EXECUTIVE SUMMARY
Data presented at the December 2015 National HIV Prevention Conference indicate annual HIV diagnoses in the United States dropped 19% from 2005 to 2014. It was driven by continuing declines among several populations, including heterosexuals, people who inject drugs, and African Americans, with the steepest declines seen among black women.
- For gay and bisexual men, trends over the decade have varied by race and ethnicity, research suggests.
- The CDC and its partners are taking steps to encourage further declines, with a new national HIV testing campaign and the beta version of an online tool to help individuals assess and reduce their risk of acquiring or transmitting HIV.
The December 2015 National HIV Prevention Conference saw exciting developments announced by the Centers for Disease Control and Prevention (CDC) and partners, including new data on trends and disparities in the U.S. HIV epidemic. Data indicate annual HIV diagnoses in the United States dropped 19% from 2005 to 2014.1 The decrease was driven by continuing declines among several populations, including heterosexuals, people who inject drugs, and African Americans, with the steepest declines seen among black women.1
For gay and bisexual men, trends over the decade have varied by race and ethnicity, research suggests.1 Among white gay and bisexual men, diagnoses fell by 18%, while diagnoses among Latino gay and bisexual men continued to rise: up 24%. Diagnoses among black gay and bisexual men rose 22% between 2005 and 2014, but they leveled off after 2010. Public health officials note a similar trend in young black gay and bisexual men ages 13-24, who experienced an 87% increase in diagnoses from 2005 and 2014. However, between 2010 and 2014, the trend has leveled off at 85%.1
HIV testing has remained stable or increased among the groups experiencing declines in diagnoses in recent years. Researchers believe the decreases in diagnoses reflect a decline in new infections. Because HIV testing has remained stable among Latino gay and bisexual men during this period, the increases in HIV diagnoses suggest infections likely are increasing in this group, CDC officials note.
The recent five-year trends coincide with the launch of the first National HIV/AIDS Strategy in 2010, said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention. Now that the investment in high-impact prevention approaches has increased, there is promise for further progress, he noted.
“We have the tools to stop HIV right now,” said McCray in a statement accompanying the new date. “We urgently need to accelerate access to testing, treatment, and new biomedical prevention strategies so that everyone can protect themselves and their partners.”
CHECK THE NUMBERS
What else does the new data reveal when it comes to HIV trends? Take a look at the statistics, which focused on trends in diagnoses over two time periods: 2005-2014 and 2010-2014. Among the findings:
- From 2005-2014, the annual number of HIV diagnoses in the United States fell 19% (from 48,795 to 39,718 per year), which was driven by declines among heterosexuals (down 35%) and people who inject drugs (down 63%).
- HIV diagnoses among black women dropped from 8,020 to 4,623 over the 2005-2014 period (down 42%), with continuing declines in recent years: 25% since 2010.
- Diagnoses among gay and bisexual men overall rose about 6% over the decade (from 25,155 to 26,612), but leveled off in more recent years.
- Among white gay and bisexual men, diagnoses dropped steadily, both over the decade (decreasing 18% from 9,966 to 8,207) and in more recent years (falling 6% from 8,766 to 8,207).
- Over the decade, diagnoses among black gay and bisexual men rose 22% (from 8,235 to 10,080), but stabilized in more recent years. While black gay and bisexual men ages 13-24 experienced a steep increase (87%, from 2,094 to 3,923) in diagnoses over the decade, diagnoses among young black gay and bisexual men actually declined by 2% (from 3,994 to 3,923) in the most recent years.
- Diagnoses continue to increase among Latino gay and bisexual men, both over the decade (by 24%, from 5,492 to 6,829) and in more recent years (by 13%, from 6,060 to 6,829).1
The CDC and its partners are taking steps to encourage further declines, with a new national HIV testing campaign and the beta version of an online tool to help individuals assess and reduce their risk of acquiring or transmitting HIV announced at the conference.
Jonathan Mermin, MD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, says, “The cornerstone of CDC’s HIV prevention strategy is a high-impact approach that provides the right tools to the right people to achieve the greatest results. We will continue our high-impact approach to close gaps in HIV prevention and care, and accomplish the objectives that are essential to achieving further declines in diagnoses.”
Data presented at the conference indicate that nationally, 87% of Americans knew their HIV status in 2012, but this percentage varied substantially across states, from a low of 77% in Louisiana to a high of 93% in New York and Hawaii.1 Across the nation, just five states reached the national goal of 90% awareness: Hawaii, New York, Colorado, Connecticut, and Delaware. Seventy percent of the worst-performing states were in the South.
The “CDC is responding to the challenge of HIV in the South and nationwide by prioritizing the hardest-hit areas and populations and investing in the most effective strategies,” said McCray. “These strategies include expanded testing for HIV, helping people living with HIV obtain ongoing care and treatment, and increasing awareness of and access to all effective prevention tools, including condoms, pre-exposure prophylaxis, or PrEP, and interventions to decrease risky behavior.”
“Doing It” campaign
Conference attendees were given a first-hand look at the new national HIV testing campaign “Doing It,” which features everyday people, community leaders, and celebrities emphasizing that HIV testing is a smart choice to stay healthy and protect people and their partners. Vignettes highlight people from a spectrum of communities, including gay, bisexual, heterosexual, African-American, Latino, white, male, female, and transgender people. (Access information on “Doing It” at http://1.usa.gov/1PWhadW.)
The bilingual HIV testing campaign within the Act Against AIDS portfolio emphasizes the importance of testing for all people ages 18-64. In addition to encouraging testing for all Americans, the campaign focuses on populations who are most at risk for HIV.
What role can providers play in the “Doing It” campaign? More than 90% of new HIV infections in the United States could be prevented by testing and diagnosing people who have HIV and ensuring they receive prompt, ongoing care and treatment, notes Mermin. People with more than one sex partner, people with sexually transmitted infections (STIs), sexually active gay and bisexual men, and people who inject drugs are likely to be at high risk and should get tested at least once a year. Some sexually active gay and bisexual men might benefit from more frequent testing.
“Providers should be aware that CDC recommends everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine healthcare,” says Mermin. “They should also be aware that some people, like men who have sex with men, could benefit from more frequent testing.”
The new comprehensive online HIV Risk Reduction Tool (http://1.usa.gov/1PkpeiY) allows people to obtain customized information on behaviors that place them at risk for HIV and to learn strategies that reduce their risk. The interactive tool allows users to compare the risks of different sexual activities and to see how one or a combination of prevention methods, such as condoms, PrEP, or HIV treatment for those living with HIV, could change their level of protection.
The CDC anticipates continued revision of the tool, as the agency pilots the tool with users and incorporates feedback and findings.
REFERENCE
- McCray E. Shaping the future of HIV prevention: New possibilities, new expectations. Presented at the 2015 National HIV Prevention Conference. Atlanta: December 2015.
