With COVID, 2020 was a ‘lost year’ in the fight against HIV

May 25, 2022 — Due to the COVID-19 pandemic, 2020 was likely a “lost year” in the public health fight against the long-running HIV epidemic in the United States, a public health official says.

The launch of a federal initiative called “Ending the HIV Epidemic in the US” has been overshadowed by delays in diagnosis and treatment due to lockdown and other coronavirus-related safety restrictions.

“We definitely had a hit from COVID-19,” Demetre Daskalakis, MD, director of the CDC’s Division of HIV/AIDS Prevention, told NBC News.

“We don’t really know where HIV transmission will end up, but it’s something we’re obviously concerned about,” he said.

Public health officials speak about the 40-year HIV epidemic this week after the release of the CDC’s annual HIV surveillance report. The report includes data from 2020 showing that HIV testing fell sharply in the first year of the pandemic due to disruptions in clinical care, hesitance to seek healthcare services and shortages of HIV testing materials.

It could be years before the pandemic-related disruptions to HIV services are reversed, NBC News reported. The national HIV transmission rate could also potentially increase again after years of decline.

HIV diagnoses fell 17% from 2019 to 2020, according to the CDC report. Nearly 37,000 cases were diagnosed in 2019, compared to about 30,600 in 2020. Since 2016, the numbers have declined by no more than 3% annually.

“There’s probably a lot more people who are undiagnosed than we’ve had in the last few years,” Hansel Tookes, MD, an infectious disease specialist who cares for HIV patients at the University of Miami, told the news outlet .

Delays in HIV diagnosis can lead to greater transmission of the disease, he explained. HIV is more easily transmitted when people have recently contracted the virus and have a high viral load. When people are diagnosed and start antiretroviral therapies, transmission decreases.

The HIV Surveillance Report found that in 2020, nearly 1.1 million people were living with diagnosed HIV in the United States. Based on 2019 data, the CDC previously estimated that 1.2 million Americans are likely to have HIV, including those who have not been diagnosed.

The report also shows how the pandemic has exacerbated inequalities in HIV transmission. Overall, the diagnosis rate in the South was twice that in the Midwest in 2020. Georgia had the highest HIV diagnosis rate of the year at 22 diagnoses per 100,000 people, compared to 12 per 100,000 in California and New York.

The epidemic also disproportionately affects Black Americans, who make up 13% of the US population but accounted for 42% of HIV diagnoses in 2020. Hispanic and Latino Americans accounted for 27% of the diagnoses and White Americans for 26% of the diagnoses.

“Racial and ethnic disparities in new HIV diagnoses persist,” the CDC wrote in the report. “Racism, HIV stigma, discrimination, homophobia, poverty and barriers to healthcare continue to drive these disparities.”

Despite the setbacks of 2020, there is some hope. In 2019, Congress approved $267 million to support the launch of Ending the HIV Epidemic in the US. According to NBC News, the initiative will continue this year.

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