Has COVID-19 changed the approach to HIV diagnosis?: A multicentric Italian experience

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• The COVID-19 pandemic significantly disrupted healthcare systems globally.
• Focus on COVID-19 led to potential neglect of other critical health services, including HIV screening and diagnosis.
• Disruptions may have impacted the detection rates and characteristics of new HIV diagnoses.

Purpose of the Study:

• To evaluate the number and characteristics of new HIV/AIDS diagnoses in Italy during the COVID-19 pandemic.
• To compare the demographic and clinical features of individuals diagnosed with HIV before (2019) and during (2020) the pandemic.

Main Methods:

• A retrospective, multicenter, observational study design was employed.
• Data on new HIV/AIDS diagnoses were collected and analyzed for the years 2019 and 2020.
• Characteristics such as age, disease stage (CD4+ T cell count), and transmission group were compared between the two periods.

Main Results:

• A significant decrease in the overall number of HIV diagnoses was observed during the pandemic year (2020) compared to the pre-pandemic year (2019).
• Individuals diagnosed in 2020 were older and presented with higher CD4+ T cell counts (indicating earlier diagnosis) than those diagnosed in 2019.
• A notable reduction in new HIV diagnoses among men who have sex with men was recorded, potentially linked to social distancing measures.

Conclusions:

• Despite a reduction in diagnoses, late presentation of HIV remains a concern.
• Integrating routine HIV testing into SARS-CoV-2 screening protocols can facilitate earlier detection and linkage to care.
• There is an urgent need for a national HIV screening policy to address diagnostic gaps exacerbated by the pandemic.