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. 2023 Dec 27;13(1):23003.
doi: 10.1038/s41598-023-50359-y.

Reduced HIV/AIDS diagnosis rates and increased AIDS mortality due to late diagnosis in Brazil during the COVID-19 pandemic

Lucas Almeida Andrade #  1 , Thiago de França Amorim #  2 , Wandklebson Silva da Paz  3 , Mariana do Rosário Souza  4 , Emerson Lucas S Camargo  5 , Débora Dos Santos Tavares  6 , Shirley Verônica M A Lima  7 , Enaldo Vieira de Melo  8 , Marco Aurélio de O Góes  8 , Rodrigo Feliciano do Carmo  9 , Carlos Dornels F de Souza  10 , Allan Dantas Dos Santos  7 , Álvaro Francisco L de Sousa  11   12 , Isabel Amélia C Mendes  5 , Abelardo Silva-Júnior  13   14   15 , Wagnner José N Porto  13   14   15 , Márcio Bezerra-Santos  4   2   13   16
Affiliations

Reduced HIV/AIDS diagnosis rates and increased AIDS mortality due to late diagnosis in Brazil during the COVID-19 pandemic

Lucas Almeida Andrade et al. Sci Rep. .

Abstract

The COVID-19 pandemic has severely affected global health, leading to the suspension of numerous routine healthcare services and posing challenges in efforts to control other diseases, such as HIV/AIDS. This study aimed to assess the impact of the COVID-19 pandemic on HIV/AIDS diagnoses and mortality rates in Brazil during 2020 and 2021. The percentage change was calculated to determine whether there was an increase or decrease in HIV/AIDS diagnoses and mortality, considering the average numbers from the last 5 years. Additionally, a Joinpoint regression model and an interrupted time series analysis were applied to assess time trends before and after the onset of the pandemic. Lastly, choropleth maps were prepared. We observed a reduction of 22.4% (2020) and 9.8% (2021) in the diagnosis of HIV/AIDS in Brazil. Conversely, there was a significant increase in the percentage change of late diagnosis of AIDS deaths in 2020 (6.9%) and 2021 (13.9%), with some states showing an increase of over 87%. Decreasing time trends in the diagnosis of HIV/AIDS were identified before the pandemic in Brazil, especially in the Southeast and South regions, and then time trends stabilized after including the pandemic years. Along with the dissemination of COVID-19, there was a reduction in the diagnosis of HIV/AIDS and an increase in late diagnosis AIDS deaths, signaling a serious impact of the pandemic on HIV/AIDS control strategies in Brazil. Therefore, we highlight the need for continuous efforts to control both diseases, that is, maintaining regular health services even in crisis situations.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Study area: map of Brazil divided into five regions, and its 26 states and one Federal District. QGis 3.20.4 (https://qgis.org/pt_BR/site/).
Figure 2
Figure 2
Percentage change in key indicators of AIDS diagnosis and related mortality in Brazilian states, regions, and country during 2020 and 2021. (A) Number of HIV/AIDS cases in Brazil in 2020; (B) Number of HIV/AIDS cases in Brazil in 2021; (C) Late diagnosis AIDS deaths in Brazil in 2020; (D) Late diagnosis AIDS deaths in Brazil in 2021; (E) Total number of AIDS deaths in Brazil in 2020.
Figure 3
Figure 3
Interrupted time series analysis of mortality from AIDS in Brazil in 2020: (A) number of AIDS deaths in Brazil; (B) number of AIDS deaths in the North region of Brazil; (C) number of AIDS deaths in the Northeast region of Brazil; (D) number of AIDS deaths in the Southeast region of Brazil; (E) number of AIDS deaths in the South region of Brazil; and (F) number of AIDS deaths in the Central-West region of Brazil. The line that cuts each time series indicates the intervention point, that is the onset of the COVID-19 pandemic in Brazil in March 2020.
Figure 4
Figure 4
Spatial distribution of percentage change in key indicators of HIV/AIDS diagnosis and related mortality in Brazilian states during 2020 and 2021. (A) Number of HIV/AIDS cases in Brazil in 2020; (B) Number of HIV/AIDS cases in Brazil in 2021; (C) Late diagnosis AIDS deaths in Brazil in 2020; (D) Late diagnosis AIDS deaths in Brazil in 2021; (E) Total AIDS death in Brazil in 2020. QGis 3.20.4 (https://qgis.org/pt_BR/site/).
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