Disruptions related to COVID-19 could increase HIV incidence among MSM
Pandemic-related disruptions to HIV testing a treatment could lead to a more than 10% increase in new HIV infections among men who have sex with men in the United States, researchers reported.
The researchers modeled the effect that decreases in condom use, HIV testing, viral suppression, PrEP initiations and adherence, and ART initiations caused by the COVID-19 pandemic could have.
“We had previously been modelling HIV transmission and treatment among men who have sex with men (MSM) in the United States,” Kate M. Mitchell, PhD, a research fellow at Imperial College London, told Healio. “In spring 2020, we began to see reports of disruptions to HIV testing and treatment and changes in sexual behaviour in the U.S. due to the COVID-19 pandemic and measures put in place to combat COVID-19. We decided to use our model to estimate what the overall impact of all these different COVID-19-related disruptions might be.”
To quantify the potential effect of COVID-19-related disruptions on HIV incidence and HIV-related mortality among MSM in the U.S., Mitchell and colleagues used an HIV transmission model for MSM in Baltimore, as well as available data on COVID-19-related disruptions to HIV services.
According to the study, in their main analysis, researchers modeled disruptions due to COVID-19 starting Jan. 1, 2020, and lasting 6 months. They estimated the median change in new HIV infections and HIV-related deaths among MSM over 1 and 5 years compared with a scenario without COVID-19-related disruptions.
The study demonstrated that reported reductions in condom use, HIV testing, viral suppression, PrEP initiation and adherence, along with a 50% reduction in people starting treatment for HIV lasting for 6 months, would lead to an estimated median 10.5% increase in new HIV infections over 1 year and a median 3.5% increase over 5 years, and also an increase in HIV-related deaths.
Mitchell said that a 25% reduction in the number of sexual partners among MSM could prevent the increase in new HIV infections. However, doing so would still result in an approximate 11% increase in HIV deaths.
“It’s important to make sure that those living with HIV can continue to access treatment and get support to adhere well to their treatment during the COVID-19 pandemic to prevent excess HIV-related mortality,” Mitchell said. “This may involve increased use of digital and telemedicine approaches, and it will be important to evaluate services to make sure they’re reaching those who most need them.”