First the good news about our nation’s capital: New cases of HIV, hepatitis B, hepatitis C, chlamydia, gonorrhea and syphilis dropped in 2020, according to findings in Washington DC’s annual HIV, Sexually Transmitted Infections, Hepatitis, and Tuberculosis Surveillance Report.

However, the data must be viewed in the context of the COVID-19 pandemic, which “had an immense impact on the availability, accessibility and utilization of disease screening, prevention and care services,” the report’s authors write. “The presented data for 2020 should be interpreted cautiously given the decline in testing and other preventive health services that was experienced last year, both here in DC and across the country.”

According to the report, some 12,161 DC residents (1.7% of the total population) are living with HIV. Of the district’s total HIV population, 53.2% are 50 or older. Additionally, the report notes that of the total HIV population:

  • 28% are Black men who have sex with men (including those who inject drugs).

  • 16% are Black heterosexual women.

  • 13% are white men who have sex with men (including those who inject drugs).

  • 5.5% are Latino men who have sex with men (including those who inject drugs).

  • 2.1% are transgender.

A press release from the mayor’s office highlights the following topline data points from the report:

  • Newly diagnosed HIV cases in the district decreased to 217 in 2020, a decline of 23% from 282 in 2019 and 85% from the peak of 1,374 cases in 2007.

  • Zero babies were born with HIV in 2020, a decline from two babies born with HIV in 2019.

  • Newly diagnosed HIV cases attributable to injection drug use decreased by 99%, from 150 cases in 2007, prior to the scale-up of DC’s needle exchange program, to 1 case in 2020.

  • 5,956 cases of chlamydia, 3,593 cases of gonorrhea and 234 cases of primary and secondary syphilis were reported in 2020.

  • 874 people were newly reported to have hepatitis C in 2020.

While these numbers represent a drop in new HIV cases, other health measurements show that the progress in fighting HIV is slowing and has reversed in some cases. For example, among people diagnosed with HIV in 2020, 49% of them were virally suppressed within 90 days, a decrease from 2019.

Viral suppression—that is, the maintenance of an undetectable viral load—among all residents living with HIV (not just those diagnosed in 2020) flatlined at 66% overall. That number jumped to 87% when considering people engaged in care. Younger people had the lowest rates of viral suppression: 55.6% among those ages 13 to 19 and 45.6% among those ages 20 to 24.

People living with HIV who take meds and suppress their virus not only live longer and healthier lives, but they do not transmit HIV sexually, a fact referred to as Undetectable Equals Untransmittable, or U=U.

The report also covered data on viral hepatitis B and C, which cause inflammation of the liver and can lead to scarring of the liver (cirrhosis), liver cancer and the need for a liver transplant. In 2020, the report noted 200 news cases of hepatitis B, a decline from 301 the previous year. Between 2016 and 2020, a total of 1,588 new cases of chronic hep B were reported.

Health officials reported 874 cases of chronic hepatitis C virus (HCV) in 2020, a drop from 1,109 cases in 2019. Between 2016 and 2020, a total of 6,020 cases of chronic hepatitis C were newly reported among a total of 11,804 positive cases of chronic hepatitis C.

Of the 11,804 cases, 8,543 people had a confirmatory RNA test, and 1,383 people (12%) had an undetectable viral load. These numbers illustrate, according to the report’s authors, that “there are opportunities to enhance care linkage and engagement activities within the district in relation to addressing the treatment needs of people with chronic HCV.”

Regarding the district’s prevention and harm reduction efforts, the report notes that health officials:

  • Started 268 people on pre-exposure prophylaxis (PrEP, to prevent HIV) at the DC Health and Wellness Center in 2020;

  • Distributed more than 3.2 million male and female condoms in 2020;

  • Removed 578,730 needles from the street in 2020 through the DC needle exchange programs;

  • Distributed 43,768 Naloxone kits and saved 756 people from opioid overdose deaths in 2020;

  • Provided HIV medical care and support services to more than 7,436 people through the Ryan White Program in 2020;

  • Launched and supported 2,015 at-home tests for HIV (launched June 2020) and sexually transmitted infections, or STIs (launched September 2020) and 598 walk-in tests at LabCorp for HIV, STIs, and hepatitis.

“Progress in science and health have provided us the tools we need to end the HIV epidemic, and we are focused on making sure Washingtonians know where and how they can access the resources and treatment they need to live healthy lives,” said DC Mayor Muriel Bowser in the press release. “DC Health has worked with community organizations and health care providers to make testing, including free at-home testing, widely available. Just last year, we launched a new 24/7 hotline so that people who may have been exposed to HIV can get information about accessing PEP. And we will continue putting these tools in place and making sure people know about them so that we can prevent new HIV cases, help more people reach viral suppression, and crush this epidemic.”