Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 15;92(5):370-377.
doi: 10.1097/QAI.0000000000003156. Epub 2022 Dec 26.

Impact of COVID-19 Response on the HIV Epidemic in Men Who Have Sex With Men in San Francisco County: The Importance of Rapid Return to Normalcy

Citina Liang  1 , Sze-Chuan Suen  1 , Anthony Nguyen  1 , Corrina Moucheraud  2   3 , Ling Hsu  4 , Ian W Holloway  3   5 , Edwin D Charlebois  6 , Wayne T Steward  6
Affiliations

Impact of COVID-19 Response on the HIV Epidemic in Men Who Have Sex With Men in San Francisco County: The Importance of Rapid Return to Normalcy

Citina Liang et al. J Acquir Immune Defic Syndr. .

Abstract

Background: In response to the COVID-19 pandemic, San Francisco County (SFC) had to shift many nonemergency health care resources to COVID-19, reducing HIV control resources. We sought to quantify COVID-19 effects on HIV burden among men who have sex with men (MSM) as SFC returns to pre-COVID service levels and progresses toward the Ending the HIV Epidemic (EHE) goals.

Setting: Microsimulation model of MSM in SFC tracking HIV progression and treatment.

Methods: Scenario analysis where services affected by COVID-19 [testing, care engagement, pre-exposure prophylaxis (PrEP) uptake, and retention] return to pre-COVID levels by the end of 2022 or 2025, compared against a counterfactual where COVID-19 changes never occurred. We also examined scenarios where resources are prioritized to reach new patients or retain of existing patients from 2023 to 2025 before all services return to pre-COVID levels.

Results: The annual number of MSM prescribed PrEP, newly acquired HIV, newly diagnosed, and achieving viral load suppression (VLS) rebound quickly after HIV care returns to pre-COVID levels. However, COVID-19 service disruptions result in measurable reductions in cumulative PrEP use, VLS person-years, incidence, and an increase in deaths over the 2020-2035 period. The burden is statistically significantly larger if these effects end in 2025 instead of 2022. Prioritizing HIV care/prevention initiation over retention results in more person-years of PrEP but less VLS person-years and more deaths, influencing EHE PrEP outcomes.

Conclusions: Earlier HIV care return to pre-COVID levels results in lower cumulative HIV burdens. Resource prioritization decisions may differentially affect different EHE goals.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1.
FIGURE 1.
Cumulative differences in outcomes between the non-COVID counterfactual and 4 different COVID-19 scenarios by 2035.
FIGURE 2.
FIGURE 2.
Difference between non-COVID counterfactual and base, best case, and worst case in scenarios 1 and 2 (COVID-19 effects until the end of 2022 or 2025).
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. COVID Data Tracker; 2022. Available at: https://covid.cdc.gov/covid-data-tracker/#datatracker-home. Accessed July 7, 2022.
    1. Iuliano AD, Brunkard JM, Boehmer TK, et al. . Trends in disease severity and health care utilization during the early Omicron variant period compared with previous SARS-CoV-2 high transmission periods—United States, December 2020–January 2022. MMWR Morb Mortal Wkly Rep. 2022;71:146–152. - PMC - PubMed
    1. Rio Cdel, Malani PN. COVID-19 in 2022—the beginning of the end or the end of the beginning? JAMA. 2022;327:2389–2390. - PubMed
    1. Moitra E, Tao J, Olsen J, et al. . Impact of the COVID-19 pandemic on HIV testing rates across four geographically diverse urban centres in the United States: an observational study. Lancet Reg Health Am. 2022;7:100159. - PMC - PubMed
    1. del Amo J, Diaz A, Polo R. The impact of coronavirus disease 2019 on people with HIV. Curr Opin Infect Dis. 2022;35:9–14. - PubMed

Publication types