After 20 years of a steady downward trend, new HIV cases in New York City jumped 14% in 2021, due in large part to a resurgence in HIV testing after the COVID-19 pandemic caused citywide shutdowns in 2020, according to the NYC Department of Health and Mental Hygiene.
That atypical increase in HIV diagnoses came after a steep 21% drop in 2020, when the COVID-19 pandemic made HIV testing services far less accessible and available to New Yorkers, according to the Health Department’s 2021 HIV Surveillance Annual Report, released in December.
But even with the 14% resurgence in 2021, new HIV diagnoses still were 8% lower than in 2019. That continues the overall trendline of fewer new HIV diagnoses each year, as New York pushes to end the HIV and AIDS epidemic.
Encouragingly, early indicators point to a resumed decline in new HIV cases since the spike in 2021. “New HIV diagnoses continue to fall, and we are also seeing a rebound in HIV testing and care-seeking,” said NYC Health Commissioner Dr. Ashwin Vasan in an announcement.
How GMHC Responded
GMHC quickly foresaw that the COVID-19 pandemic would affect HIV testing and care, so the agency immediately made several operational changes to keep testing accessible. We rolled out wellness calls, on-site testing by appointment, and at-home test kits, so that we could safely continue to provide free and confidential HIV testing and follow-up counseling that is affirming, sex positive and stigma-free.
Testing is central to the agency’s approach to reducing new HIV infections and ending the epidemic, because everyone benefits from knowing their HIV status. People testing HIV-positive can start taking medication to protect their health and keep from transmitting the virus to others, while those testing negative have the option of pre-exposure prophylaxis, or PrEP, which is 99% effective at preventing HIV transmission.
Soon after the citywide shutdowns in March 2020, GMHC started offering free HIV self-test kits and follow-up phone counseling from our Testing Center staff, so that people could test at home. This option proved so effective that we’ve made it a permanent part of Testing Center services.
The agency’s staff also began making regular wellness calls to our most vulnerable clients to find out how they were doing and what they needed, which provided an opportunity to offer HIV self-test kits and care. Because the calls have been so well received, the agency has made them a permanent service as well.
GMHC never shut down for testing, because we knew the people we serve needed it more than ever. Instead, for the safety of our staff and clients, we asked clients to make appointments in advance for testing services at our offices. Currently, we are offering on-site testing services and care on Mondays through Fridays–and we’ve recently added walk-in testing all day on Thursdays.
We’ve also been deploying our mobile testing unit to reach New Yorkers across the five boroughs, in partnership with JBT Foundation.
In September, GMHC partnered with Avita Pharmacy to open a pharmacy at our offices at 307 West 38th Street, so our clients, staff and the community can easily obtain HIV and other medications needed to stay in good health. Avita’s pharmacists are specially trained to dispense HIV medications, including PrEP and PEP (post-exposure prophylaxis), and they are culturally competent in sexual wellness patient care and serving LGBTQ people.
Disparities in Diagnoses
The Health Department recorded 1,594 new HIV cases in 2021, up from 1,396 in 2020. Encouragingly, it found that the HIV viral suppression rate increased slightly in 2021, despite disruptions to health care from the COVID-19 pandemic. Overall, 79% of New Yorkers living with HIV had undetectable viral loads at the last calendar year assessment date, up just a bit from 78% in 2020.
However, communities of color and people living in areas of high poverty in New York City continue to be disproportionately affected by HIV. In 2021, 44.2% of new HIV diagnoses were for Black people, compared with 37.2% for Latinx people, 11.7% for white people and 5.7% for Asian/Pacific Islanders.
Almost two-thirds of NYC’s 2021 cases (64.9%) were among people ages 20 to 39, and fully 77.5% were in communities that the Health Department defines as medium to high poverty.