The nation’s ability to prevent HIV was “dealt a hard blow” early in the COVID-19 pandemic, according to a new Centers for Disease Control and Prevention (CDC) analysis. But a rapid rebound in services “is a testament to quick, resourceful local innovations that, if scaled up and sustained, could help reach national HIV prevention goals.”

Nationwide, HIV testing declined by about 32% and pre-exposure prophylaxis (PrEP) prescriptions fell by about 6% during the early months of the pandemic as cities imposed stay-at-home orders, medical services were curtailed and many people lost their jobs and health insurance. Reported HIV diagnoses fell by 26%, but this is thought to be a consequence of less testing rather than a real drop in new HIV cases. Testing and PrEP prescriptions started to rebound during the second half of 2020, but they did not reach pre-pandemic levels until 2021.

While HIV testing and PrEP prescriptions were disrupted, the provision of HIV treatment remained strong. The proportion of people who were linked to care after an HIV diagnosis, received prescriptions for antiretroviral therapy and achieved an undetectable viral load all remained stable.

To maintain access to critical HIV services, some providers launched or expanded programs to substitute for traditional in-person care, including telehealth, HIV self-testing and home delivery of HIV medications and PrEP.

“Investment in local community innovation is vital to strengthening our nation’s HIV prevention and care systems to endure future public health emergencies,” according to the CDC. “Expanding those innovations can also help achieve national goals to end the HIV epidemic.”