Evaluating the Effects of the COVID-19 Pandemic on HIV Testing, Enrollment, ART Use and Mortality in Suriname Using Interrupted Time Series Analysis

Abstract

Our study evaluates the changes in HIV testing, new enrollments in the HIV surveillance system, treatment, and mortality of people with HIV during and after the SARS-CoV-2 (COVID-19) pandemic in Suriname. A retrospective population-based study was conducted, using interrupted time series analyses with data from the HIV surveillance system from January 2013 until December 2023. The commencement of the COVID-19 pandemic lead to a decline in HIV testing, enrollment, treatment initiation, and the annual number of individuals receiving treatment, respectively, by 16%, 32%, 40%, and 2% in 2020 compared to 2019. The mortality rate among people with HIV went from 7.8 in 2019 to 26 per 100,000 in 2022. The regression model showed an immediate significant effect at the start of the COVID pandemic for the HIV enrollments and the yearly number of people on treatment. For HIV mortality there is significant sustained effect. An overall decline in HIV services resulted in an increased mortality in 2021 and 2022. Innovative strategies and additional human and financial investments are needed to regain and improve access to health services and reverse the current epidemical trend.