Impact of COVID-19 on late HIV diagnosis rates by race/ethnicity in Ending the HIV Epidemic (EHE) priority jurisdictions in the United States

INTRODUCTION: This study aims to determine the effect of the COVID-19 pandemic on changes in late HIV diagnoses by race/ethnicity across Ending the HIV Epidemic (EHE) priority jurisdictions in the US. METHODS: We analyzed annual county- and state-level (when county-level data were unavailable) late HIV diagnosis data in EHE priority jurisdictions from local epidemiological profiles and the AIDSVu between 2017-2022. Descriptive analyses were conducted to examine the percentages of late diagnoses across racial/ethnic groups before and after the onset of the pandemic. We then used interrupted time-series analysis to assess changes in both the level and trend of late diagnosis percentages across non-Hispanic White, non-Hispanic Black, and Hispanic populations. RESULTS: We included a total of 31 jurisdictions. The highest percentages of late HIV diagnoses were more often reported among Black or Hispanic populations. There were statistically significant (P<0.05) downward trends in late diagnosis percentages before the pandemic among the Black population in Kings County, NY(-3.8%), Georgia(-0.8%), and Los Angeles County, CA(-4.5%), and among the Hispanic population in Georgia(-4.9%). Subsequently, there were significant immediate increases in 2020 in the Black population in Kings County, NY(11.5%), Georgia(2.5%), and Los Angeles County, CA(10.8%), and among the Hispanic population in Georgia(11.5%). Additionally, there was a significant annual increase in the trend after the onset of the pandemic in both the Black(1.0%) and Hispanic populations(4.8%) in Georgia. In contrast, no statistically significant changes were found in the White population. CONCLUSIONS: The COVID-19 pandemic appears to have exacerbated existing race/ethnic disparities in late HIV diagnoses among several EHE jurisdictions.