If lockdowns and stay – at – home orders are succeeding in slowing the spread of the coronavirus , health experts warn that the measures could unintentionally undermine efforts to contain another potentially deadly disease : HIV.
At the start of April, Travis Sanchez , an epidemiologist at Emory University , carried out an online survey of around 1 , 000 men and half of them reported a drop in the number of sexual partners, as well as reduced use of hook- up apps .
In theory, this should reduce transmission .
But he quickly added a disturbing warning : a quarter of the men said they had experienced problems getting tested for sexually transmitted diseases , because thousands of centers that used to provide them have closed down .
That means that those people still having sex have no idea about their status , which Sanchez warned is a potential ticking bomb .
“ It’ s very likely that people ’ s risk behaviours will resume before they will have full access to prevention services , ” he said .
“ And I think that combination could lead to increases in HIV transmission . ”
The full impact of the pandemic on HIV transmission will not be known before next year , when the Centers for Diseases Control and Prevention publishes its statistics on 2020 infections .
But numerous experts and healthcare professionals fear a step backward , a year after the United States announced the goal of cutting the number of new infections by 75 percent by the year 2025 .
In Washington , a city that has been hit hard by HIV, the Whitman – Walker clinic has had to stop its daily walk – in tests for the virus and other sexually transmitted infections like syphilis , gonorrhea and chlamydia.
“All those folks are going without testing, ” said nurse practitioner Amanda Cary , who now only sees symptomatic patients by appointment . “ I do think there’ s going to be a rise in STIs , ” she said .
The CDC told AFP it was expecting a drop in the number of STIs being diagnosed in the short term , “ but an increase in the long -term once restrictions lift and more people are screened and tested again . ”
It said that for HIV, “ the decrease in the availability of testing and limited access to treatment and prevention services may result in more infections and poor health outcomes in the long run. ”
– Everything can change –
In San Francisco , Doctor Matthew Spinelli worries about the homeless , or those who lack the connectivity to take part in the televisits that have replaced in- person visits to health centers .
“ People are just scared of a hospital right now , so I’ m pretty worried, ” said Spinelli , who practices at the city’ s largest hospital .
His clinic is also following some 3 , 000 people living with HIV.
He fears that in the chaos of the pandemic , some of them are not going to pharmacies or taking their daily medication , which could allow their viral load to shoot up and make the patients become contagious again .
“ I’ m worried that their mental health or substance use may be worsening in this environment and hence their pill- taking adherence is worse .
In the United States , the use of the preventive daily pill PrEP , which allows those who take it to be almost 100 percent risk-free from contracting HIV during unprotected sex , has increased , but Spinelli reports that some have stopped taking it during the lockdown .
Which leads to the question : will they start again afterwards ?
“ On the balance it is probably going to worsen the HIV epidemic, that would be my prediction , both in this country, and worldwide, ” Spinelli said .
But by forcing healthcare professionals to improvise, the pandemic will also bring about other lasting, positive changes in prevention strategies.
Telemedicine will become commonplace, for one thing . Needle exchange programs are already handing out more syringes at one time , and even shipping them out by mail .
The use of home HIV test kits , which have been around for years but have been under -utilized , will spread , said Stephen Lee , director of Nastad , an association of public health officials who specialize in HIV.
The CDC is pushing home -testing, and both Florida and Tennessee are considering implementing it .
“ The pandemic has shown us that we can and should do it , ” he said .
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