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HIV diagnoses in US declined significantly in past decade
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The national HIV diagnosis rate in the United States decreased more than 30% during the past decade, according to new research published in JAMA. However, increases in diagnoses were observed in certain age groups of men who have sex with men, particularly young men.
“Accurate HIV diagnosis data recently became available for all states, allowing for the first time an examination of long-term national trends,” researchers wrote. “These data can be used to monitor the awareness of serostatus among persons living with HIV, primary prevention efforts, and testing initiatives.”
Researchers from the CDC and Johns Hopkins University assessed trends in HIV diagnoses from 2002 to 2011 using data collected through routine HIV surveillance in all 50 states and the District of Columbia. They estimated the annual percentage change (EAPC) in HIV diagnosis rates using Poisson regression analyses.
They found that 493,372 people in the United States were diagnosed with HIV during the study period. The annual diagnosis rate decreased by 33.2% (EAPC=–4%; 95% CI, –4.1 to –3.9) from 24.1 per 100,000 population in 2002 to 16.1 per 100,000 population in 2011. Statistically significant decreases in HIV rates were observed in almost every demographic population, especially in women, those aged 35 to 44 years and people of multiple races. The annual number of HIV diagnoses attributed to injection drug use and heterosexual contact declined, as well.
Overall, HIV diagnoses related to male-to-male sexual contact remained stable during the study period, but increased among certain age groups, including those aged 45 to 54 years and at least 55 years. The most significant change was seen in males aged 13 to 24 years (132.5%; EAPC=10.5; 95% CI, 10.1-10.9).
“Among men who have sex with men, unprotected risk behaviors in the presence of high prevalence and unsuppressed viral load may continue to drive HIV transmission,” the researchers wrote. “Disparities in rates of HIV among young men who have sex with men present prevention challenges and warrant expanded efforts.”
The researchers noted that the study is limited by the fact that trends in HIV diagnoses can be influenced by changes in testing patterns — specifically that HIV testing services were expanded during the study period.
Disclosure: One of the researchers reported that Johns Hopkins University received grant support from Johnson and Johnson and the Female Health Company that was unrelated to the study. The other researchers report no relevant financial disclosures.
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