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

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 had mandatory and complete reporting of all levels of CD4 and viral load test results for each year during 2014-2018. Methods: Estimated annual percentage change and 95% confidence intervals were calculated to assess trends in stage of disease at time of diagnosis, linkage to HIV medical care within 1 month of HIV diagnosis, and viral suppression within 6 months after HIV diagnosis. Differences in percentages were analyzed by sex, age, race/ethnicity, and transmission category for persons with HIV diagnosed from 2014 to 2018. Results: Among 133,477 persons with HIV diagnosed during 2014-2018, the percentage of persons who 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 of 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, respectively. Conclusions: New infections will continue to occur unless improvements are made in implementing the Ending the HIV Epidemic: A Plan for America strategies of diagnosing, treating, and preventing HIV infection.

Automated summary

The number of people diagnosed with HIV in the United States has been steadily increasing from 2014 to 2018. While early infections (stage 1-2) have slightly increased, the percentage of AIDS diagnoses (stage 3) has declined. Linkage to HIV medical care within 1 month of diagnosis has improved, as well as viral suppression within 6 months, with an average annual increase of 6.5%.