Impact of the COVID-19 pandemic on regional and national uptake of HIV testing services in Sierra Leone: a descriptive analysis

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BACKGROUND: A key milestone in the reduction of the global HIV burden is reaching the UNAIDS 95-95-95 target by 2025. The COVID-19 pandemic may have affected the ability of countries to achieve this target, but data to describe this impact is limited. This study assessed national HIV testing service uptake in Sierra Leone during three periods of the COVID-19 pandemic. METHODS: We conducted a retrospective cross-sectional study using secondary program data of all patients tested for HIV in all 16 districts of Sierra Leone. Data from March 2019 to February 2020 (pre-COVID-19); March 2020 to February 2021 (during COVID-19); and March 2021 to February 2022 (post-COVID-19) were extracted from DHIS-2 and descriptive analyses were performed using Stata (15.1, StataCorp LLC, College Station, TX). RESULTS: The median number of HIV tests was 58,588 (IQR 54,232 to 62,077) in the pre-COVID phase, 55,141 (IQR 52,975 to 57,689) during the COVID-19 phase, and 74,954 (IQR 72,166 to 76,250) in the post-COVID phase. This shows that HIV testing rate decreased by 6.0% during the COVID-19 period and increased substantially by 36.0% in the post-COVID-19 period. Twice more women than men were tested for HIV across all periods-pre-COVID-19 (38,825 vs. 19,789), during COVID-19 (36,923 vs. 17,755), and post-COVID-19 (49,205 vs. 25,472) phases. CONCLUSION: Our study shows that HIV testing was significantly disrupted during the COVID-19 pandemic but recovered quickly after the pandemic. These findings highlight that lessons learned from previous epidemics may influence adaptive strategies to maintain essential health services during public health emergencies.

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