Abstract

Scope and objectives. The spread of HIV has stabilized in Estonia in recent years but remains high. The aim of this study was to assess how large a proportion of the population was tested for HIV during the provision of health care services at least once from 2018 to 2020, testing outcomes, and the effects of COVID-19 pandemic on testing rates.
Methods. This retrospective study used data from the Estonian Health Insurance Fund database for treatment claims and the Health Board database for infectious diseases reporting.
Results and conclusions. In 2018–2020, 14% of people who received health care services were tested for HIV at least once. A total of 439 new HIV cases were diagnosed (85% of all HIV cases in Estonia during this period). The highest proportion of tested people was among women, people aged 16–49-years and people living in North-East Estonia (Ida-Viru County). The percentage of tested was 19%, 24%, and 22%, respectively. The highest positivity rate was among 16–49-year-old men (0.7% were newly diagnosed with HIV). The positivity rate among women of the same age was 0.1%. During the first year of the COVID-19 pandemic, testing decreased by 15%. The test rate decreased the most among both men and women aged 16–49-years in Harju and Ida-Viru counties (15–22%), the regions with historically highest HIV rates. Restrictions associated with the pandemic did not significantly impact HIV testing for indicator conditions, which remained at 2012–2015 levels. Depending on the indicator condition, the testing rate in primary care was 1–6% and in specialist care 5–33%. A large proportion of people tested for HIV in health care are of low-risk groups, especially young women, who are tested during pregnancy. More attention should be paid to testing people with a higher risk for HIV, including patients with HIV indicator conditions and people from higher prevalence regions, especially men, in both primary and specialist care.