6); however, the full impact of the pandemic on use of HIV prevention and care services and HIV outcomes is not known. To assess changes in these measures during 2019-2021, quarterly data from two large U.S. commercial laboratories, the IQVIA Real World Data -Longitudinal Prescription Database (IQVIA), and the National HIV Surveillance System (NHSS) were analyzed. During quarter 1 (Q1) 2020, a total of 2,471,614 HIV tests were performed, 190,955 persons were prescribed PrEP, and 8,438 persons received a diagnosis of HIV infection. Decreases were observed during quarter 2 (Q2), with 1,682,578 HIV tests performed (32% decrease), 179,280 persons prescribed PrEP (6% decrease), and 6,228 persons receiving an HIV diagnosis (26% decrease). Partial rebounds were observed during quarter 3 (Q3), with 2,325,554 HIV tests performed, 184,320 persons prescribed * https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview https://www.iqvia.com/locations/belgium/librar y/fact-sheets/ real-world-longitudinal-prescription-data The study period for analyses using NHSS data was January 2019-December 2020. Quarters were defined as Q1 (January 1-March 31), Q2 (April 1-June 30), Q3 (July 1-September 30), and Q4 (October 1-December 31).