Publication date: Mar 24, 2025

The COVID-19 pandemic affected sexually transmitted infection (STI) testing and diagnosis rates in the United States (U. S.), but these patterns have not been well characterized among people with HIV (PWH). We analyzed medical records data of HIV Outpatient Study (HOPS) participants seen for HIV care from January 2019-March 2021, with ≥1 CD4+ cell count and viral load test results recorded. We used Poisson regression models to estimate rate ratio (RR) and 95% confidence interval (CI) to compare STI testing and diagnoses rates on/after vs before March 1, 2020 (early COVID-19 pandemic (pandemic) vs. pre-pandemic). Of 2,311 eligible patients, STI tests (STI cases, primarily defined as tests that were positive) were as follows during the analysis timeframe: 4,991 gonorrhea (157), 4,978 chlamydia (135), and 4,216 syphilis (114). Comparing pandemic vs. pre-pandemic periods, STI testing RRs were 0. 78 for both gonorrhea (CI: 0. 73-0. 82) and chlamydia (CI: 0. 73-0. 83), and 0. 93 for syphilis (CI: 0. 88-0. 99); diagnosis rates were not statistically different. Multivariable models showed reduced testing for gonorrhea (adjusted RR 0. 79, CI: 0. 72-0. 87) and chlamydia (adjusted RR 0. 78, CI: 0. 71-0. 86) for men who have sex with men, but not for other HIV transmission groups. The fallout of the COVID-19 pandemic on sexual health may not be seen for some time. Despite reduced STI testing, rates of STI diagnoses did not decrease. It will take a return to more routine screening and improved access to sexual health care to uncover the true impact of undetected or untreated STIs.

Semantics

Original Article