# Changes in HIV incidence during the COVID-19 pandemic (2020–22) compared with the pre-pandemic period (2015–19) in Peru: An observational study

## TL;DR

HIV incidence in Peru dropped during the early pandemic but rose above pre-pandemic levels by 2022, especially in the Amazon region.

## Contribution

This study provides the first observational analysis of HIV incidence changes in Peru during the pandemic compared to pre-pandemic years.

## Key findings

- HIV incidence in 2020 was 26% lower than in the pre-pandemic period.
- By 2022, HIV incidence was 16% higher than pre-pandemic levels, especially in the Amazon region.
- HIV incidence among men and younger age groups showed significant fluctuations during the pandemic.

## Abstract

During the COVID-19 pandemic, non-pharmaceutical interventions affected the screening of sexually transmitted infections. We investigated the incidence of HIV infection during the COVID-19 pandemic compared with incidence in the pre-pandemic period.

In this observational study, we analyzed HIV surveillance data for all age-groups from 25 geographically diverse regions in Peru from Jan 1, 2015 to Dec 31, 2022. HIV incidence during the COVID-19 pandemic (2020, 2021, and 2022) was compared with pre-pandemic rates (2015–19).

Overall, there were 65,166 new cases of HIV infection from January 1, 2015 to December 31, 2022. HIV incidence risk ratio (IRR) was 26% lower in 2020 (IRR = 0.74; 95% CI, 0.71–0.76), 5% higher in 2021 (IRR = 1.05; 95% CI, 1.02–1.08) and 16% higher in 2022 (IRR = 1.16; CI, 1.13–1.20), compared with the pre-pandemic period. Furthermore, compared with the pre-pandemic period, the annual incidence of HIV among men was 29% lower in 2020 (IRR = 0.71; 95% CI, 0.68–0.73), 4% higher in 2021 (IRR = 1.04, 95% CI, 1.01–1.08) and 10% higher in 2022 (IRR = 1.10; 95% CI, 1.06–1.14). In the age-stratified analysis, the annual HIV incidence in 2020 was 21 and 33% lower for those aged 18–29 (IRR = 0.79; 95% CI, 0.75–0.83) and 30–59 (IRR = 0.67; 95% CI, 0.64–0.70), respectively, compared with the pre-pandemic period. Finally, annual HIV incidence has decreased in 11 out of 25 regions in 2020, compared with the pre-pandemic period.

Our study showed that during the COVID-19 pandemic in 2020, the incidence of HIV infection in the population of Peru decreased. However, this incidence began to return to pre-pandemic rates in 2021, coinciding with the easing or elimination of non-pharmaceutical interventions. By 2022, the incidence of HIV infection was higher than in the pre-pandemic period, especially in regions of the Peruvian Amazon.