Impact of the COVID-19 pandemic public health measures on HIV consultations in England

We describe changes in HIV consultations in England (2019-2021) due to COVID-19 and briefly explore the consultation medium in 2023. National attendance-based HIV surveillance data (2019-2021) were analysed by demographics, consultation medium and clinical complexity. Preliminary 2023 analyses focused on the consultation medium. There were 358,734 consultations in 2019, 327,156 in 2020, and 361,703 in 2021, corresponding to 90,238, 88,560, and 91,387 people accessing care, respectively. Consultations were lowest between April and May 2020 during the first lockdown. Telephone consultations rose sharply by 603% from 734 in February to 5163 in March 2020 with consultations recovering in late 2020. Face-to-face consultations declined across all age groups between 2019 and 2020, with smaller reductions among those aged 50-64 and 65+. The second and third lockdowns produced less steep declines in consultations. In 2023, virtual consultations accounted for 15% of the total 391,174 consultations. Fewer people accessed HIV care in 2020 compared to 2019, reflecting the impact of COVID-19 on service delivery. This highlights the need for evaluating the impact on retention in care as people lost to follow-up may face treatment interruptions and adverse health outcomes. Despite disruption, rapid service adaptation mitigated major impacts in care, with virtual consultations remaining integral in 2023.