Impact of the COVID-19 pandemic on an emergency department-based opt-out HIV screening program in a South Florida hospital: An interrupted time series analysis, July 2018-March 2021

Abstract

Background: The COVID-19 pandemic has posed a tremendous burden on healthcare services. We evaluated its impact on an emergency department (ED)-based opt-out Human immunodeficiency virus (HIV) testing in a public healthcare system.

Methods: The programmatic data of ED-based HIV testing from July 2018 to March 2021 at the Memorial Regional Hospital, Hollywood, Florida was analyzed by interrupted time series analysis to evaluate the immediate and gradual effects of the COVID-19 pandemic on the number of monthly HIV tests, with an interruption point at March 2020.

Results: The average number of monthly HIV tests were significantly lower during the pandemic than the pre-pandemic (791 ± 187 vs 1745 ± 266, P < .001). There was a slight decline trend in the number of monthly HIV tests before the pandemic (estimate -10.29, P = .541). HIV testing dramatically decreased during the initial 7 months of the pandemic, compared to the pre-pandemic period, with the largest decline in the number of HIV tests on March 2020 (estimate -678.48, P = .007). HIV testing slightly increased every month (estimate 4.84, P = .891) during the pandemic period, and the number of HIV tests per month rebounded to the pre-pandemic levels by October 2020.

Conclusions: ED-based HIV testing significantly decreased during the initial 7 months of the pandemic in south Florida. Multiple strategies are necessary to maintain HIV testing during this pandemic era.

Keywords: Covid-19; HIV; HIV testing; Pandemic.