J Acquir Immune Defic Syndr 2021 Feb 17. Epub 2021 Feb 17.
Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, IN, USA. Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan. School of Human Evolution and Social Change, Arizona State University, Arizona, USA. Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan. Graduate School of Public Health, St. Luke's International University, Tokyo, Japan. Institute for Consumer Sciences and Human Life, Kinjo Gakuin University, Nagoya, Japan. Department of Biology, Faculty of Sciences, Kyushu University, Fukuoka, Japan. MIRAI, JST, Saitama, Japan. Institute for the Advanced Study of Human Biology (ASHBi), Kyoto University, Kyoto, Japan. NEXT-Ganken Program, Japanese Foundation for Cancer Research (JFCR), Tokyo, Japan. Science Groove Inc., Fukuoka, Japan.
Background: During the COVID-19 outbreak, facility capacity for HIV testing has been limited. Further, 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 two 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, while 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 MSM and non-Japanese subgroups.
Conclusion: 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 as well as 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.