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Ending the HIV Epidemic: Screening, Treatment, and Prevention
Ending the HIV Epidemic: Screening, Treatment, and Prevention

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A Guide for Health Care Providers 2022 1 Overview The scope of HIV in the United States New HIV diagnoses in United States subpopulations and trends Introduction to Ending the HIV Epidemic in the US ID: 920564 Download Presentation

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Slide1

Ending the HIV Epidemic: Screening, Treatment, and Prevention

A Guide for Health Care Providers2022

1

Slide2

Overview

The scope of HIV in the United States

New HIV diagnoses in United States subpopulations and trendsIntroduction to Ending the HIV Epidemic in the U.S.

2

Slide3

HIV in the United States

The number of new HIV diagnoses

fell 9% between 2015 and 2019:from

40,431

in 2015

to 36,801 in 20191

In 2019

~1.2M

people

were living with HIV in the United States

2

1 in 8people with HIV did not know it2

1 in 5people diagnosed with HIV were young adults (13‒24 years)1

1 in 5people already had AIDS3

About 40% of new HIV transmissionsare from people undiagnosed and unaware they have HIV4

1

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2019.

HIV Surveillance Report

. 2021;32:51. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-32.pdf 2 Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2015–2019. HIV Surveillance Report: Supplemental Report. 2021;26(1):44. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-26-1.pdf3 Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using surveillance data. United States and 6 dependent areas, 2019. HIV Surveillance Report: Supplemental Report. 2021;26(2): 11. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-vol-26-no-2.pdf 4 Dailey AF, Hoots BE, Hall HI, et al. Vital signs: human immunodeficiency virus testing and diagnosis delays—United States. MMWR Morb Mortal Wkly Rep. 2017;66:1301-1302.

3

Slide4

HIV Diagnoses by Transmission Category*

Male

‒male sexual contact

Injection drug use

Other

Heterosexual contact

Two-thirds

of new HIV diagnoses in 2019 were among gay, bisexual, and other men who have sex with men

3,976 (11%)

63 (0%)

8,617 (23%)

24,084 (66%)0%

100%*Excluding children (aged <13 y; n=61);

†Includes infections attributed to both male‒male sexual contact and injection drug use. 

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2019.

HIV Surveillance Report

. 2021;32:51. h

ttps://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-32.pdf

4

Slide5

HIV Diagnoses by Age at the Time of Diagnosis

Youth and young adults aged 13−34 years accounted for

>50%

of all people newly diagnosed with HIV in 2019

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2019.

HIV Surveillance Report

. 2021;32:51.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-32.pdf

>50%

N=36,740

5

Slide6

HIV Diagnoses by Subpopulation

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2019.

HIV Surveillance Report

. 2021;32:53.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-32.pdf

6

Slide7

HIV and Transgender People

Nearly

1 million

adults in the United States

identify as transgender

1

HIV diagnoses among transgender adults and adolescents

increased 7%

between 2015 and 2019

2

Approximately

1 in 7

transgender people with HIV already had AIDS when they were diagnosed3

Disproportionately high numbers of transgender people of color were diagnosed with HIV in 2019: 48%

were Black or African American, and 37% were

Hispanic or Latino2

1 Becasen JS, Denard CL, Mullins MM, Higa DH, Sipe TA. Estimating the prevalence of HIV and sexual behaviors among the US transgender population: a systematic review and meta-analysis, 2006-2017.

Am J Public Health. 2018;109(1);e1-e8.2

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report. 2021;32:57.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-32.pdf

3 Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using surveillance data: United States and 6 dependent areas, 2019. HIV Surveillance Report: Supplemental Report. 2021;26(2):69. https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-vol-26-no-2.pdf 7

Slide8

HIV Diagnosis Disparities

Among Transgender People*

HIV Diagnoses Among Transgender People in the United States, 2015–2019

Between 2015 and 2019, transgender women accounted for

94% of all

HIV diagnoses

among transgender people

1

*

Data for people of additional gender identities, such as nonbinary, genderqueer, two spirit, and others, are not included because of small numbers.

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2019.

HIV Surveillance Report

. 2021;32:57.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-32.pdf

8

Slide9

HIV Diagnoses Among People Who Inject Drugs*

In 2019,

1 in 9 people (3,978/36,801) diagnosed with HIV got HIV through injection drug use

72%

Male

(2,867)

28%

Female

(1,111)

* These data include infections attributed to male-male sexual contact

and

injection drug use (i.e., men who reported both risk factors)

Centers for Disease Control and Prevention. Diagnoses of HIV infection in the United States and dependent areas, 2019.

HIV Surveillance Report

. 2021;32:62-65, 70-73.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2018-updated-vol-32.pdf

9

Slide10

Trends in HIV Diagnoses Among People Who Inject Drugs*

Between 2009 and 2019, HIV diagnoses attributed to injection drug use decreased by

31%

* These data include infections attributed to male-male sexual contact

and

injection drug use (i.e., men who reported both risk factors).

Centers for Disease Control and Prevention. NCHHSTP AtlasPlus. Accessed July 19, 2021.

https://www.cdc.gov/nchhstp/atlas/index.htm

10

Slide11

Summary: HIV in the United States

Around 1.2 million people in the United States are living with HIV

1

Approximately

1 in 8

do not know they have HIV

1

Roughly

1 in 5

already have AIDS at the time of HIV diagnosis

2

If current trends continue, an additional 400,000 people in the United States will be diagnosed with HIV over the next 10 years3

HIV disproportionately affects some populations

:

Men who have sex with menPeople of colorTransgender peoplePeople who inject drugs

1

Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2015–2019.

