Rates of Syphilis and STIs in D.C. Remain High Amid Lingering COVID Challenges
Sustained Uptick in New Cases Attributed to COVID-era Challenges
Rates of syphilis and other sexually transmitted infections in D.C. did not return to pre-pandemic levels in 2022, according to an annual District analysis released Friday. The report highlighted the persistent increase in new cases, largely attributed to the continued impact of service interruptions and reluctance to seek healthcare during the COVID-19 pandemic.
District officials emphasized that the upward trend reflects the repercussions caused by clinic closures and individuals avoiding healthcare settings. They noted that this has resulted in fewer culturally competent professionals available to screen, test, and treat residents, particularly in light of increased barriers to accessing care, such as heightened homelessness scenarios.
Throughout the pandemic, disease screening, prevention, and care services have experienced significant disruptions, impacting availability, accessibility, and utilization. The report stresses the key role care seeking behaviors play in HIV testing and other preventive measures, emphasizing that these behaviors are still lagging.
Impact on Black Residents and Efforts for Boosting Access to Care
According to Clover Barnes, senior deputy director for D.C. Health’s HIV/AIDS, Hepatitis, STD and TB Administration, individuals greatly impacted by these challenges are not primarily concerned about HIV testing and prevention measures due to higher priorities, such as daily survival with food and shelter. Distressingly, Black residents, who are disproportionately affected, particularly struggled to access necessary care.
Given the context of a nationwide staffing shortage, the District has faced difficulties in providing culturally sensitive public health workers. Barnes highlighted the District’s diminished capacity, pointing out the challenges brought about by the pandemic. Delving deeper, healthcare providers have tried to contribute creatively towards improving access to care by actively reaching out to communities, attending events, and enlisting the help of artists in sharing messages about prevention and treatment.
A Progressive Stride in Syphilis and HIV Trends
The report revealed a downward trend in new HIV cases and an overall decline since the peak two decades ago. Similarly, syphilis cases among women and their babies, a national trend, had an uptick in 2022. However, District public health experts suggest that evidence indicates a potential decline in the future.
The impactful disruptions caused by the pandemic, including the reduced capacity for disease screening and care services, have greatly affected HIV and syphilis testing. Notably, new HIV diagnoses have decreased over time, with 210 new diagnoses reported in 2022, compared to 224 in 2021 and 274 in 2019. The report reveals the positive strides made since the 2007 peak of 1,374 cases.
Approximately 1.7 percent of the D.C. population, amounting to 11,747 individuals, is living with HIV. Of concern, Black individuals account for about 70 percent of HIV cases, although they make up around 44 percent of the population, a testament to the disproportionate impact experienced by the Black community.
Aiming for HIV Eradication by 2030
The Centers for Disease Control and Prevention (CDC) has established goals for major cities, including D.C., to have fewer than 21 new HIV diagnoses per year by 2030. However, D.C. Health officials, including Clover Barnes, acknowledged that these numbers may require revision. The District is committed to intensifying efforts in preventing new HIV cases and facilitating early diagnosis.
Challenges Posed by Rising Syphilis Cases
While the District has not reported any babies born with HIV since 2019, cases of syphilis in babies have increased, coinciding with a general uptick in syphilis cases overall. Alarming data reveals that three out of every five people diagnosed with syphilis in 2022 were Black, with cases increasing by 10 percent from 2021 to 2022, rising from 692 to 761.
To tackle congenital syphilis, first identified in the 2022 Annual Epidemiology & Surveillance Report, healthcare providers have shifted their focus to better understanding the needs of women with the infection, notably those with substance abuse issues. Doctors are encouraged to conduct tests throughout a pregnant woman’s term, as delayed screenings may complicate effective treatment. However, access to adequate prenatal care continues to pose challenges for some women.
Efforts have been made to spread hopeful messages and practical information related to HIV prevention. Initiatives for World AIDS Day showcased residents who have been living with HIV for up to 40 years, alongside the active involvement of go-go bands to promote the importance of HIV status awareness on social media. Public health initiatives have also reached out to events such as Black Pride and Capital Pride to raise awareness.
Improving Accessibility and Results Sharing
With the aim of increasing accessibility, the District has introduced walk-in options for LabCorp tests, stationed city workers at Whitman-Walker Health and George Washington University Hospital clinics, and provided free HIV and STI tests. Lab results are conveniently accessible via a QR code, offering support and resources for those testing positive, as well as guidance on managing their status for those testing negative.
Paving the Way Forward
The District has celebrated success with a federally funded pilot program offering up to eight residents one year of housing coverage along with intensive case management and employment training. Initially available for men who have sex with men, officials are currently examining the inclusion of transgender women.
Note: This article is for informational purposes only and should not replace the advice of a medical professional.
