Impact of COVID‐19 on HIV late diagnosis in a specialized German centre

Bremen, Kathrin van; Monin, Malte B; Schlabe, Stefan; Bischoff, Jenny; Rieke, Gereon J; Schwarze‐Zander, Carolynne; Wasmuth, Jan‐Christian; Rockstroh, Jürgen K.; Boesecke, Christoph

doi:10.1111/hiv.13426

Cited by 13 publications

(9 citation statements)

References 17 publications

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“…The increase in late-stage diagnoses 1 and 2 years after the pandemic supports this assertion. Van Bremen et al [7] found similar results, noting a higher likelihood of late diagnosis in Germany during the pandemic, an increased rate of HIV diagnoses during hospital admissions, and a reduction in diagnoses during routine check-ups.…”

Section: Discussionmentioning

confidence: 67%

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How the COVID-19 pandemic and the health system's response reduced HIV testing and increased late diagnoses in Mexico

Macías-González,

Vermandere,

Piñeirúa-Menendez

et al. 2024

Aids

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Objectives: This study aims to evaluate the disruption in HIV screening and diagnoses due to the COVID-19 pandemic and to investigate the pandemic's subsequent influence on the HIV epidemic. Design: A retrospective examination of testing and confirmed diagnoses time series was undertaken from 2011 to 2022. The analysis encompassed testing, positive tests, positivity rates, and diagnosis outcomes, including new HIV diagnoses, asymptomatic HIV diagnoses, and symptomatic HIV diagnoses. Methods: We used Autoregressive Integrated Moving Average (ARIMA) models to estimate the COVID-19 epidemic's impact on screening and diagnosis outcomes. We gauged the pandemic's effect between January 2020 and December 2022 by comparing modeled predicted results with actual outcomes. Results: The advent of COVID-19 prompted a reduction of 50.7% in HIV testing, followed by a monthly escalation in testing afterward, estimated at 30.2% and 65.1% for 2021 and 2022, respectively. While new diagnoses reported between 2020 and 2022 gradually increased to pre-pandemic levels, we estimate a gap of 13,207 new diagnoses, with symptomatic detections increasing more than proportionally in 2021 and 2022. Conclusions: Our results suggest that the COVID-19 pandemic resulted in missed HIV diagnoses and a rise in late HIV diagnoses. Implementing tailored post-COVID-19 strategies to accelerate timely HIV testing and prevention is needed to avert additional burdens and remain on track toward achieving the 2030 HIV management goals.

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Section: Discussionmentioning

confidence: 67%

“…This disruption could potentially increase HIV transmission risks as fewer individuals were able to maintain undetectable viral loads [1]. By the end of 2021, reports of a rise in late HIV diagnoses from 2020 to the end of 2021 [7,8] illustrated the long-lasting effect of the pandemic on public health.…”

Section: Introductionmentioning

confidence: 99%

How the COVID-19 pandemic and the health system's response reduced HIV testing and increased late diagnoses in Mexico

Macías-González,

Vermandere,

Piñeirúa-Menendez

et al. 2024

Aids

View full text Add to dashboard Cite

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“…Therefore, the experts suggested that only well-adjusted and engaged LPs should use the app. However, initial studies show that the number of LPs in Germany may have increased during the COVID pandemic [47,48]. Physicians should distinguish in each case whether an app can be useful or not.…”

Section: Organizational Conditionsmentioning

confidence: 99%

Interviews with HIV Experts for Development of a Mobile Health Application in HIV Care—A Qualitative Study

et al. 2023

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The Communication and Tracing App HIV (COMTRAC-HIV) project aims to develop a mobile health application for integrated care of HIV patients due to the low availability of those apps in Germany. This study addressed organizational conditions and necessary app functionalities, especially for the care of late diagnosed individuals (late presenters) and those using pre-exposure prophylaxis. We followed a human-centered design approach and interviewed HIV experts in Germany to describe the context of use of the app. The interviews were paraphrased and analyzed with a qualitative content analysis. To define the context of use, user group profiles were defined and tasks derived, which will represent the functionalities of the app. A total of eight experts were included in the study. The results show that the app should include a symptom diary for entering symptoms, side effects, and their intensity. It offers chat/video call functionality for communication with an HIV expert, appointment organization, and sharing findings. The app should also provide medication overview and reminders for medications and appointments. This qualitative study is a first step towards the development of an app for HIV individuals in Germany. Further research includes involving patients in the initial app design and test design usability.

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“…55 Various studies from other countries have also shown a delay in diagnosing HIV/AIDS during the COVID-19 pandemic. Reorganizing health services to focus on SARS-CoV-2 infection, reducing HIV screening tests, delaying or avoiding hospital or HIV testing center visits for fear of contracting SARS-CoV-2 infection, changing sexual behavior during the pandemic, misinterpretation of nonspecific HIV symptoms as SARS-CoV-2 infection findings or COVID vaccine side effects were the reasons attributed to reduced and delayed HIV diagnosis during the COVID-19 pandemic [55][56][57][58][59][60][61]. This study has several limitations.…”

mentioning

confidence: 99%

Evaluation of the late presentation and associated factors of people living with HIV in Turkey

Sevgi,

Demirbas,

Genc Yaman

et al. 2023

Journal of Medical Virology

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To identify the frequency of late presentation and late presentation with advanced disease, and associated factors in people living with HIV (PLHIV). Data from PLHIV diagnosed between 2008 and 2021 were retrospectively analyzed. Time of diagnosis (categorized based on key events affecting HIV care continuum e.g., national strategies, HIV guidelines, COVID-19 pandemic) and characteristics of late presenters (LP: CD4 ≤350 cells/mm³ or an AIDS defining event) and late presenters with advanced disease (LPAD: CD4 <200 cells/mm³) were describe. Associations between dependent (LP, LPAD) and independent variables were assessed using univariate/multivariate regression tests and presented as odds ratios (95% confidential interval). Of 1585 individuals (93.7% men), 42.5% were LPs and 19.3% were LPADs. Most common route of transmission was sex between men (54.3%). Non-LPs were younger (30 vs. 34 and 36 years; p < 0.001) and included more men who have sex with men (60.3% vs. 46.3% and 39.5%; p < 0.001). Factors associated with being LP and LPAD were age >30 years, heterosexual/unknown route of transmission (vs. sex between men), diagnosis in 2008−2013 or 2020−2021, (vs. 2014−2019). With reference to Turkish subjects, migrants from Africa had higher odds of being LPAD. LP is still an important health issue in HIV care. Heterosexuality, older age (>30 years), migration from Africa, and the COVID-19 pandemic are associated with delays in HIV presentation in Turkey. These factors need to be considered when developing and implementing policies to enable earlier diagnosis and treatment of PLHIV to achieve UNAIDS 95-95-95 targets.

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Impact of COVID‐19 on HIV late diagnosis in a specialized German centre

Cited by 13 publications

References 17 publications

How the COVID-19 pandemic and the health system's response reduced HIV testing and increased late diagnoses in Mexico

How the COVID-19 pandemic and the health system's response reduced HIV testing and increased late diagnoses in Mexico

Interviews with HIV Experts for Development of a Mobile Health Application in HIV Care—A Qualitative Study

Evaluation of the late presentation and associated factors of people living with HIV in Turkey

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