February 24, 2017 BY imani leave a comment
The number of annual new HIV infections in the US fell by 18% since 2008, offering evidence that prevention and treatment efforts are having an impact, according to data from the US Centers for Disease Control and Prevention (CDC) released this week. According to the report, the number of annual HIV infections fell from an estimated 45,700 in 2008 to 37,600 in 2014. This included a 36% decline among heterosexuals (from 13,400 to 8600) and a dramatic 56% drop among people who inject drugs (from 3900 to 1700).
“The nation’s new high-impact approach to HIV prevention is working,” Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, stated in a CDC press release. “These data reflect the success of collective prevention and treatment efforts at national, state, and local levels. We must ensure the interventions that work reach those who need them most.”
But annual new infections remained stable among gay and bisexual men – at about 26,000 per year – as increases and decreases in different subgroups offset each other. Men who have sex with men were the only group that did not see an overall decline in yearly HIV incidence from 2008 to 2014.
Between 2008 and 2014 new infections decreased substantially in several states and in Washington, DC. In fact, the researchers did not see increases in any of the 36 jurisdictions where annual HIV incidence could be estimated.
- Washington, DC: 10% drop per year over the six-year period
- Maryland: about 8% per year
- Pennsylvania: about 7% per year
- Georgia: about 6% per year
- New York: about 5% per year
- North Carolina: about 5% per year
- Illinois: about 4% per year
- Texas: about 2% per year.
States in the Southeast US continued to bear a disproportionate burden of HIV. While Southern states include 37% of the US population, they accounted for half of estimated infections in 2014.
CDC researchers suggested that the declines in new HIV infections, where they occurred, were largely due to efforts to increase the number of HIV-positive people who have been tested, are taking effective antiretroviral treatment, and have suppressed viral load, as undetectable virus is essentially untransmittable.
Increased use of pre-exposure prophylaxis (PrEP) may also have played a role in recent years – especially in some groups of gay men. However, Truvada (tenofovir/emtricitabine) was only approved for PrEP in 2012 and not widely used for this purpose until the second half of 2013, and so would not have played a role for most of the study period.
Expansion of syringe services and other harm reduction efforts likely helped reduce the number of new infections among people who inject drugs by more than half. But the new figures do not reflect localized HIV outbreaks among drug injectors like the one that occurred in rural Indiana in early 2015.
“The opioid epidemic in our country is jeopardizing the dramatic progress we’ve made in reducing HIV among people who inject drugs,” Mermin cautioned. “We need to expand the reach of comprehensive syringe services programs, which reduce the risk of HIV infection without increasing drug use, and can link people to vital services to help them stop using drugs.”