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San Francisco clinics push to revive HIV companies that dropped off throughout pandemic

By Sydney Johnson

Examiner employee author

After a massive decline in HIV services during the pandemic, urban health workers are now trying to find and engage San Franciscans living with the virus.

“We couldn’t offer HIV tests for a while. We had to make sure we weren’t putting participants at risk, especially if they were HIV positive, ”said Juliana DePietro, director of harm reduction services at Glide, a nonprofit that provides homeless services in San Francisco, including free HIV testing.

In 2020, San Francisco saw the average number of monthly HIV tests decreased by an overall 18%, according to a report released Monday by the city’s health department. The biggest drop occurred between March and May 2020, when California was under a protection order but tests still haven’t recovered to pre-pandemic levels.

Community test sites were particularly hard hit, violating one of San Francisco’s primary means of bringing HIV treatment to people who were homeless. The average number of monthly HIV screenings in smaller hyperlocal clinics in 2020 was 44% below the monthly average of 2019.

Tenderloin-based Glide has been slowly working to resume its HIV testing services since employees and customers were able to get vaccinated against COVID-19. But reopening doors is only half the battle – especially for smaller clinics with scarce resources across the city.

The task now is to expand HIV health care to those who did not receive adequate benefits during the pandemic, a fate that has mainly been hit by the homeless.

So far, this has required a mix of resuming pre-pandemic practices, such as sending health workers out onto the streets of San Francisco to provide direct assistance, Pietro said. It also includes searching through old patient records that have been disconnected from the pandemic, making cold calls, and even sending out people with addresses on record to let them know the services are back.

Some community health clinics also work with the San Francisco Department of Public Health to provide on-site HIV testing for people living in hotel accommodations. Proponents say it has been a critical lifeline in reaching some of the city’s most vulnerable populations and keeping up with HIV treatment during the COVID-19 crisis.

But this option, too, is now threatened. San Francisco has already closed four of its 25 on-site shelters, and officials said there could be more closings in the following weeks despite the continued surge in the Delta variant.

“The hotels with on-site accommodation are imperfect, but they have created important accommodation especially for people infected or at risk of HIV. A safe place allows us to get in touch with them, ”said Pietro.

Even after schools, stadiums, and other businesses have reopened, HIV testing has yet to recover. Compared to 2019, the monthly average number of HIV tests was 45% lower in March 2021, the report shows.

“This means that some San Franciscans may have had a delay in determining their HIV status or may not yet be aware that they are living with HIV,” said San Francisco Health Director Dr. Grant Colfax.

One solution the health department has offered is free HIV testing through a program called Take Me Home, which sends test kits to a person’s home. The program was piloted from March to December 2020, with 204 people performing 324 home tests, according to the department’s report.

But aside from April 2020, when 81 participants used the home kits, overall usage declined after July 2020 while HIV services were limited in most community clinics and telemedicine remained inaccessible to those with no access to computers.

“I was really concerned when we saw a massive drop in HIV testing. All of these doctors I know talked about it, but nobody did much to bring it back to pre-pandemic levels, even though we couldn’t ignore other public health issues, ”said Monica Gandhi, director of HIV. Infectious Diseases and Global Medicine at UCSF.

At the Mission Neighborhood Health Center, HIV testing decreased 44% in 2020. The center is now preparing to resume public relations, such as going to local bars and spreading the news about HIV testing and care options nearby.

However, a full recovery will take time as the clinic’s HIV prevention staff tasked with working on Covid-19 tests and treatments will focus on the Delta variant.

“These people are doing both jobs now, but their focus is still really on COVID. We have a great demand for vaccines and tests. In Mission, we are the epicenter of the COVID pandemic in San Francisco, ”said Fernando Gomez-Benitez, deputy director and chief administrative officer, Mission Neighborhood Health.

For a city that has made great strides in fighting HIV, San Francisco health workers are now looking for ways to continue that advance while prioritizing work and resources for COVID-19 testing and vaccination.

“At the moment, many smaller clinics are still closed,” said Reina Hernandez, associate director of the San Francisco AIDS Foundation. “We saw people drop out of care completely because the clinic they were connected to couldn’t see them.”

Allocating more resources to the city’s hyperlocal HIV testing and treatment programs to further combat Covid and pre-existing health issues will be essential to recovery from the San Francisco pandemic, Gandhi said.

“There are people in this city with HIV who weren’t diagnosed last year,” she said. “I hope we can find them by expanding our community-based programs.”

sjohnson@sfexaminer.com

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