Effect of COVID-19 on Late HIV Diagnosis Rates by Race/Ethnicity in Ending the HIV Epidemic Priority Jurisdictions in the United States.

Abstract

Introduction: This study aims to determine the effect of the COVID-19 pandemic on changes in late HIV diagnoses by race/ethnicity across Ending the HIV Epidemic (EHE) priority jurisdictions in the US.

Methods: We analyzed annual county-level and state-level (when county-level data were unavailable) late HIV diagnosis data in EHE priority jurisdictions from local epidemiological profiles and the AIDSVu between 2017 and 2022. Descriptive analyses were conducted to examine the percentages of late diagnoses across racial/ethnic groups before and after the onset of the pandemic. We then used interrupted time-series analysis to assess changes in both the level and trend of late diagnosis percentages across non-Hispanic White, non-Hispanic Black, and Hispanic populations.

Results: We included a total of 31 jurisdictions. The highest percentages of late HIV diagnoses were more often reported among Black or Hispanic populations. There were statistically significant ( P < 0.05) downward trends in late diagnosis percentages before the pandemic among the Black population in Kings County, NY (-3.8%), Georgia (-0.8%), and Los Angeles County, CA (-4.5%), and among the Hispanic population in Georgia (-4.9%). Subsequently, there were significant immediate increases in 2020 in the Black population in Kings County, NY (11.5%), Georgia (2.5%), and Los Angeles County, CA (10.8%), and among the Hispanic population in Georgia (11.5%). In addition, there was a significant annual increase in the trend after the onset of the pandemic in both the Black (1.0%) and Hispanic populations (4.8%) in Georgia. By contrast, no statistically significant changes were found in the White population.

Conclusions: The COVID-19 pandemic seems to have exacerbated existing race/ethnic disparities in late HIV diagnoses among several EHE jurisdictions.