HIV Surveillance Report: Supplemental Report.

2021;26(1):44.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-26-1.pdf

2

Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using surveillance data. United States and 6 dependent areas, 2019.

HIV Surveillance Report: Supplemental Report.

2021;26(2): 11.

https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-vol-26-no-2.pdf

3

About Ending the HIV Epidemic in the U.S.: Overview. HIV.gov. Updated June 2, 2021. Accessed July 19, 2021.

https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview

11

Slide12

Looking to the Future: Ending the HIV Epidemic in the U.S.

Ending the HIV Epidemic in the U.S.

is a bold plan announced in 2019 that aims to end the HIV epidemic in the United States by 2030 by:

Reducing the number of new HIV infections by

75% by 2025

Reducing the number of new HIV infections by

at least 90% by 2030

Averting an estimated

250,000 total HIV infections

About Ending the HIV Epidemic in the U.S.: Overview. HIV.gov. Updated June 2, 2021. Accessed July 19, 2021.

https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview

12

Slide13

Ending the HIV Epidemic Priority Jurisdictions

Phase I EHE state

Non-EHE state/territory with Phase I EHE counties

Ending the HIV Epidemic

identified 57 U.S. jurisdictions highly impacted by HIV

1

:

48 counties

Washington, DC

San Juan, Puerto Rico

7 states with substantial HIV burden in rural areas

Phase I (the first 5 years) of this initiative will target these jurisdictions with additional personnel, prevention resources, expertise, and technology

2

1

AHEAD: America’s HIV Epidemic Analysis Dashboard. AHEAD.HIV.Gov. Accessed July 19, 2021.

https://ahead.hiv.gov/

2

About Ending the HIV Epidemic in the U.S.: Key Strategies. HIV.gov. Updated May 8, 2020. Accessed July 19, 2021.

https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/key-strategies

13

Slide14

Ending the HIV Epidemic: Four Pillars

Through its four pillars

—Diagnose, Treat, Prevent, Respond—Phases I and II of

Ending the HIV Epidemic

aim to reduce the number of new HIV diagnoses by 90% by 2030

Phase III will leverage intensive case management to maintain <3,000 new HIV infections per year

About Ending the HIV Epidemic in the U.S.: Key Strategies. HIV.gov. Updated May 8, 2020. Accessed July 19, 2021.

https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/key-strategies

14

Slide15

Ending the HIV Epidemic: AHEAD Indicators

Overarching Goal:

To decrease HIV incidence in the United States by 75% by 2025 and by 90% by 2030

Incidence

Estimated number of new HIV infections in a given year

Midterm Goal:

Will be used to show historical movement toward achieving the overall goal

Knowledge of Status

Estimated percentage of people with HIV who have received an HIV diagnosis

Leading Indicators

(Ending the HIV Epidemic pillars)

Diagnoses

Number of people with HIV diagnosed in a given year confirmed by laboratory or clinical evidence

Linkage to HIV Medical CarePercentage of people with HIV diagnosed in a given year who receive medical care for HIV within 1 month of diagnosisViral SuppressionPercentage of people living with diagnosed HIV infection in a given year who have <200 copies per milliliter of blood

Pre-Exposure Prophylaxis (PrEP) CoverageEstimated percentage of individuals with indications for PrEP classified as having been prescribed PrEP

AHEAD: America’s HIV Epidemic Analysis Dashboard. AHEAD.HIV.gov. Accessed July 19, 2021.

https://ahead.hiv.gov/

15

Slide16

Ending the HIV Epidemic: Indicators

PrEP Coverage

Viral Suppression

Linkage to HIV Medical Care

Diagnoses

16

AHEAD: America’s HIV Epidemic Analysis Dashboard. AHEAD.HIV.gov. Accessed January 12, 2022.

https://ahead.hiv.gov/

Slide17

Ending the HIV Epidemic

: Indicators (cont’d 1)

17

AHEAD: America’s HIV Epidemic Analysis Dashboard. AHEAD.HIV.gov. Accessed January 12, 2022.

https://ahead.hiv.gov/

PrEP Coverage

Viral Suppression

Linkage to HIV Medical Care

Diagnoses

Slide18

Ending the HIV Epidemic

: Indicators (cont’d 2)

18

AHEAD: America’s HIV Epidemic Analysis Dashboard. AHEAD.HIV.gov. Accessed January 12, 2022.

https://ahead.hiv.gov/

PrEP Coverage

Viral Suppression

Linkage to HIV Medical Care

Diagnoses

Slide19

Ending the HIV Epidemic: Indicators (cont’d 3)

Diagnoses

Linkage to HIV Medical Care

Viral Suppression

PrEP Coverage

AHEAD: America’s HIV Epidemic Analysis Dashboard. AHEAD.HIV.gov. Accessed January 12, 2022.

https://ahead.hiv.gov/

19

Slide20

“We can do this. We can eliminate HIV transmission. We can get the epidemic under control here in the United States and in countries around the world. We have the scientific understanding, we have the treatments, and we have the tools we need.”

—President Biden

More information on Ending the HIV Epidemic

can be found at:

HIV.gov

.

Biden, J. Remarks by President Biden to commemorate World AIDS Day, launch the National HIV/AIDS Strategy, and kick off the Global Fund replenishment process. whitehouse.gov.

https://www.whitehouse.gov/briefing-room/speeches-remarks/2021/12/01/remarks-by-president-biden-to-commemorate-world-aids-day-launch-the-national-hiv-aids-strategy-and-kick-off-the-global-fund-replenishment-process/

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