That's because there was so much focus on fighting the pandemic, HIV testing and access to treatment were all halted for some time.
The headline is one that many feared. New HIV cases in San Francisco increased for the first time in nine years.
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For starters, HIV clinics were forced to close during the peak of the pandemic.
"It's sort of very disheartening because we have this way of combating HIV and we fell. We completely backslid," said Dr. Monica Gandhi, the medical director of the HIV Clinic at Zuckerberg San Francisco General Hospital.
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The report was sponsored by the pharmaceutical company Gilead and the advocacy group GLAAD.
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The numbers are concerning. HIV testing dropped by 97% at the peak of the COVID-19 pandemic.
"If they are not getting HIV tested, learning their HIV status, whether positive or negative, we see that that impact -- the way we treat and care for the whole person," said Shanell McGoy of Gilead Sciences.
As a result, the number of people diagnosed with HIV went down by 17% in 2020 compared to 2019.
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"The challenges resulted in less testing, a setback for us getting to zero cases and we're trying to pick it up," said Vincent Crisostomo of the San Francisco AIDS Foundation.
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Without testing, many could not start on PREP, daily medication given to prevent HIV.
"We have been seeing quite a few patients in the hospital coming in with late-stage AIDS who never got diagnosed, so this is a very important time to bring up testing. Testing is so critical in HIV," said Gandhi.