Lifetime disparities in HIV risk persist, CDC data shows

Using data from the National HIV Surveillance System, the National Center for Health Statistics, and the US Census, a CDC team investigated the lifetime risk of HIV in the United States.

Persistent disparities in the lifetime risk of an HIV diagnosis between women and men, as well as between races and ethnicities, underscore the continued need for increased education and prevention efforts in the United States. , noted CDC researchers. in a presentation at this year’s conference on retroviruses and opportunistic infections.

These investigators used data on HIV diagnosis, mortality, and census population from the National HIV Surveillance System, the National Center for Health Statistics, and the US Census, respectively. The probability of an HIV diagnosis at any age was calculated using HIV diagnoses and non-HIV deaths from 2017 to 2019 and compared to similar data from 2010 to 2014.

“The lifetime risk estimate may be a useful tool for clinicians, partners, and policy makers when describing HIV burden because it can be more easily understood by the public,” the authors wrote. “Lifetime risk estimates are used to compare disease burden between populations.”

Overall, their figures show a 1 in 120 lifetime risk of an HIV diagnosis from 2017 to 2019 compared to 1 in 106 from 2010 to 2014, an improvement of 11%.

Comparing this result between women and men, the risk was lower for women (1 in 309) and higher for men (1 in 76), so the latter had a 4 times higher risk of being diagnosed. of HIV.

Additionally, when stratifying risk by race, women had a lower universal lifetime risk of acquiring HIV than men:

  • Black:
    • Women: 1 in 75
    • Men: 1 in 27
  • Hispanic/Latino:
    • Women: 1 in 287
    • Men: 1 in 50
  • Native Hawaiian/Other Pacific Islander:
    • Women: 1 in 611
    • Men: 1 in 89
  • Native American/Alaska Native:
    • Women: 1 in 435
    • Men: 1 in 116
  • White:
    • Women: 1 in 874
    • Men: 1 in 171
  • Asian:
    • Women: 1 in 1298
    • Men: 1 in 187

Additionally, when comparing 2010 to 2014 and 2017 to 2019, lifetime risk is down for most groups. Exceptions were American Indian/Alaska Native, Hispanic/Latino, and Hawaiian/Other Pacific Islander men and white women.

Breaking down the findings by state and jurisdiction, the highest overall risks were seen in Washington, DC (1 in 39); followed by Georgia (1 in 59); Florida (1 in 63); Louisiana (1 in 69); Nevada (1 in 84); and Maryland (1 in 85). The lowest risks were in Vermont (1 in 515), New Hampshire (1 in 533), Montana (1 in 536), Maine (1 in 584), Idaho (1 in 624) and Wyoming (1 in 655).

Summarizing the investigators’ findings, lead author Sonia Singh, PhD, of the CDC’s Division of HIV Prevention, noted that their findings assume “the rate of infection will continue [and] that the prevention efforts are working”, as evidenced by the drop observed between the 2 periods.

However, continued progress is still needed in HIV prevention and treatment due to persistent risk disparities.

Reference

Singh S, Hu X, Hess K. Estimated lifetime risk of a diagnosis of HIV infection in the United States. Presented at: Conference on Retroviruses and Opportunistic Infections; February 12-16, 2022; Virtual. Abstract 43. https://www.croiconference.org/abstract/estimating-the-lifetime-risk-of-a-diagnosis-of-hiv-infection-in-the-united-states/

Martin E. Berry