By Corey Rose | Oakland North
As the COVID-19 pandemic closed the doors of free clinics and primary care providers, LifeLong Medical Care HIV/AIDS program Manager Keyshia Lynch was faced with a problem: how to test patients and care for them without seeing them in person.
Doctors recommend an HIV test at least every three to six months for sexually active gay and bisexual men to keep them and their partners safe, but shelter-in-place orders interrupted regular testing patterns in the Bay Area and nationwide.
HIV testing rates declined everywhere during the pandemic. A study by Monogram Biosciences/Labcorp, a biotech laboratory in San Francisco, found a 23% drop in HIV testing in the western U.S. between March and October 2020, compared to the same time period in 2019.
And in California, the number of HIV-positive cases in males went up during the first year of the pandemic.
The study showed that many of the positive cases that were found weren’t newly acquired, but primary, or long-standing infections. Dusica Curanovic, a researcher at Monogram Biosciences who co-authored the study, said that combined with an increase in overall positivity rate among males, this finding indicates that men were less likely than women to get health care “in a timely manner.”
It’s crucial to connect with care as early as possible for several reasons, Lynch said.
“The longer you wait, you can begin contracting opportunistic infections, like pneumonia,” she said. “We want to prevent a weakened immune system by beginning treatment right away.”
Caregivers at LifeLong, which has a clinic in downtown Oakland, had to get creative to make sure people at risk of HIV were still getting tested regularly during the height of the pandemic.
Last year, Lynch and her team partnered with the Oakland LGBTQ Community Center to mail at-home HIV testing kits in discreet boxes that included instructions for self-testing, condoms and information on preventive treatment.
“If the result came back preliminary positive, we would link them to a case manager,” Lynch said. “If it was negative, we would talk to them about PrEP.”
LifeLong has a team of navigators, who reach out to patients and guide them through the PrEP process of getting a prescription for the daily HIV preventive pill.
“During the heart of COVID, it was rough,” said Alton Lou, who became a navigator last year.
Once a week, Lou’s team would go to outdoor COVID-19 testing and vaccine sites across Oakland, put up a tent and offer HIV tests to people waiting in line.
LifeLong also held virtual focus groups to learn how those already on PrEP were faring during the pandemic. And in partnership with the Oakland LGBTQ Center and the Berkeley Free Clinic, LifeLong produced a virtual sexual health Q&A called, “Keeping it Smart, Sexy, and Safe During a Global Pandemic.”
While there were virtual events, it was hard to replicate an in-person atmosphere.
People were “missing out on a sense of community,” Lou said.
Lynch added that the social services patients are connected to following diagnosis are just as important as the medical treatment. These can range from assistance navigating health insurance, to support groups with others living with HIV.
“It’s more than just starting medication, it’s about building a community of support,” she said, “We provide them with all the resources we possibly can.”
But first a person has to realize they need care. Because acute HIV is associated with symptoms that can resemble the flu, some who had newly acquired the virus may not immediately have realized that they needed care — and, given shelter-in-place orders, may not have gotten tested as a result.
That puts the entire community at risk, Curanovic said.
“If you lack awareness that you now have HIV, then you can transmit it to others,” she noted.
Now that people are vaccinated, they are venturing into testing centers again. Lynch, for one, is trying to make up for lost time.
At Oakland’s Pride in the Park festival last month, she and her colleagues set up a tent for free rapid HIV testing. To encourage people to stop by, they threw in a $30 Visa gift card as an incentive.
“The incentive was a nice addition, but it didn’t drive the efforts,” Lynch said. “Those that wanted to, just did it.”