New: CDC’s 2020 HIV Surveillance Report Shows COVID Disruptions

Posted May 31, 2022

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On May 24, 2020, the Centers for Disease Control and Prevention (CDC) published a new HIV surveillance report: Diagnoses of HIV Infection in the United States and Dependent Areas, 2020 and a new HIV supplemental surveillance report: Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data, United States and 6 Dependent Areas, 2020CDC will also publish an AtlasPlus update that will include data from these reports.

The COVID-19 pandemic in the United States led to disruptions in HIV testing services and access to clinical services throughout 2020. This disruption resulted in a steep, single-year decline in HIV diagnoses that is mostly attributed to declines in testing caused by less frequent visits to health centers, reduced outreach services, and shifting of public health staff to COVID-19 response activities. Given these disruptions, data for 2020 should be interpreted with caution. For these reasons, although data are presented for HIV diagnoses, trends that include 2020 are not discussed in the commentary sections of the new reports. COVID-19 disruptions in HIV testing and care during 2020 have also made estimation of incidence, prevalence, and knowledge of status unreliable. Therefore, the HIV surveillance supplemental report Estimated HIV Incidence and Prevalence in the U.S., which provides data on estimated incidence, prevalence, and knowledge of status in the U.S., was not published this year.

The overall number of HIV diagnoses in the United States in 2020 (30,403) was 17% lower than in 2019. Disruptions in clinical care services, patient hesitancy in accessing clinical services, shortages in HIV testing reagents and materials, shifting of partner services staff to COVID-19 activities, and disruptions in services provided by community-based organizations in 2020 likely led to underdiagnosis of HIV in the U.S. Although state and local health departments quickly developed and implemented innovative strategies for HIV-related testing and care services, such as self-testing and telehealth, during the first year of the COVID-19 pandemic, these strategies did not make up for declines in laboratory-based HIV testing. In addition, telehealth visits might not have included orders for laboratory testing due to social distancing recommendations, or patients may have been reluctant to access testing during this time. Underreporting of laboratory test results to state and local HIV surveillance programs was not a major contributor to declines in diagnoses, as all jurisdictions reported entry and reported to CDC all laboratory results received.

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