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Overall lifetime risk for HIV declines in US; risk greatest for black, Latino MSM

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BOSTON — New CDC data presented here at CROI 2016 projected that approximately one in 99 persons in the United States will be diagnosed with HIV should current trends persist, a decrease from the one in 78 rate estimated more than a decade ago.

However, this projected lifetime rate remains high among certain demographics, with diagnoses anticipated among approximately one in six men who have sex with men, including one in two black MSM and one in four Latino MSM, according to Kristen Hess, PhD, researcher at the CDC, and colleagues.

Kristen Hess

“It was already known that these groups account for the largest proportion of HIV diagnoses, but presenting it in this manner can more effectively communicate the level of risk and large disparities to the general public,” Hess said during a press event. “This can be a useful tool for clinicians, average workers and policymakers.”

To determine the current risk for HIV diagnosis in the U.S., Hess and other CDC researchers compiled diagnoses and death rate data from the National HIV Surveillance System (NHSS), National Center for Health Statistics and U.S. Census Bureau. They used this information to estimate populationwide lifetime and age-conditional HIV risk, as well as in regard to sex, race, state and HIV risk group. Lifetime risk estimates were defined as the cumulative probability of an individual’s HIV diagnosis, while age-conditional risk was the chance for an individual of a certain age to be diagnosed with HIV in the next 10 years. All data were collected from 2009 to 2013, which Hess said provided a robust update to previous estimates based on data from 2004-2005.

“Previous estimates were available, but they were from a decade ago,” Hess said. “We now have information from all 50 states and also can now calculate by risk group, so this is new information.”

The researchers determined an overall estimated risk for lifetime HIV infection to be 1.05%, a rate roughly equivalent to one in every 99 people. Lifetime risk was greater among men than women (1 in 64 vs. 1 in 227), and was consistent regardless of age. Risk for diagnosis was highest among many states in the Southeast; however, the highest risk was seen in Washington, D.C. (1 in 13).

When estimates were broken down by race, lifetime risk was greatest among black men (1 in 20) and women (1 in 48) as well as Latino men (1 in 48) and women (1 in 227). Female injection drug users were at greater risk than male injection drug users. (1 in 23 vs. 1 in 36).

Jonathan Mermin

“As alarming as these lifetime risk estimates are, they are not a foregone conclusion. They are a call to action,” Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, said in a press release. “The prevention and care strategies we have at our disposal today provide a promising outlook for future reductions of HIV infections and disparities in the U.S., but hundreds of thousands of people will be diagnosed in their lifetime if we don’t scale up efforts now.” – by Dave Muoio

Reference:

Hess K, et al. Abstract 52. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 22-25, 2016; Boston.

Disclosure: The researchers report no relevant financial disclosures.