The impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV in Catalonia, Spain: A population-based cohort study

The COVID-19 pandemic disrupted healthcare services usage. We estimated the impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV (PLWH) in Catalonia, Spain. We accessed public healthcare usage in HIV units, primary care, hospitals, and emergency departments among 17,738 PLWH in the PISCIS cohort from January 1, 2017, to December 31, 2020. We performed an interrupted time series analysis using the autoregressive integrated moving average to estimate the effect of COVID-19 on medical visits and HIV monitoring among PLWH. A non-significant decrease of 17.1% (95% CI: [−29.4, 0.4]) in overall medical visits was observed during the lockdown, followed by a steady resumption until the end of 2020. Three health facilities presented statistically significant declines in visits during the lockdown: HIV units (−44.8% [−56.7, −23.6]), hospitals (−40.4% [−52.8, −18.1]), and emergency departments (−36.9% [−47.0, −21.9]); thereafter, the visits have begun to increase steadily but not to previous levels as of December 2020. In contrast, primary care visits remained unchanged during the lockdown by 1.9% (95% CI: −13.5, 23.9). CD4 cell (54.2% [95% CI: −64.4, −36.0]) and HIV RNA viral load (53.1% [95% CI: −62.9, −36.1]) laboratory monitoring reduced significantly during the lockdown. COVID-19 lockdowns significantly disrupted in-person healthcare services usage among PLWH. The reduction in healthcare utilization however did not affect primary care services. Despite services gradually rebounding to pre-pandemic levels, it is imperative to effectively prepare for future pandemics and implement measures to ensure continuous provision of care to PLWH during pandemic lockdowns. La pandemia de COVID-19 interrumpió el uso de los servicios sanitarios. Estimamos el impacto de la pandemia de COVID-19 en la utilización de los servicios de salud entre las personas que viven con el VIH (PVV) en Cataluña, España. Registramos el uso de la atención médica pública en unidades de VIH, atención primaria, hospitales y centros de urgencias en 17.738PVV de la cohorte PISCIS desde el 1 de enero de 2017 hasta el 31 de diciembre de 2020. Realizamos un análisis de series temporales interrumpidas utilizando el promedio móvil integrado autorregresivo para estimar el efecto de la COVID-19 en las consultas médicas y el seguimiento del VIH entre las PVV. Se observó una disminución no significativa del 17,1% (IC95%: −29,4 a 0,4) en las visitas médicas generales dur