Setting: Health facilities providing human immunodeficiency
virus (HIV) testing, care and treatment in Liberia.
Objective: To evaluate individuals aged 15 years who
were tested, diagnosed and enrolled into HIV care before
(2013), during (2014) and after the Ebola outbreak
(2015).
Design: A cross-sectional descriptive study.
Results: A median of 6930 individuals aged 15 years
per county were tested for HIV before the Ebola outbreak;
this number declined by 35% (2444/6930) during the
outbreak. HIV positivity remained similar before
(7028/207314, 3.4%) and during the outbreak
(4146/121592, 3.5%). During Ebola, HIV testing declined
more in highly affected counties (68035/127468,
47%) than in counties that were less affected
(16444/23955, 31%, P  0.001). Compared to the
pre-Ebola period, HIV testing in less-affected counties recovered
more quickly during the post-outbreak period,
with a 19% increase in testing, while medium and highly
affected counties remained at respectively 38% and 48%
below pre-outbreak levels. Enrolment for HIV care increased
during and after the outbreak compared to the
pre-Ebola period.
Conclusion: HIV testing and diagnosis were significantly
limited during the Ebola outbreak, with the most severe
effects occurring in highly affected counties. However,
enrolment for HIV care and treatment were resilient
throughout the outbreak. Pro-active measures are
needed to sustain HIV testing rates in future epidemics.