National HIV testing and diagnosis rates dropped dramatically in 2020 due to the COVID-19 pandemic, according to new data from the Centers for Disease Control and Prevention (CDC).

In one analysis, new HIV diagnoses fell from 36,940 in 2019 to 30,635 in 2020—a 17% reduction. But disparities persisted, with higher rates for gay and bisexual men (72% of new cases), people ages 13 to 34 (57%), Black people (42%), Latinos (27%) and those living in Southern states (14.7%).

But the CDC is not drawing conclusions about whether HIV incidence has actually dropped, as the decline in new cases could be a result of interruptions in testing and other services.

A second analysis found that just 11.6 million HIV tests were performed during 2020, compared with almost 14.3 million during a similar period in 2019. That’s more than an 18% drop, likely leading to thousands of missed or delayed diagnoses.

Testing plummeted in March 2020 as people stayed home to avoid the coronavirus and regular health care was disrupted. Testing rates fell steeply for gay and bisexual men (down 49%), transgender people (down 47%), Latino people (down 46%) and Black people (down 44%). While testing slowly recovered after April, it remained below previous levels at the end of the year.

To come back from the pandemic, the CDC urges a coordinated effort involving public, private and nonprofit agencies, especially those targeting vulnerable populations. “Everyone should enjoy good health—and getting an HIV test is part of a successful plan to do so,” says Demetre Daskalakis, MD, MPH, director of the CDC’s Division of HIV Prevention.