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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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Presentation on theme: "Ending the HIV Epidemic: Screening, Treatment, and Prevention"— Presentation transcript
Slide1
Ending the HIV Epidemic: Screening, Treatment, and Prevention
A Guide for Health Care Providers2022
1
Slide2Overview
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
Slide3HIV 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
Slide4HIV 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
Slide5HIV 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
Slide6HIV 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
Slide7HIV 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
Slide8HIV 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
Slide9HIV 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
Slide10Trends 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
Slide11Summary: 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
Slide12Looking 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
Slide13Ending 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
Slide14Ending 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
Slide15Ending 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
Slide16Ending 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/
Slide17Ending 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
Slide18Ending 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
Slide19Ending 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/