The impact of the COVID-19 pandemic on HIV testing in Peru: an interrupted time series analysis from 2014 to 2022

Objectives: Our objective was to evaluate the impact of COVID-19 on the proportion of past-year HIV testing in Peru.

Methods: Utilizing data from the National Demographic and Health Survey of Peru from 2014 to 2022, we conducted an interrupted time series analysis. The proportion of past-year HIV testing per quarter of each year was considered our unit of analysis. Statistical analysis involved segmented regression with Newey-West standard errors, dividing each year of evaluation into four quarters. Additionally, we applied an Autoregressive Integrated Moving Average (ARIMA) model.

Results: We included 211,359 participants aged 15 to 49 years. The proportion of past-year HIV testing in Peru showed a mean decrease of 8.33% (95%CI: -10.73% to -5.93%) after the COVID-19 lockdown (from August-2020) compared to the previous period (before March-2020). Prior to lockdown, there was a mean quarterly increase of 0.30% (95%CI: 0.21-0.40%) in testing proportion, while after the lockdown, there was a mean quarterly decrease of -0.24% (95%CI: -0.56-0.09%). HIV testing declined in 23 of the 25 regions, ranging from - 23.7% to -3.0%, except in Amazonas and Cajamarca, where increases of 5.3% and 6.8% were observed. Predictions of counterfactual values without the pandemic using the ARIMA model revealed a percentage drop of -9.20% (95%CI: -13.70 to -4.80) in observed compared to predicted values.

Conclusions: This study highlights the decrease in proportion of past-year HIV testing in Peru following the COVID-19 lockdown, emphasizing the urgent need for targeted interventions to address disparities and ensure equitable access to testing services.