Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
Eur J Public Health. 2023 Dec 9;33(6):1171-1176. doi: 10.1093/eurpub/ckad156.
New HIV diagnoses in Italy decreased drastically in 2020 due to COVID-19 related effects: 50% fewer diagnoses were reported by the National HIV Surveillance System. COVID-19 pandemic impact on HIV surveillance is unclear. We estimated the expected number of new HIV diagnoses in 2020 in order to isolate the impact of the COVID-19 pandemic.
We analyzed 29 697 new HIV infections diagnosed from 2012 to 2020, reported to the National HIV Surveillance System. We assessed temporal trends of new HIV diagnoses applying negative binomial mixed effects models. We estimated the COVID-19 impact as the difference between the model-estimated slopes from 2012 to 2019 and the change reported in the diagnoses. The expected number of new HIV diagnoses in 2020 was also estimated and compared with the reported count.
Based on the historical trend, we expected a 15% (95% CI: 5-25%) decline of new HIV diagnoses in 2020. We reported, however, a 49% decrease, yielding to a 34% net decrease in the number of new diagnoses. The strongest impact was estimated in northern regions (-40%) and MSM (-38%). We estimated 761 (95% prediction interval: 350-1277) missed diagnoses during 2020, the majority of them occurring in the North (465 cases), among MSM (416) and heterosexual males (217).
In 2020, when excluding 15% decrease of new diagnoses attributable to the expected reduction, an additional 34% decrease was observed, representing a large decline in new HIV diagnoses associated with the COVID-19 pandemic.
由于 COVID-19 的相关影响，意大利 2020 年新诊断出的 HIV 病例数量急剧下降：国家 HIV 监测系统报告的诊断病例减少了 50%。COVID-19 大流行对 HIV 监测的影响尚不清楚。我们估计了 2020 年新 HIV 诊断的预期数量，以便隔离 COVID-19 大流行的影响。
我们分析了 2012 年至 2020 年报告给国家 HIV 监测系统的 29697 例新 HIV 感染病例。我们应用负二项式混合效应模型评估新 HIV 诊断的时间趋势。我们将 COVID-19 的影响估计为 2012 年至 2019 年模型估计斜率与诊断报告中变化之间的差异。我们还估计了 2020 年新 HIV 诊断的预期数量，并将其与报告的数量进行比较。
根据历史趋势，我们预计 2020 年新 HIV 诊断将下降 15%（95%CI：5-25%）。然而，我们报告的下降幅度为 49%，导致新诊断数量净减少 34%。北部地区（-40%）和男男性行为者（MSM）（-38%）的影响最大。我们估计 2020 年有 761 例（95%预测区间：350-1277）漏诊，其中大多数发生在北部（465 例），MSM（416 例）和异性恋男性（217 例）。
2020 年，在排除由于预期减少而导致的新诊断下降 15%的情况下，观察到额外下降 34%，这代表了与 COVID-19 大流行相关的新 HIV 诊断的大幅下降。
