HIV Testing by Public Health Centers and Municipalities and New HIV Cases During the COVID-19 Pandemic in Japan

Abstract

Background: During the COVID-19 outbreak, facility capacity for HIV testing has been limited. Furthermore, people may have opted against HIV testing during this period to avoid COVID-19 exposure. We investigated the influence of the COVID-19 pandemic on HIV testing and the number of reported HIV cases in Japan.

Methods: We analyzed quarterly HIV/AIDS-related data from 2015 to the second quarter of 2020 using an anomaly detection approach. The data included the number of consultations, the number of HIV tests performed by public health centers or municipalities, and the number of newly reported HIV cases with and without an AIDS diagnosis. We further performed the same analysis for 2 subgroups: men who have sex with men (MSM) and non-Japanese persons.

Results: The number of HIV tests (9,584 vs. 35,908 in the year-before period) and consultations (11,689 vs. 32,565) performed by public health centers significantly declined in the second quarter of 2020, whereas the proportion of new HIV cases with an AIDS diagnosis (36.2% vs. 26.4%) significantly increased after removing the trend and seasonality effects. HIV cases without an AIDS diagnosis decreased (166 vs. 217), but the reduction was not significant. We confirmed similar trends for the men who have sex with men and non-Japanese subgroups.

Conclusions: During the COVID-19 pandemic, the current HIV testing system in Japan seems to have missed more cases of HIV before developing AIDS. Continuously monitoring the situation and securing sufficient test resources by use of self-testing is essential to understand the clear epidemiological picture of HIV incidence during the COVID-19 pandemic.

FIGURE 1.

Number of HIV tests and consultations performed by public health centers and municipalities and number of newly diagnosed HIV cases with and without an AIDS diagnosis from 2015 to the first quarter of 2020: (A) Number of newly reported HIV cases without an AIDS diagnosis, (B) number of newly reported HIV cases with an AIDS diagnosis, (C) number of newly reported HIV cases with and without an AIDS diagnosis, (D) number of HIV tests performed by public health centers or municipals, (E) number of consultations received by public health centers, (F) proportion of new HIV cases with an AIDS diagnosis. The black circles are observed data, and the grey shaded areas correspond to the normal range. Observed data outside the normal range are considered abnormal and are filled with black.