Background The degree to which the 2019 novel coronavirus disease (COVID-19) pandemic will affect the US human immunodeficiency virus (HIV) epidemic is unclear. Methods We used the Johns Hopkins Epidemiologic and Economic Model to project HIV infections from 2020 to 2025 in 32 US metropolitan statistical areas (MSAs). We sampled a range of effects of the pandemic on sexual transmission (0–50% reduction), viral suppression among people with HIV (0–40% reduction), HIV testing (0–50% reduction), and pre-exposure prophylaxis use (0–30% reduction), and indexed reductions over time to Google Community Mobility Reports. Results Simulations projected reported diagnoses would drop in 2020 and rebound in 2021 or 2022, regardless of underlying incidence. If sexual transmission normalized by July 2021 and HIV care normalized by January 2022, we projected 1,161 (1%) more infections from 2020 to 2025 across all 32 cities than if COVID had not occurred. Among “optimistic” simulations in which sexual transmission was sharply reduced and viral suppression was maintained we projected 8% lower incidence (95% credible interval: 14% lower to no change). Among “pessimistic” simulations where sexual transmission was largely unchanged but viral suppression fell, we projected 11% higher incidence (1% to 21% higher). MSA-specific projections are available at jheem.org?covid. Conclusions The effects of COVID-19 on HIV transmission remain uncertain and differ between cities. Reported diagnoses of HIV in 2020–2021 are likely to correlate poorly with underlying incidence. Minimizing disruptions to HIV care is critical to mitigating negative effects of the COVID-19 pandemic on HIV transmission.

中文翻译：

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COVID-19 大流行对 HIV 传播的潜在影响：美国 32 个城市的建模研究

背景 2019 年新型冠状病毒病 (COVID-19) 大流行对美国人类免疫缺陷病毒 (HIV) 流行的影响程度尚不清楚。方法 我们使用约翰霍普金斯流行病学和经济模型预测 2020 年至 2025 年美国 32 个大都市统计区 (MSA) 的 HIV 感染情况。我们抽取了大流行对性传播（减少 0-50%）、HIV 感染者的病毒抑制（减少 0-40%）、HIV 检测（减少 0-50%）和暴露前预防使用的一系列影响（减少 0–30%），并随着时间的推移将减少量编入 Google 社区流动性报告。结果 模拟预测报告的诊断将在 2020 年下降，并在 2021 年或 2022 年反弹，无论潜在发病率如何。如果到 2021 年 7 月性传播正常化并且 HIV 护理到 2022 年 1 月正常化，我们预计 1，从 2020 年到 2025 年，所有 32 个城市的感染人数比没有发生 COVID 的情况多 161 (1%)。在性传播急剧减少和病毒抑制得到维持的“乐观”模拟中，我们预计发病率降低 8%（95% 可信区间：降低 14% 至无变化）。在性传播基本保持不变但病毒抑制下降的“悲观”模拟中，我们预计发病率会高 11%（高 1% 至 21%）。MSA 特定预测可在 jheem.org?covid 上获得。结论 COVID-19 对 HIV 传播的影响仍不确定，并且因城市而异。2020-2021 年报告的 HIV 诊断可能与潜在发病率相关性很低。尽量减少对 HIV 护理的干扰对于减轻 COVID-19 大流行对 HIV 传播的负面影响至关重要。