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CHANGES in HIV and STI TESTING and DIAGNOSES during the COVID-19 PANDEMIC
Topics in Antiviral Medicine ; 30(1 SUPPL):54-55, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-1880082
ABSTRACT

Background:

The COVID-19 pandemic led to significant disruptions in the provision of routine medical services. Myriad pandemic-related factors such as access to healthcare facilities, virtual care delivery, social distancing, changes in sexual behaviors, and periodic swab shortages may have affected detection rates for HIV and other sexually transmitted infections (STIs). Thus, we evaluated trends in testing and diagnoses of chlamydia, gonorrhea, syphilis, and HIV from 2017 to 2020 in a large integrated health system in the United States.

Methods:

We conducted a retrospective study using electronic health records among individuals ages ≥12 years enrolled in the Kaiser Permanente Southern California (KPSC) system. For each year from 2017 to 2020, we assessed the rates per 100,000 person-years of tests conducted and new positive results for genital and extragenital chlamydia, gonorrhea, syphilis, and HIV. Case definitions for chlamydia and gonorrhea included newly positive laboratory results in the absence of any other positive test within the past 30 days, or a positive test after a negative test within a 30-day period. Case definitions for syphilis included any new four-fold increase in RPR titer compared to the immediate prior RPR titer obtained within a 1-year period. We used Poisson regression to estimate rate ratios (RR) for each outcome, comparing pre-pandemic periods (January 2017 to February 2020) to the pandemic period (March to December 2020).

Results:

The study included a population of more than 4 million KPSC members yearly. During the pre-pandemic period, rates of testing remained stable or modestly increased, whereas case rates increased for syphilis and chlamydia, and decreased for gonorrhea and HIV (Table 1). Compared to the pre-pandemic period, testing rates were significantly lower from March to December 2020 for all STIs and HIV (range of RR 0.69-0.83). HIV/STI diagnosis rates were 7-29% lower during the pandemic for HIV (RR 0.74 [0.66-0.83]), chlamydia (RR 0.71 [95% CI.70-0.73]), and gonorrhea (RR 0.93 [0.89-0.96]), but higher for syphilis (RR 1.32 [1.27, 1.37]).

Conclusion:

We observed profound reductions in testing and diagnosis rates for chlamydia, gonorrhea, and HIV during the COVID-19 pandemic in Southern California compared to the pre-pandemic period. Despite lower pandemic period testing rates, syphilis diagnoses increased. These findings suggest the pandemic had an adverse impact on identification of STIs, which may impede efforts to curb STIs and the HIV epidemic.
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Coleções: Bases de dados de organismos internacionais Base de dados: EMBASE Idioma: Inglês Revista: Topics in Antiviral Medicine Ano de publicação: 2022 Tipo de documento: Artigo

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Coleções: Bases de dados de organismos internacionais Base de dados: EMBASE Idioma: Inglês Revista: Topics in Antiviral Medicine Ano de publicação: 2022 Tipo de documento: Artigo