Vital Signs

Status of Human Immunodeficiency Virus Testing, Viral Suppression, and HIV Preexposure Prophylaxis

United States, 2013-2018

Norma S. Harris, PhD; Anna Satcher Johnson, MPH; Ya-Lin A. Huang, PhD; Dayle Kern, MA; Paul Fulton; Dawn K. Smith, MD; Linda A. Valleroy, PhD; H. Irene Hall, PhD

Disclosures

Morbidity and Mortality Weekly Report. 2019;68(48):1117-1123. 

In This Article

Results

The annual number of new HIV infections remained stable from 2013 (38,500) to 2017 (37,500) (p = 0.448). Among the estimated 1.2 million persons living with HIV infection in 2017, 85.8% (95% confidence interval [CI] = 84.3–87.5) had received a laboratory-confirmed diagnosis of HIV infection. The lowest percentages of diagnosed HIV infections were among persons aged 13–24 years (54.6%, 95% CI = 52.7–56.7), American Indians/Alaska Natives (79.5%, 95% CI = 58.7–100.0), and heterosexual males (82.0%, 95% CI = 76.5–88.3), compared with other age, racial/ethnic, or transmission risk groups. (Table 1). The percentage of diagnosed infections ranged from 79.7% in Nevada to 94.4% in New Jersey (Table 2).

In 2017, 62.7% of 854,206 persons with diagnosed HIV infections in 42 jurisdictions had a suppressed viral load (Table 1). The lowest percentages of persons with viral suppression were those aged 13–24 years (56.9%), blacks/African Americans (blacks) (57.4%), and males who inject drugs (52.0%), compared with other age, racial/ethnic, and transmission risk groups. The percentage of persons with a suppressed viral load ranged from 47.0% in South Dakota to 79.6% in Iowa (Table 2). The percentage of persons with a suppressed viral load within 6 months of diagnosis of HIV infection was 61.5 overall and <59% in 12 jurisdictions (Figure).

Figure.

Viral suppression*,†,§ within 6 months of diagnosis of human immunodeficiency virus (HIV) infection among persons aged ≥13 years — United States, 2017
Abbreviation: DC = District of Columbia.
*Percentage viral suppression within 6 months of HIV diagnosis, calculated as the number of persons with a viral load test result of <200 copies of HIV RNA per mL at last test divided by the number of persons with HIV diagnosed in 2017. Residence was based on residence at the time of diagnosis of HIV infection.
Total = 61.5%.
§Data classified using quartiles.
Analysis based on data reported from 41 states and DC; data for nine states were incomplete or not reported.

An estimated 1.2 million persons had indications for PrEP; 12.6% were prescribed PrEP in 2017 and 18.1% in 2018. In 2018, PrEP coverage was three times as high among males (20.8%) as among females (6.6%) (Table 1). Compared with other age groups, the lowest PrEP coverage rate was among persons aged 16–24 years (11.4%). Adjusting for missing race/ethnicity, PrEP coverage was 5.9% for blacks, 10.9% for Hispanics/Latinos, and 42.1% for whites. PrEP coverage ranged from 5.0% in Wyoming to 41.1% in New York (Table 2).

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