D.C.'s HIV decline slowed in 2020

D.C.’s progress in ending the HIV epidemic slowed in 2020 despite drops in new diagnoses, per a new report out Monday.

Driving the news: The annual epidemiology surveillance report measures D.C.’s progress towards ending the HIV epidemic as well as presents new data on sexually transmitted infections, hepatitis, and tuberculosis.

• The authors of the report, which included data through Dec. 2020, say the results should be treated with caution given the pandemic’s impact on health screening and health care access.

Why it matters: D.C. has been hit hard by the HIV epidemic, with a peak of 1,374 new cases in 2007, according to the report, a number that has since declined by 85%.

• Nearly two percent, or 12,161, of D.C.’s population is living with HIV, with Black and Latino residents disproportionately impacted.

Flashback: Since 2015, D.C. has been working towards reducing HIV and, in 2020, increased its goals to:

• Get 95% of HIV-positive residents aware of their status;
• Get 95% of HIV-positive residents in treatment;
• Help 95% of HIV-positive residents reach viral suppression, which means a low viral load that cannot be passed to others;
• And reduce new HIV diagnoses — all by 2030.

Even before the pandemic, D.C. was losing momentum on crushing the epidemic despite huge gains since the mid-2000s.

• In 2019, the Washington Post reported that D.C. would not meet its goals of slashing new HIV infections in half by 2020, a point DC Health officials conceded.

By the numbers: According to the new report, there was a reduction in new HIV diagnoses from 273 in 2019 to 217 towards D.C.’s goal of 130 by 2030.

• 76% of D.C. residents with HIV are in treatment, a drop from 80% in 2019.
• The percentage of residents who have reached viral suppression hasn’t budged from 87% since 2019.
• Data on how many people know their status is still pending, but 90% of HIV-positive residents in 2019 knew their status.
• No babies were born with HIV in 2020, down from 2 in 2019, and only 1 case in 2020 was due to injection drug use, down from 150 in 2007.
• But while more than half of people living with HIV in D.C. are over the age of 50, those aged 13 to 24 made up 19% of new cases between 2016 and 2020.

• 58% of those newly diagnosed with HIV were linked to medical care within 7 days and 80% within 30 days, the report says. 49% of people were virally suppressed within 3 months, a decrease from 2019, which shows people are not getting on HIV treatment fast enough.

The report also says there were 5,956 cases of chlamydia, 3,593 cases of gonorrhea, and 234 cases of primary and secondary syphilis reported in 2020.

• There were 874 people with newly reported Hepatitis C in 2020.

What they’re saying: In a statement, the mayor’s office pointed to a new hotline launched in 2021 to connect HIV-positive people with PrEP, a drug that prevents transmission, and that free rapid HIV test kits became available in 2020.

• “And we will continue putting these tools in place and making sure people know about them so that we can prevent new HIV cases, help more people reach viral suppression, and crush this epidemic,” Mayor Muriel Bowser said in a statement.

What’s next: To achieve the goals set in 2020, the report says D.C. has to work on increasing the uptake and use of PrEP to get more than 13,000 people on the medication.