HIV POLICY UPDATE

June 23, 2021

CDC Releases New Reports Utilizing HIV Surveillance Data

The Centers for Disease Control and Prevention (CDC) released three new reports last month that utilize HIV surveillance data. Collectively, the reports evaluate HIV prevention, incidence, prevalence and care objectives across the U.S. and CDC-defined Dependent Areas from 2015 to 2019.

Estimated HIV Incidence and Prevalence in the United States, 2015–2019

Some highlights of the report’s findings:

  • Estimates show that new HIV infections declined 8 percent from 2015 to 2019.
  • Estimated annual infections fell from 37,800 to 34,800. There has been a large drop in infections among young men who have sex with men (MSM) over recent years, which contribute to this overall decrease; however, young Black and Latino MSM continue to be disproportionately affected.
  • More than half of new infections in 2019 occurred in the South – a region that continues to experience high HIV incidence.
  • At the end of 2019, an estimated 1.2 million people 13 and older were living with HIV, including about 13 percent of people who had not been diagnosed.

While the report provides some promising statistics, we know anecdotally that 2020 provided many challenges to HIV prevention and treatment. Future surveillance data will indicate whether trends held or whether incidence and prevalence rates increased.

  • Progress in recent years is likely linked to increased uptake of prevention and treatment strategies, such as pre-exposure prophylaxis (PrEP), and ongoing treatment and care necessary for maintaining viral suppression.
  • In 2019, nearly 23 percent of people eligible for PrEP received prescriptions, up 20 percent from 2015.
  • Also in 2019, 66 percent of people in 45 U.S. jurisdictions with diagnosed HIV were virally suppressed, an increase of six percent from 2015.
  • These data also show that in 2019, 81 percent of people in 45 U.S. jurisdictions with diagnosed HIV were rapidly linked to care within one month of diagnosis compared to 75 percent in 2015.
These data are encouraging, but to achieve the goals outlined in the Ending the HIV Epidemic (EHE) initiative, we’ll need to achieve 50 percent PrEP coverage and 95 percent rapid linkage to care and viral suppression.
Discouraging data in this report show that Black and African Americans experience rates of infection more than eight times as high as White Americans, and four times as high as Latinos. Racial disparities in healthcare continue to be significant drivers of unequal outcomes. In 2019, only 8 percent of Black people and 14 percent of Latinos who were eligible for PrEP received prescriptions, compared to 63 percent of White people. Only 61 percent of Black people and 65 percent of Latinos with diagnosed HIV were virally suppressed, compared to 71 percent of White people.
  • In 2019, 36,801 people received a diagnosis of HIV infection. From 2015-2019, HIV diagnoses decreased by nine percent in the U.S. and six dependent areas.
  • HIV diagnoses decreased among: males and females; Black, White, and Asian persons; multiracial persons; persons aged 13-24 years, 35-44 years, and 45-54 years; heterosexuals; and MSM overall.
  • HIV diagnoses increased among transgender males and females, white transgender persons and transgender persons aged 25-34 years and 35-44 years.
  • HIV diagnoses also increased among American Indian/Alaska Native persons; MSM aged 30-34 years, 55-59 years and 60-64 years.
  • Notable increases occurred among White people who inject drugs. These increases likely are due to the ongoing opioid crisis and the related concentration of HIV outbreaks among this group.
While there are some data points showing progress, these data also show a need to expand and improve HIV prevention, care and treatment for particular groups.

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