COVID-19 impact; HIV care; HIV diagnosis; HIV testing; HIV trend; Humans; Belgium/epidemiology; Pandemics; Communicable Disease Control; COVID-19/epidemiology; HIV Infections/diagnosis; HIV Infections/epidemiology; Belgium; COVID-19; HIV Infections; Infectious Diseases
Abstract :
[en] BACKGROUND: To gain insight into the impact of the COVID-19 pandemic and containment measures on the HIV epidemic and services, this study aims to describe HIV trends in 2020 and compare them with previous years.
METHODS: Belgian national HIV surveillance data 2017-2020 were analysed for trends in HIV testing, HIV diagnoses, VL measurements, ART uptake and PrEP purchase. Descriptive statistics from 2020 are compared to annual averages from 2017 to 2019 (proportional difference, %).
RESULTS: In 2020, 725 HIV infections were diagnosed in Belgium (- 21.5% compared to 2019). The decline was most pronounced during the first lockdown in April-May but also present in July-December. The number of HIV tests performed decreased by 17.6% in 2020, particularly in March-May and October-December (- 57.5% in April and -25.4% in November 2020 compared to monthly 2017-19 numbers). Diagnosis of acute HIV infections decreased by 47.1% in 2020 (n = 27) compared to 2019 (n = 51). Late HIV diagnoses decreased by 24.7% (95% CI [- 40.7%; -9.7%]) in 2020 compared to 2019. Of patients in care in 2019, 11.8% interrupted HIV care in 2020 compared to 9.1% yearly in the 3 previous years. The number of HIV patients with VL monitoring per month dropped in March-May 2020, whilst proportions of VL suppression and ART coverage remained above 86% and 98.5% respectively in 2020. PrEP purchases, number of purchasers and starters dropped during April-May 2020 (respectively - 45.7%, - 47.4%, - 77.9% in April compared to February 2020).
CONCLUSIONS: The significant decrease in HIV diagnoses in Belgium in 2020 coincided with the COVID-19 pandemic and following containment measures, particularly in April-May during the first lockdown. A slowdown of HIV transmission due to reduced HIV risk exposure is suggested by the halving in diagnosis of acute HIV infections in March-December 2020 compared to the previous year, and the adaptive decrease in PrEP use and PrEP initiation from April onwards. Despite a slight increase in HIV care interruptions, the indicators of quality of HIV care remained stable. Access to prevention, testing and care for all people living with HIV and at risk of acquiring HIV is a priority during and after times of pandemic.
Disciplines :
Immunology & infectious disease
Author, co-author :
Van Beckhoven, Dominique ; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium. dominique.vanbeckhoven@sciensano.be ; Faculty of Public Health, Université Catholique de Louvain, Brussels, Belgium. dominique.vanbeckhoven@sciensano.be
Serrien, Ben; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Montourcy, Marion; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Verhofstede, Chris; Department of Diagnostic Sciences, Aids Reference Laboratory, Ghent University, Ghent, Belgium
Van den Bossche, Dorien; Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
Libois, Agnes; Department of Infectious Diseases, Saint-Pierre University Hospital, Université Libre de Bruxelles, Brussels, Belgium
De Geyter, Deborah; Department of Clinical Biology, Laboratory of Microbiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
The Belgian HIV surveillance is financed by the National Institute for Sickness and Invalidity Insurance (INAMI/RIZIV). The design of the study, data collection, analysis, interpretation of results and writing of the manuscript was performed independently of the National Institute for Sickness and Invalidity Insurance.We acknowledge as collaborating authors to this study, the following members of the Belgian Research on AIDS and HIV Consortium (BREACH): Nathalie Ausselet (HRC UCL-Namur), Marie-Luce Delforge (ARL Hôpital Erasme), Rémy Demeester (HRC CHU de Charleroi), Paul De Munter (HRC UZ Leuven), Eric Florence (HRC ITM), Jean-Christophe Goffard (HRC Hôpital Erasme), Benoït Kabamba (ARL UCL), Agnès Libois (HRC CHU Saint-Pierre), Rembert Mertens (HRC UZ Brussel), Peter Messiaen (HRC Jessa ziekenhuis), Michel Moutschen (HRC CHU de Liège), Denis Pierard (ARL UZ Brussel), Dolorès Vaira (ARL CHU de Liège), Linos Vandekerckhove (HRC UZ Gent), Dorien Vanden Bossche (ARL ITM), Sigi Van den Wijngaert (ARL CHU St Pierre), Kristel Van Laethem (ARL UZ Leuven), Jens Van Praet (HRC AZ Sint-Jan), Chris Verhofstede (ARL Universiteit Gent), Jean-Cyr Yombi (HRC Cliniques Universitaires Saint-Luc).
Commentary :
We acknowledge as collaborating authors to this study, the following members of the Belgian Research on AIDS and HIV Consortium (BREACH): Nathalie Ausselet (HRC UCL-Namur), Marie-Luce Delforge (ARL Hôpital Erasme), Rémy Demeester (HRC CHU de Charleroi), Paul De Munter (HRC UZ Leuven), Eric Florence (HRC ITM), Jean-Christophe Goffard (HRC Hôpital Erasme), Benoït Kabamba (ARL UCL), Agnès Libois (HRC CHU Saint-Pierre), Rembert Mertens (HRC UZ Brussel), Peter Messiaen (HRC Jessa ziekenhuis), Michel Moutschen (HRC CHU de Liège), Denis Pierard (ARL UZ Brussel), Dolorès Vaira (ARL CHU de Liège), Linos Vandekerckhove (HRC UZ Gent), Dorien Vanden Bossche (ARL ITM), Sigi Van den Wijngaert (ARL CHU St Pierre), Kristel Van Laethem (ARL UZ Leuven), Jens Van Praet (HRC AZ Sint-Jan), Chris Verhofstede (ARL Universiteit Gent), Jean-Cyr Yombi (HRC Cliniques Universitaires Saint-Luc).
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