Officials expect greater spread of HIV this year
By Deborah Jeanne Sergeant
For people at risk for human immunodeficiency virus (HIV) infection, receiving regular testing and prompt test results can help reduce their chances of spreading HIV. Since the pandemic began last spring, testing and prompt results have been disrupted.
According to Planned Parenthood of Central and Western New York, which maintains offices serving the Rochester, Buffalo and Syracuse areas, testing for HIV has decreased dramatically since the local onset of the pandemic.
The agency facilitated 4,644 tests from Mar. 1, 2019 through Oct. 1, 2019. During the same period in 2020, the number of tests plummeted to only 2,403. That is 51% fewer tests.
The reasons vary behind why testing has declined so dramatically.
“I think that is directly related to our patients not wanting to come in,” said Amy Hsi, nurse practitioner for Planned Parenthood of Central and Western New York in Rochester, Buffalo and Syracuse. “In general, it’s because of the risk of COVID and having to adjust for safety reasons.”
The healthcare industry underscored the seriousness of COVID-19 by suspending non-emergency services for weeks during the pandemic’s onset. Although on April 1, Planned Parenthood announced expansion of telehealth, testing for HIV through Planned Parenthood requires a physical presence.
“Most healthcare providers are offering telehealth services so people can get care, but for HIV testing, you have to go somewhere,” Hsi said. “They need to come in or we could order it and they could go to a lab.”
The agency does not provide home-based tests for patients to take or mail to a lab. Home tests are available at pharmacies such as CVS and Rite Aid for about $35 to $45. Oral tests offer accurate results in minutes; however, they are only accurate if the test is taken after three months of the exposure incident. For people who frequently engage in risky activity, waiting that long for test results can contribute to the spread of HIV.
Although healthcare providers have opened back up for seeing more patients, the social distancing rules mean fewer patients can be admitted in offices at a time. That can hamper providers’ ability to offer services in a timely fashion.
Hsi said that periodic surges in COVID-19 infection numbers continue to keep many wary patients away.
She thinks that the pandemic may cause greater spread of HIV compared with previous years. At this point, it is difficult to tell.
“If people really are self-quarantining and not getting out as much, they may not be doing at-risk activities,” Hsi said. “Then again, maybe people at home are having more unprotected sex without knowing their HIV status. If people can’t get condoms and PrEP, it puts them more risk.”
Pre-Exposure Prophylaxis (PrEP) is a daily medication that can prevent people at high risk for HIV from contracting the infection.
According to the Centers for Disease Control and Prevention, “In the United States, HIV is mainly spread by having sex or sharing syringes and other injection equipment with someone who is infected with HIV. Substance use can contribute to these risks indirectly because alcohol and other drugs can lower people’s inhibitions and make them less likely to use condoms.”
Number of Tests Up at Evergreen Health
Trillium Health, which serves Buffalo and Rochester, offers HIV testing among its services. Ashley Zuppelli, senior director of strategic service lines, said that the organization has seen a decrease from 200 HIV tests per month in 2019 to about 125 per month since the pandemic began.
Part of the reason is that Trillium is not accepting walk-in patients.
Completing fewer tests may mean that more people who are unknowingly infected could spread HIV.
“It’s a significant concern,” Zuppelli said. “We’re starting to see an increase of new COVID infections. I suspect that people seeking testing services will decline again.”
At Evergreen Health in Buffalo, Matthew Crehan Higgins, associate vice president of specialty care, said that the number of tests performed has increased because in March, the Erie County Department of Health began focusing on COVID-19 testing and routing sexual health patients to Evergreen.
“We’ve seen increases across all sexually transmitted infection testing,” Crehan Higgins said.
He takes pride in the main office of the organization remaining open throughout the pandemic, although some sites and outreaches have had to close and tweak their hours and policies.
“Nonavailability of services leading to more transmission is one reason we felt committed to stay open,” he said. “During this time period, we felt the need to be here as much as we could. Virtual doesn’t work for everybody. There are plenty of people who don’t have access to technology or own a smartphone. We had times where a staff member wasn’t here but the person came here to use a phone.”
The state provides a Home Test Giveaway (HTG) program which offers consumers a free home HIV test kit as needed.
The request form for the New York State Home Test Giveaway is at https://survey.alchemer.com/s3/5977532/HHTG-Fall-2020-Eligibility-Survey-Live.