Trends in HIV Care Outcomes Among Adults and Adolescents - 33 Jurisdictions, United States, 2014-2018.

Dailey, André; Johnson, Anna Satcher; Hu, Xiaohong; Gant, Zanetta; Lyons, Shacara Johnson; Adih, William

BACKGROUND With significant improvements in the diagnosis and treatment of HIV, the number of people with HIV in the United States steadily increases. Monitoring trends in HIV-related care outcomes is needed to inform programs aimed at reducing new HIV infections in the United States. SETTING The setting is 33 United States jurisdictions that as of December 2019 had complete laboratory reporting for specimens through September 2019. METHODS Estimated annual percent change (EAPC) and 95% confidence intervals (CIs) were calculated to assess trends in stage of disease at time of diagnosis, linkage to HIV medical care within 1 month after HIV diagnosis, and viral suppression within 6 months after HIV diagnosis. Differences in percentages were analyzed by gender, age, race/ethnicity, and transmission category for persons with HIV diagnosed from 2014-2018. RESULTS Among 133,477 persons with HIV diagnosed during 2014-2018, the percentage of persons that received a diagnosis classified as stage 0 increased 13.7% , stages 1-2 (early infections) increased 2.9%, stage 3 (AIDS) declined 1.5%, linkage to HIV medical care within 1 month after HIV diagnosis increased 2.3%, and viral suppression within 6 months after HIV diagnosis increased 6.5% per year, on average. Subpopulations and areas that showed the least progress were persons aged 45-54 years, American Indian/Alaska Native persons, Asian persons, Native Hawaiian/other Pacific Islander persons, and rural areas with substantial HIV prevalence. CONCLUSIONS New infections will continue to occur unless improvements are made in implementing the EHE strategies of diagnosing, treating, and preventing HIV infection.