Washington | This is the paradox of the great containment: if it slows down the spread of the new coronavirus, it could indirectly help another virus, HIV: the absolute priority given to the COVID-19 has had as collateral effect of undermining the edifice of prevention on which is based the war against aids.
Travis Sanchez, an epidemiologist at Emory university, interviewed online at the beginning of April a thousand men having sex with men, and half of them reported a reduction in the number of their sexual partners, and reduced use of applications dating.
But Travis Sanchez adds immediately worrying: a quarter said that they had problems to get tested, due to the closure of thousands of sites for screening. Those who continue the plans of the evening are in the dark about their status-a potential time bomb.
“It is very likely that risk behaviours will take before that prevention services have fully re-opened”, is concerned the researcher. “This combination could lead to more HIV infections”.
We will not know the impact of the pandemic on HIV that next year, when the Centers of prevention and control of diseases (CDC) will publish the numbers of infections by 2020.
But multiple experts and public health professionals fear a slackening, a year after the United States set themselves the objective of reducing by 75% the number of new infections by 2025.
In Washington, a town highly affected by HIV, the clinic Whitman Walker had to close the home daily without an appointment for screening of this virus and other sexually transmitted infections (STIS): syphilis, gonorrhea, chlamydia.
Fifty people were previously getting tested every day, many of them homosexuals, for whom this was the routine, every three months.
“All of these people do more testing,” said Amanda Cary, a nurse who continues to see symptomatic patients, by appointment only. “I am sure that there will be a rise in STIS”.
The CDC say the AFP expect a decline in short-term diagnostics of STIS, but “a long-term upward trend once the restrictions are lifted and more people will be tested”. For HIV, the closure of sites “may cause more infections,” in the long term.
Everything can change
In San Francisco, the physician-researcher Matthew Spinelli is concerned about the homeless, those who have more credits to the phone or the internet for téléconsulter.
“People are afraid to go to the hospital at the moment, it worries me”, said the doctor, who practices at a large public hospital local.
His unit also follows 3000 people with HIV. He feared that in the chaos of the pandemic, some do not go to the pharmacy or take their pills every day, which would raise their viral loads and make them contagious.
“I’m afraid that their psychological health deteriorates in the current environment, or that their addiction is getting worse,” he said.
The united States, the preventive treatment PrEP, which saves you almost 100% to be contaminated, is to be developed, but according to Matthew Spinelli, some have stopped for the containment. Resume they then? “I predict that in fine, the HIV epidemic will worsen,” he said.
But by forcing professionals to improvise, the pandemic will also make a lasting difference, to the good practices of prevention. Telemedicine will become commonplace.
The sites of needle exchanges distribute more syringes at a time, or deliver or send by parcel.
The HIV tests at home, which exist for years, but are little used, will grow, ” says Stephen Lee, director of Nastad, an association of responsible public health specialist HIV. The CDC and encourage the Florida and Tennessee are thinking about it, ” he said to the AFP.
“The pandemic has shown us that we can and must do,” he concludes.