P-479. The Impact of the COVID-19 Pandemic on HIV Testing in Peru: An Interrupted Time Series Analysis from 2014 to 2022

Abstract Background HIV testing is crucial for early treatment and mortality reduction. In Latin America and the Caribbean, 18% of individuals are unaware of their HIV status, which leads to a late diagnosis. Furthermore, COVID-19 lockdowns had a negative impact on HIV testing rates. This study focused on comparing pre-pandemic (January 2014-February 2020) and post-lockdown (August 2020-December 2022) testing rates to support effective HIV screening and public health strategies.Figure 1.Interrupted time series analysis for the frequency of HIV testing per quarter. Methods We performed an interrupted time series analysis with cross-sectional data from Peru's National Demographic and Health Survey (ENDES), covering 2014 to 2022. ENDES follows a complex, three-stage sampling method: proportional cluster selection, random household selection within clusters, and individual selection aged 15 or older for the health survey. A segmented regression analysis adjusted for age and gender evaluated changes in testing rates, with an ARIMA model providing counterfactual predictions against actual pandemic-period rates.Figure 2.Interrupted time series analysis for HIV testing. Results The study included 211,359 participants aged 15 to 49 years. There was a significant drop in HIV testing by 8.33% (95% CI: -10.73% to -5.93%, p< 0.001) post-lockdown. Before the lockdown, HIV testing rates trend was increasing by 0.30% per quarter (95% CI: 0.21% to 0.40%, p< 0.001); however, after the lockdown, they declined by -0.24% per quarter (95% CI: -0.56% to 0.09%, p=0.125) (Figure 1), with the most pronounced decrease among adolescents (15-17 years), the economically disadvantaged, those who lived in rural areas, and non-capital residents. The ARIMA model indicated a potential non-pandemic decline of -9.20% in testing proportions (95% CI: -13.70% to -4.80%) in comparison with the forecasted values (Figure 2). Conclusion COVID-19 lockdown policies markedly decreased HIV testing in Peru, especially affecting high-risk groups. Although limited by potential recall bias and self-reporting, this research, focusing primarily on individuals aged 15 to 49, provides essential data for targeted interventions to restore and ensure HIV testing accessibility post-pandemic. Disclosures All Authors: No reported disclosures