Lifetime risk for HIV decreases among men and women in US
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The overall lifetime risk for an HIV diagnosis in the United States has decreased, CDC researchers found, although decreases were not experienced by all races or ethnicities.
Sonia Singh, PhD, an epidemiologist in the CDC’s Division of HIV/AIDS Prevention, presented the findings Monday at the Conference on Retroviruses and Opportunistic Infections virtual meeting.
“Lifetime risk is used to compare the burden of diseases across population. It is frequently used to describe cancer risk, but it is infrequently used for HIV infection,” Singh said during a presentation. “As lifetime risk is more easily understood by the general population, it could be a useful tool for clinicians, outreach workers and policymakers.”
Singh and colleagues used mortality and census population data and HIV diagnosis data from the National HIV Surveillance System to estimate the lifetime risk for an HIV diagnosis from 2017 to 2019 for all ages by sex, race/ethnicity and place of residence. They compared the estimates with data from 2010 to 2014, during which the lifetime risk for HIV was an estimated one in 68 males and one in 253 females.
The new estimate for lifetime risk for an HIV diagnosis in the U.S. was one in 120 overall ⎼⎼ down 11% from an estimated 1 in 106 people in the 2010 to 2014 study period. The estimates were one in 76 men and one in 309 women.
The researchers found that the risks were even higher for men of specific races/ethnicities ⎼⎼ one in 27 for Black men, one in 50 for Hispanic/Latino men, one in 89 for Native Hawaiian/other Pacific Islander men, one in 116 for American Indian/Alaska Native men, one in 171 for white men and one in 187 for Asian men.
Among women, rates were also higher for some races/ethnicities, including Black and Hispanic/Latino women, who experienced rates of one in 75 and one in 387, respectively.
The overall lifetime risk for an HIV diagnosis from 2017 to 2019 improved in all groups except for American Indian/Alaska Native, Hispanic/Latino and Native Hawaiian/other Pacific Islander males and white females compared with 2010 to 2014.
The researchers were also able to assess diagnosis risk by jurisdiction. They found that the lifetime risk ranged from one in 39 in the District of Columbia to one in 655 in Wyoming. States with the highest lifetime risks were Georgia (one in 59), Florida (one in 63), Louisiana (one in 69), Nevada (one in 84) and Maryland (one in 85).
“Lifetime risk may be a useful tool to more effectively communicate the burden of HIV overall and in specific communities,” Singh said. “It can also help to identify areas where preventive efforts can be accelerated and can help to highlight disparities.”
Perspective
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The lifelong risk for HIV is obviously coming under control in the U.S., driven by more successful ART and PrEP. But as always, HIV shows health disparities in our society and the HIV risk remains far too high in sex and racial/ethnic subgroups. Hopefully, data such as these can lead to more effective interventions to broaden the amazing benefits we have the potential to achieve.
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Singh S, et al. Abstract 43. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 12-16, 2022 (virtual meeting).
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