November 25, 2020
CDC: Death Rates for People with HIV Declined by 36.6% from 2010-2018
The Centers for Disease Control and Prevention (CDC) released a new Morbidity and Mortality Weekly Report (MMWR) last week showing a 36.6% decline in deaths among people with HIV from 2010-2018. The Academy was pleased to see the “Vital Signs” report which provided strong evidence to back up the Academy’s position that early diagnosis with immediate linkages to high quality HIV treatment leads to significant reductions in death. It also shows that the Academy’s membership, as direct responders to the HIV epidemic, are on the right track in pursuing not only the individual and team knowledge and skills needed to carry out this complex work but also in urging key policy makers at the federal and state level to pursue policies that will end the epidemic.
The CDC’s report relayed data from the National HIV Surveillance System (NHSS) which showed that the number of deaths among persons diagnosed with HIV (PWDH) decreased from 16,742 in 2010 to 15,483 in 2018, a drop in total numbers of 7.5%. However, given a concurrent increase in the number of PWDH, the rate of HIV-related deaths decreased substantially from 9.1 per 1000 PWDH in 2010 to 4.7 per 1000 in 2017. The death rate showed improvement among all categories including gender, race, ethnicity and geography. There continues to be disparities in outcomes by gender, race and geography although in almost every category the disparities decreased. Rates of death were higher for females than males and transgender females and higher for people of multiple races and Black people than for White and Hispanic people. The highest rates of death being reported in the South with the lowest in the Northeast. Interestingly, death rates for White persons and Latinx persons were identical at 3.9 per 1000.
The 36.6% decreases in the rate of death surpasses the target of 33% set forward by the National HIV Strategy, a sign that the strategy is working and signaling potential for the incoming Biden Administration to move forward with the campaign goal of ending the HIV epidemic by 2025. The authors of the study attributed the decline to increases in the number of people diagnosed with HIV knowing their status and updated treatment guidelines that increased viral suppression. Additionally, they cite a greater relative improvement in the time of diagnosis to viral suppression (especially among Black people). Despite the reductions, HIV remains in the top 10 leading causes of death in certain categories.
In an article in the New York Times, the study’s primary author, Dr. Karin Bosh, called attention to concerns regarding the need for early diagnosis and sustained care, treatment and the ability to achieve viral suppression. One issue highlighted by the Times, is that younger people are dying at a higher rate than older people, in part, because they either lack access to care or lack health insurance. Dr. Bosh told the Times that, “This is concerning, because HIV deaths are preventable.”
The Academy concurs. Most HIV deaths are ultimately preventable and the disparities in health care by race, gender, sexual orientation, age and geography must be ended. With a reset of the National HIV Strategy and an aggressive effort to fulfill their campaign promise to end the HIV epidemic in the United States by 2025, the Biden Administration should be able to reduce these deaths to almost zero.
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