STI Testing and Rates of STI Diagnoses Before and During the COVID-19 Pandemic in a US HIV Cohort

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• The COVID-19 pandemic significantly impacted healthcare services, including sexually transmitted infection (STI) testing and diagnosis.
• Limited data exists on how these pandemic-related changes affected STI testing and diagnosis rates specifically among individuals living with HIV in the United States.

Purpose of the Study:

• To analyze the impact of the COVID-19 pandemic on STI testing and diagnosis rates among people with HIV.
• To compare STI testing and diagnosis trends during the early pandemic period versus the prepandemic period.

Main Methods:

• Retrospective analysis of medical records from HIV Outpatient Study (HOPS) participants between January 2019 and March 2021.
• Poisson regression models were used to compare STI testing and diagnosis rates before and after March 1, 2020.
• Key outcomes included rates of gonorrhea, chlamydia, and syphilis testing and diagnoses.

Main Results:

• STI testing rates for gonorrhea and chlamydia decreased during the pandemic (RR 0.78), while syphilis testing showed a smaller decrease (RR 0.93).
• No statistically significant differences were observed in STI diagnosis rates between the pandemic and prepandemic periods.
• Multivariable analysis indicated reduced gonorrhea and chlamydia testing among men who have sex with men during the pandemic.

Conclusions:

• The full impact of the COVID-19 pandemic on sexual health among people with HIV may not yet be apparent.
• Despite reduced STI testing, diagnosis rates did not decline, suggesting potential underdiagnosis or delayed detection.
• Resuming routine screening and enhancing access to sexual healthcare are crucial to assess the true burden of undetected or untreated STIs.