By: Marcus J. Hopkins, Policy Consultant
A new abstract presented in late October 2020 found that new diagnoses of HIV more than doubled in 13 healthcare centers located on the South and West Sides of Chicago when patients presenting for COVID-19 testing were also tested for HIV (Stanford, Schmitt, Taylor, Eller, Friedman, McNulty, Ridway, Hazra, Michelle, Beavis, & Pitrak, 2020).
This testing effort was undertaken using a preexisting model of automatically testing incoming patients presenting for influenza symptoms, expanding that model to include patients presenting for COVID-19 – an effort that found the rate Acute HIV Infections (AHI) to be significantly higher during COVID-19 testing than in the four previous years – 14.4 (per 100,000) in 2020, compared only 6.8 per year from 2016-2019. AHI patients comprised 25.7% of all new HIV diagnoses – the highest percentage, ever. (Stanford, et al, 2020).
Elsewhere in the U.S., COVID-19 has had a net negative impact on the number and frequency of HIV tests being offered, as virtually all providers have shifted their collective foci to be on COVID-19, which presents a higher short-term mortality rate. This is true across every healthcare setting and across population settings (e.g. – urban, suburban, rural). The concern, here, is that, while everyone’s eyes are on COVID-19, HIV (as well as Viral Hepatitis) will continue to spread relatively unchecked.
In states that were experiencing increases in HIV and Viral Hepatitis diagnoses (such as West Virginia) regular testing has all but ceased. Despite this lack of regular testing, what testing is being done is turning up higher than average numbers of new HIV diagnoses. In West Virginia, for example, with severely reduced testing frequency, there have been 93 new HIV diagnoses in 2020, as of October 22 (Office of Epidemiology and Prevention Services, 2020). Until 2018, the annual number of new cases averaged out to 67 new diagnoses per year.
The decreased testing for HIV is concern, but equally concerning is the decrease in Viral Hepatitis testing – diseases that are more efficiently transmitted and less frequently tested. In many states, Hepatitis B and C testing are treated as an afterthought, already; with the onset of COVID-19 and the switch of focus it has required to deal with the eminent threat to health and human safety, chronic diseases are receiving less attention than ever before, in terms of testing urgency.
Concerns continue to be voiced that, once the COVID-19 threat has passed and we return to some sense of normalcy, we will find that rates of new HIV and Viral Hepatitis diagnoses will explode, as patients who would normally have been tested during non-COVID conditions delayed or were not offered testing during the pandemic.
- Office of Epidemiology and Prevention Services. (2020, October 22). HIV Diagnoses by County, West Virginia, 2018-2020. Charleston, WV: West Virginia Department of Health and Human Resources: Office of Epidemiology and Prevention Services: HIV and AIDS: Increase in HIV. https://oeps.wv.gov/hiv-aids/documents/data/WV_HIV_2018-2020.pdf
- Stanford, K., Schmitt, J., Taylor, M. M., Eller, D., Friedman, E., McNulty, M., Ridway, J., Hazra, A., Michelle, M., Beavis, K., & Pitrak, D. (2020, October 24). LB-6 – Increased Diagnoses of Acute HIV Infection through Routine ED Screening and Rapid Linkage to Care and initiation of HAART During the COVID-19 Pandemic. IDWeek. https://www.eventscribe.net/2020/IDWeek/fsPopup.asp?Mode=presInfo&PresentationID=798014
Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.