How COVID-19 Impacted HIV Testing in the Emergency Department

The impact of COVID-19 has certainly been felt far and wide, especially when it comes to health care. Follow-up check-ups, screenings, procedures, overcrowding in ICUs, health care worker burnout have all been the effects related to it.

The emergency department (ED) in many hospitals can take on the role of primary care provider (PCP) along with its traditional acute care role. With that, the ED can be the place where a lot of testing gets completed but is typically done with PCPs.

In a study presented virtually at IDWeek, a Hollywood, Fla., hospital saw a significant drop in the number of monthly ED HIV tests given to patients.

Investigators retrospectively reviewed testing patterns done from July 2018 to March 2021 at Memorial Regional Hospital in Hollywood where 45,185 HIV tests were recorded.

They developed interrupted time series (ITS) analysis models to gauge the immediate and gradual effects of the pandemic on the monthly number of HIV tests over time. They included an interruption point at March 2020.

The investigators wrote there was, “A mean of 1745 (SD, 266) HIV tests per month before the COVID-19 pandemic (July 2018 to Feb 2020) and a mean of 791 (SD, 187) HIV tests per month during the pandemic period (March 2020 to March 2021).”

HIV tests declined significantly during the earliest phase of the pandemic (March to September 2020). Investigators reported a 48.0% decrease in March; 43% in April; and 50.7% in May—compared with the same months of the pre-pandemic period. They noted the decline in HIV tests were consistent with the first wave of the pandemic in South Florida.

During the October 2020 through March 2021 time period, they saw the decrease in testing become less pronounced and gradually it returned to pre-pandemic levels, the investigators reported.

“Disruption of basic health services by the COVID-19 pandemic is a public health concern. Strategies to develop an infrastructure to meet the demands of HIV testing should be implemented to ensure the current HIV prevention during the COVID-19 period,” the investigators concluded.

The study, “Impact of COVID-19 Pandemic on an Emergency Department Opt-out HIV Screening Program: An Interrupted Time Series Analysis,” was presented virtually at IDWeek 2021, held September 29-October 3, 2021.