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National staffing shortages have also left the District with fewer culturally competent professionals to assess, evaluate and treat residents at a time when they face more barriers to accessing care, such as increased homelessness, they said.
“If you don’t know where you’re going to lay your head every night, you’re not really worried about whether you got tested for HIV,” said Clover Barnes, senior deputy director of HIV/AIDS, Hepatitis and STDs at DC Health. and Tuberculosis Administration.
New HIV cases have decreased slightly from last year and are part of a general downward trend since a peak in cases almost two decades ago. Following a national trend, syphilis cases among women and their babies increased in 2022, but evidence suggests the trend may change, district public health experts say.
“The pandemic had an immense impact on the availability, accessibility and utilization of disease detection, prevention and care services, which have not yet returned to pre-pandemic levels. “Care-seeking behaviors, especially those related to preventive measures, are still lagging,” the report says.
Public health officials say they are trying to be creative to improve access to care, especially for Black residents, who are disproportionately affected. meeting people where they are, appearing at events and recruiting artists to share messages about prevention and treatment.
That has been a challenge as the District’s federally qualified health centers and community organizations have faced nationwide staffing shortages, Barnes said, slowing the District’s efforts to recruit culturally diverse public health workers. sensitive.
“We don’t have the same capacity that we had before Covid,” he said in an interview Thursday.
Less testing leads to more cases, he said, noting new HIV diagnoses, which tend to decrease over time. There were 210 new HIV diagnoses in 2022, up from 224 new diagnoses in 2021 and 274 in 2019, before the coronavirus disrupted care for many. Despite progress since the 2007 peak of 1,374 cases, according to the Annual Epidemiology and Surveillance Report.
About 1.7 percent of the District of Columbia’s population, or 11,747 people, are living with HIV. Blacks make up about 44 percent of the population, but about 70 percent of HIV cases, the report shows.
The Centers for Disease Control and Prevention set goals for dozens of cities, including D.C., that should have fewer than 21 new HIV diagnoses per year by 2030, although Barnes said the numbers may be revised.
Although the District has not reported any babies born with HIV since 2019, syphilis cases in infants increased in 2022, along with an overall increase in syphilis cases, according to the report. Three in five people diagnosed with syphilis in 2022 were black, data shows, as numbers rose 10 percent from 692 in 2021 to 761 in 2022.
Barnes said preliminary congenital syphilis numbers for 2023, which rose to 12 in 2022 from 3 in 2019, showed improvement as the focus shifted to better understanding the needs of women with the infection, which is linked to the substance abuse.
Doctors are encouraged to test at-risk women throughout their pregnancy, but Barnes said sometimes a woman may only get tested in the third trimester, making effective treatment difficult. That is, if they have access to prenatal care. Public health officials have also worked with community health providers and improved treatment of men who may have transmitted the infection to their female partners, she said.
In 2022, public health officials experimented with new ways to spread hopeful messages and practical information.
For World AIDS Day, a celebration featured residents who have been living full lives with HIV (for up to 40 years in some cases) and recruited go-go bands to speak on social media about the importance of Know your own HIV status. Public health workers also provided services to the Black Pride and Capital Pride events.
Agencies have tried to make testing more accessible with walk-in LabCorp options, integrating city workers into clinics at Whitman-Walker Health and George Washington University Hospital, as well as providing free HIV and STI testingwhich started during the pandemic but remains popular, with thousands of requests monthly, Barnes said.
Test takers scan a QR code to view their HIV results. If the result is negative, they will look at methods to maintain their status, such as PrEP, or pre-exposure prophylaxis, the once-daily pill that protects against HIV infection; a positive test show resources for help and treatment.
Officials said the District is also having success with a federally funded pilot program for up to Eight residents receive PrEP, which pays for their housing for a year while they undergo intensive case management and job training with the goal of living independently. Officials are studying ways to expand the program from men who have sex with men to transgender women, Barnes said.