CHANGES IN HIV AND STI TESTING AND DIAGNOSES DURING THE COVID-19 PANDEMIC

Presented During:

Wednesday, Feb 16, 2022: 9:58 AM - 10:06 AM MST
Denver - Virtual Conference  
Room: Room 4  

Abstract Submission Number:

142 

Abstract Type:

General Abstract  

Authors:

Jennifer J. Chang1, Qiaoling Chen1, Rulin C. Hechter1, Jodie Dionne-Odom2, Katia Bruxvoort2

Institutions:

1Kaiser Permanente Southern California, Pasadena, CA, United States, 2University of Alabama at Birmingham, Birmingham, AL, United States

Presenting Author:

Dr Jennifer J Chang  
Kaiser Permanente Southern California

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]).

Conclusions:

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.

Epidemiology/Public Health:

(X) Contraception, Sexually Transmitted Infections, and Reproductive Health in Adults

Search Terms:

Chlamydia trachomatis
Gonorrhea
HIV
STI
Syphilis

Supporting Image: Table1_ChangJJ_CROIAbstract2022.JPG
 

Does this abstract include any aspects of research on SARS-CoV-2 or COVID-19?

Yes

Is this abstract a case report, meta-analysis, or systematic review?

No