From 2008 to 2015, the estimated annual number of HIV infections in the U.S. decreased by nearly 15% but increased among Hispanic/Latino men who have sex with men, according to a recent study.
CDC researchers used data from the National HIV Surveillance System on the first CD4 test result after diagnosis to model HIV incidence from 2008 to 2015 among people ages 13 years and older. They also used data on those living with diagnosed HIV infection by the end of 2007 to estimate HIV prevalence and the percentage of undiagnosed HIV infections. Results were published online on March 20 by Annals of Internal Medicine.
The overall estimated HIV incidence in the U.S. decreased by 14.8%, from 45,200 infections in 2008 to 38,500 in 2015 (estimated annual percentage change, −2.6%; 95% CI, −3.2% to −2.1%) but remained relatively stable among men who have sex with men, decreasing from 26,700 infections in 2008 to 26,200 in 2015. In addition to having the highest incidence of HIV infection, men who have sex with men also had the highest prevalence and percentage of undiagnosed HIV infections among all risk groups.
Researchers found racial differences in HIV incidence among men who have sex with men. Among Hispanic/Latino men who have sex with men, the incidence of HIV increased 3.1% (95% CI, 1.6% to 4.5%) per year, from 6,300 infections in 2008 to 7,900 infections in 2015. Among black/African-American men who have sex with men, HIV incidence remained stable at about 10,000 infections per year, and among white men who have sex with men, HIV incidence decreased 2.7% (95% CI, −3.8% to −1.5%) per year, from 8,800 infections in 2008 to 7,100 in 2015.
For men who have sex with men, trends in HIV incidence also differed by age group, decreasing by 3.0% (95% CI, −4.2% to −1.8%) per year among those ages 13 to 24 years; increasing by 5.7% (95% CI, 4.4% to 7.0%) per year among those ages 25 to 34 years; and decreasing by 4.7% (95% CI, −6.2% to −3.1%) per year among those ages 35 to 44 years.
“Programs focusing on care and treatment for Hispanics/Latinos with HIV infection might strengthen efforts to link them to care, keep them in treatment, and promote adherence to medication to achieve optimal health outcomes,” the study authors wrote. “The decreasing trends in incidence among other risk groups may reflect prevention and care efforts, such as testing, linkage to care, HIV treatment, and access to syringe service programs for persons who inject drugs.”
The authors noted limitations of their analysis, such as the reliance of their estimates on the accuracy of the CD4 depletion model and completeness of its data. They added that estimates were based on the assumption that a person's HIV infection, diagnosis, and death all occurred in the U.S.