While reduced detection is reflected in the sample size of the 2020 data in this study and Tajikistan suffered from various COVID-19 restrictions which hindered testing during the pandemic, the Tajikistan health system demonstrated improved detection about one year into the pandemic in 2021 with an all-time high median CD4 count of near 450 cells/μL, but this improvement returned to near pre-pandemic detection levels in 2022 and 2023 with a downward trajectory. Here, CD4 is linked to COVID-19.