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. 2025 Jul;29(7):2189-2195.
doi: 10.1007/s10461-025-04683-1. Epub 2025 Apr 10.

Evaluating the Effects of the COVID-19 Pandemic on HIV Testing, Enrollment, ART Use and Mortality in Suriname Using Interrupted Time Series Analysis

Deborah Stijnberg  1   2   3 , M McKee  4 , E Commiesie  5 , M Adhin  6 , W Schrooten  7
Affiliations

Evaluating the Effects of the COVID-19 Pandemic on HIV Testing, Enrollment, ART Use and Mortality in Suriname Using Interrupted Time Series Analysis

Deborah Stijnberg et al. AIDS Behav. 2025 Jul.

Abstract

Our study evaluates the changes in HIV testing, new enrollments in the HIV surveillance system, treatment, and mortality of people with HIV during and after the SARS-CoV-2 (COVID-19) pandemic in Suriname. A retrospective population-based study was conducted, using interrupted time series analyses with data from the HIV surveillance system from January 2013 until December 2023. The commencement of the COVID-19 pandemic lead to a decline in HIV testing, enrollment, treatment initiation, and the annual number of individuals receiving treatment, respectively, by 16%, 32%, 40%, and 2% in 2020 compared to 2019. The mortality rate among people with HIV went from 7.8 in 2019 to 26 per 100,000 in 2022. The regression model showed an immediate significant effect at the start of the COVID pandemic for the HIV enrollments and the yearly number of people on treatment. For HIV mortality there is significant sustained effect. An overall decline in HIV services resulted in an increased mortality in 2021 and 2022. Innovative strategies and additional human and financial investments are needed to regain and improve access to health services and reverse the current epidemical trend.

Keywords: COVID-19; HIV; Suriname.

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Conflict of interest statement

Declarations. Competing Interests: All authors report no competing interests or conflicts of interest. Ethical Approval: Local procedures stipulate permission from the director of Health should be obtained. This research was completed by the HIV surveillance unit of the Ministry of Health. Consent to Participate: Because deidentified surveillance data was used, informed consent was not required.

Figures

Fig. 1
Fig. 1
a Number of HIV tests conducted, 2013–2023. b Yearly difference in the Number of HIV tests performed with regression line pre, during and post start COVID epidemic in Suriname, 2013–2023. Note Vertical line indicates the start of the COVID 19 epidemic in Suriname in the first quarter of 2020
Fig. 2
Fig. 2
Yearly number of people newly enrolled with an HIV diagnosis with regression line pre, during and post start COVID epidemic in Suriname, 2013–2023. Note Vertical line indicates the start of the COVID 19 epidemic in Suriname in the first quarter of 2020
Fig. 3
Fig. 3
a The number of people initiating HIV treatment with regression line pre, during and post start COVID epidemic in Suriname, 2013–2023. b The yearly difference in the number of people initiating HIV treatment with regression line pre, during and post start COVID epidemic in Suriname, 2013–2023. Note Vertical line indicates the start of the COVID-19 epidemic in Suriname in the first quarter of 2020
Fig. 4
Fig. 4
Yearly number of people on HIV treatment with regression line pre, during and post start COVID epidemic in Suriname, 2013–2023. Note Vertical line indicates the start of the COVID 19 epidemic in Suriname in the first quarter of 2020
Fig. 5
Fig. 5
a The yearly number of people with HIV dying with regression line pre, during and post start COVID epidemic in Suriname, 2013–2022. b The difference in the yearly number of people with HIV dying with regression line pre, during and post start COVID epidemic in Suriname, 2013–2022. Note Vertical line indicates the start of the COVID 19 epidemic in Suriname in the first quarter of 2020
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