Details:

Alternative Title:
MMWR Morb Mortal Wkly Rep
Personal Author:
Li, Zihao ; Purcell, David W. ; Sansom, Stephanie L. ; Hayes, Demorah ; Hall, H. Irene
Li, Zihao ; Purcell, David W. ; Sansom, Stephanie L. ; Hayes, Demorah ; Hall, H. Irene Less -
Description:
Background

In 2016, an estimated 1.1 million persons had human immunodeficiency virus (HIV) infection in the United States; 38,700 were new infections. Knowledge of HIV infection status, behavior change, and antiretroviral therapy (ART) all prevent HIV transmission. Persons who achieve and maintain viral suppression (achieved by most persons within 6 months of starting ART) can live long, healthy lives and pose effectively no risk of HIV transmission to their sexual partners.

Methods

A model was used to estimate transmission rates in 2016 along the HIV continuum of care. Data for sexual and needle-sharing behaviors were obtained from National HIV Behavioral Surveillance. Estimated HIV prevalence, incidence, receipt of care, and viral suppression were obtained from National HIV Surveillance System data.

Results

Overall, the HIV transmission rate was 3.5 per 100 person-years in 2016. Along the HIV continuum of care, the transmission rates from persons who were 1) acutely infected and unaware of their infection, 2) non-acutely infected and unaware, 3) aware of HIV infection but not in care, 4) receiving HIV care but not virally suppressed, and 5) taking ART and virally suppressed were 16.1, 8.4, 6.6, 6.1, and 0 per 100 person-years, respectively. The percentages of all transmissions generated by each group were 4.0%, 33.6%, 42.6%, 19.8%, and 0%, respectively.

Conclusion

Approximately 80% of new HIV transmissions are from persons who do not know they have HIV infection or are not receiving regular care. Going forward, increasing the percentage of persons with HIV infection who have achieved viral suppression and do not transmit HIV will be critical for ending the HIV epidemic in the United States.


Subject:
[+]
Adolescent
Adult
Anti-HIV Agents
Continuity Of Patient Care
Female
Health Knowledge, Attitudes, Practice
HIV Infections
Homosexuality, Male
Humans
Male
Middle Aged
Models, Statistical
Needle Sharing
Population Surveillance
Risk-Taking
Sexual Behavior
Substance Abuse, Intravenous
Viral Load
Vital Signs
Young Adult

Source:
MMWR Morb Mortal Wkly Rep. 68(11):267-272
Pubmed ID:
30897075
Pubmed Central ID:
PMC6478059
Document Type:
Journal Article
Place as Subject:
United States
Collection(s):
Morbidity and Mortality Weekly Report (MMWR)
Main Document Checksum:
[+]
urn:sha256:f1b60a410e9a3f4963f92934cb96be40a94a3c6eab5aa3ce2bd0be7b93ef12d3
File Type:

Supporting Files

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