by Carolyn Chu, MD, MSc, AAHIVS, AAHIVM Chief Medical Officer
February 11, 2025
Featured Literature:
Baxter A, Gopalappa C, Islam MH, et al. Updates to HIV transmission rate estimates along the HIV care continuum in the United States, 2019. J Acquir Immune Defic Syndr. 2025 Jan 23. doi: 10.1097/QAI.0000000000003623.
Investigators sought to update HIV transmission rates and distribution by care continuum status, race/ethnicity, transmission group, and age to help inform HIV prevention and care intervention goals, refine current strategies, and reduce health disparities. The Progression and Transmission of HIV (PATH) 3.0 model was updated to cover a simulation period from 2006-2019 and aligned with National HIV Surveillance System data and new elements related to race/ethnicity and age group. The model also used data from the National Survey of Sexual Health and Behaviors and National HIV Behavioral Surveillance System. Overall HIV transmission rate in 2019 was estimated at 2.94 new infections per 100 person-years: of new infections (n=35,100), 4.1% were associated with persons with acute infection and unaware of their status; 41.7% persons with chronic infection and unaware of their status; 41.0% persons aware of their status but not in care; and 13.2% persons in care on ART but not virally suppressed. Among estimated transmissions, 71.6% were associated with MSM, 11.6% heterosexual men and women, 11.4% injection drug use, and 5.4% MSM who inject drugs. Regarding age group, the largest percentage of overall transmissions (32.9%) was associated with persons aged 25-34, and persons aged 55 and older represented the largest proportion of PWH (35.5%).
Author’s Commentary:
Although this analysis suggests an overall increased percentage of PWH taking ART with viral suppression since 2016, with associated decrease in transmission rate over time, high rates of transmission still occur among persons with undiagnosed infection and persons aware of their status but not engaged in ongoing care. Authors call for continued focus on routine HIV screening/testing and increased HIV testing for priority populations, and rapid linkage to care strategies that can effectively remove barriers to engaging in care and durable ART suppression, especially for key populations.
This research highlights the importance of federal funding and support for HIV screening, testing and treatment for priority populations. You can show your support of this funding by reaching out to your representatives in Congress. AIDS United has shared an action alert regarding the freeze of federal funding. You can use this alert as a quick way to get in touch with policymakers.
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