Covid disruptions in HIV testing and prevention highlight need for innovation and investment before next public health emergency

The nation’s ability to prevent HIV was dealt a hard blow early in the COVID-19 pandemic, according to a new CDC analysis published today, on World AIDS Day: Putting Ourselves to the Test: Achieving Equity to End HIV. A rapid rebound in services, however, is a testament to quick, resourceful local innovations that, if scaled up and sustained, could help reach national HIV prevention goals.

HIV testing and prescriptions for pre-exposure prophylaxis (PrEP) dropped substantially during the onset of the COVID-19 pandemic in 2020. HIV tests declined about 32% between the first and second quarters of the year, and PrEP prescriptions fell about 6%. Testing and PrEP prescriptions started to rebound in the second half of 2020, but they did not reach pre-pandemic levels until early 2021. The initial falloffs were likely due to disruptions to in-person clinic services and redeployment of public health staff to respond to COVID-19.

Although HIV testing and PrEP prescriptions were disrupted with the arrival of the COVID-19 pandemic, the provision of highly effective HIV treatment remained strong. The proportion of people linked to care after they received an HIV diagnosis—and the proportion of people with HIV with a suppressed viral load—both remained stable.

To overcome serious roadblocks and maintain access to critical HIV services, communities, clinicians, and healthcare systems launched or expanded an array of programs that included telehealth, self-testing, and home-delivery of HIV treatment. A number of efforts by the Health Resources and Services Administration and Ryan White HIV/AIDS program prevented treatment interruptions.

Investment in local community innovation is vital to strengthening our nation’s HIV prevention and care systems to endure future public health emergencies. Expanding those innovations can also help achieve national goals to end the HIV epidemic.

Jonathan Mermin, MD, MPH,

Director of CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, says:

“Today, the world celebrates the dedication, resilience, and creativity of people with HIV and their public health and clinical allies who refused to let a new pandemic stand in the way of ending a longstanding one. It is just this type of resolve that, when paired with resources, will enable the nation to weather public health emergencies and prevent HIV at the same time.”

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