Access to HIV, STI, & Hepatitis Services During the COVID-19 Pandemic

May 26, 2020 | Rebekah Horowitz

The COVID-19 pandemic has put tremendous pressure on our nation’s public health and healthcare infrastructure, exposing and exacerbating existing vulnerabilities and inequities. The scale of the pandemic and the response are unprecedented, but the urgency of addressing COVID-19 has overshadowed existing health crises and opportunities.

The U.S. continues to battle record-high STI rates, outbreaks of hepatitis A, and an epidemic of drug overdoses. Decades of research and public health action have put within reach an end to the HIV epidemic and the elimination of hepatitis B and C. However, local health departments (LHDs) face an uphill battle—despite the availability of tools to prevent, detect, and treat HIV, STIs, and viral hepatitis—as the local public health workforce has decreased by 25% since 2008. Gaps in access to HIV, STI, viral hepatitis, and harm reduction services are getting worse during the pandemic, as LHDs and healthcare providers respond to COVID-19, millions of Americans lose their health insurance, and populations disproportionately impacted by HIV, STIs, and viral hepatitis face increased risk for COVID-19.

NACCHO has heard from LHDs across the country that HIV, STI, viral hepatitis, and harm reduction staff have been pulled to support the COVID-19 response, and that reduced staffing and the need to implement social distancing guidelines have forced them to suspend programs and reduce services. Maintaining HIV, STI, viral hepatitis, and harm reduction services during the pandemic and scaling up services after the pandemic is under control are both critical to prevent a surge in cases. Consequently, NACCHO will continue to monitor and report on the impact of the COVID-19 pandemic on HIV, STI, viral hepatitis, and harm reduction services.

This page will be updated as new research emerges. To share any relevant resources, please contact Kat Kelley, Senior Program Analyst, HIV, STI, & Viral Hepatitis at kkelley@naccho.org.

  • LHD HIV, STI, and Hepatitis Programs Respond and Adapt to COVID-19. This article highlights the results of a recent survey distributed by NACCHO to LHDs on the impact of COVID-19 on their HIV, STIs, and viral hepatitis (HSH) programs. The findings reveal that HSH program staff have been pulled to support the COVID-19 response and that reduced staffing and the need to implement social distancing guidelines have forced many HSH programs to suspend outreach, education, and prevention efforts, and reduce testing and treatment.

  • COVID-19 and the State of the STD Field. The National Coalition of STD Directors released a new report highlighting the findings of a survey conducted by STD program directors, DIS, and STD and sexual health clinic administrators regarding the impact of COVID-19 response on the STD field. The report reveals that many programs and clinics are deferring services or field visits, struggling to maintain caseloads, experiencing reduced capacity to treat, temporarily losing staff to COVID-19 deployment, and more. View the report for the full findings.
  • The Impact of COVID-19 on Syringe Services Programs in the United States. A new article in AIDS and Behavior examines the impact of COVID-19 on syringe services programs (SSPs) in the U.S. The findings are based on the results of a survey distributed to SSPs by the North American Syringe Exchange Network and key informant interviews conducted with SSPs in COVID-19 hot spots. One-fourth reported closing at least one site and nearly half of SSPs report a decrease in the availability of services, including medication for opioid use disorder and HIV, hepatitis C, and STI testing. More than half are prepacking all supplies for clients, 20% are providing delivery services, and 6% are providing mail-based services.
  • Impact of COVID-19 on CBOs and HIV Continuum of Care. A new article published in AIDS and Behavior highlights the impact of COVID-19 on community-based organizations (CBOs) and the HIV continuum of care. Many CBOs are closed, healthcare providers have reduced hours, and medical professionals are shifting from primary care to focus on COVID-19. CBOs are expecting declines in private donations and increases in clients who are unable to pay for services. As clients and staff are affected, morale has declined among providers working in CBOs.
  • The Impact of COVID-19 on MSM. A new article in AIDs and Behavior characterizes the impact of COVID-19 on the sexual health of men who have sex with men (MSM) in the U.S. The findings are based on the results of an online survey completed by 1,051 MSM and reveal that half have had fewer sex partners and that some have faced challenges in accessing HIV testing and treatment.

  • Impact of COVID-19 on STI Services in Indiana. The Indiana State Department of Health’s Division of HIV/STD/Viral Hepatitis recently examined how COVID-19 has impacted local chlamydia and gonorrhea testing efforts. The assessment found that 32% of providers had completely closed and only 16% were seeing asymptomatic patients.
  • Podcast from Washington: Effects of COVID-19 on HIV, STI and Viral Hepatitis Programs. In last week’s episode, Ian Goldstein chatted with Leah Casanave, Supervisor of the STD Prevention and Control Program at Douglas County Health Department, NE and Kat Kelley, NACCHO’s Senior Program Analyst for HIV, STI and Viral Hepatitis. They discuss the impact that the COVID-19 pandemic has had on local health department’s HIV, STI and viral hepatitis programs and services.

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