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HIV testing and diagnosis was severely disrupted in the three years of Covid-19 pandemic at All India Institute of Medical Sciences (AIIMS), according to an AIIMS study which covered the documents or records on HIV testing and diagnosis from January 1, 2016 to December 31, 2022.
The same was collected from the integrated HIV counselling and testing centre attached to AIIMS, Delhi.
The study highlighted that age, gender and risk behaviour observed significant changes. It also revealed that HIV testing is still not recovered to pre-pandemic numbers during 2022. The same could be true with other healthcare centres within India and around the globe.
“We may require modifying our approach for HIV testing after assessing the existing one to make HIV testing level normal or at least to the pre-Covid-19 pandemic level. Testing among target sub-populations, which are affected during pandemic, needs to be exaggerated,” according to Dr. Shesh Prakash Maurya who was part of the study.
The study had individual identification number, age, gender, testing date, provider/client-initiated, risk behaviour, etc. Data was analyzed on Microsoft Excel and GraphPad prism v5. Chi-square test was applied in analysis of all data sets to calculate p values. P<0.05 was considered significant, according to the study.
Timely HIV testing and thereby early ART initiation is critically important to achieve an AIDS free world. Compared to 690,000 AIDS related deaths worldwide in the year preceding Covid-19 (2019) (UNAIDS 2020), India contributed to around 58,960 (8.5%) of global AIDS related deaths (NACO India 2020).
“Recognising the capability of Covid-19 pandemic related restrictions to impact HIV services, we collected and compared the data on HIV testing and diagnosis at the apex tertiary referral hospital of India from 2020 to 2022 with pre-Covid-19 years,” Dr. Maurya explained.
During 2020, new HIV cases declined by 54% than average pre-Covid-19 years. During 2021, new HIV cases and positivity rate increased than 2020. However, new HIV cases were still lower compared to pre-Covid-19 years by 43.7% due to low HIV testing. During 2022, new HIV cases were reduced by 10.1% during 2022 compared to the average number during 2016-2019.
During 2021, there was a 30.9% increase in HIV positive male despite <1% change in male HIV testing compared to 2020. There was a 13.2% rise in the number of HIV positive females in the first year of the pandemic as the female testing also rose in a similar proportion [10.1%].
During 2022, HIV diagnosis among females were significantly reduced than males [p=0.03] due to low testing.
The number of individuals who underwent HIV testing at AIIMS, New Delhi were reduced by 56.9% during 2020(n=1182), 55.6% during 2021(n=1217) and 21.5% during 2022(n=2152) compared to the average number during 2016-2019(n=2743). During 2022, testing among females was significantly reduced than males(P=0.02).
Ashutosh Sharma, Dr. Hitender Gautam, Prof. Bimal Kumar Das from National HIV/AIDS Reference Laboratory and AIIMS, New Delhi were also part of the study.
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