Behavioral and Clinical Characteristics of Persons Living with Diagnosed HIV Infection—Medical Monitoring Project, United States, 2019 Cycle: Commentary

Commentary

At year-end 2018, an estimated 1,040,352 persons in the United States and 6 dependent areas were living with diagnosed HIV infection [1]. In 2019, the number of new HIV diagnoses was 37,881 [1]. Although the National HIV Surveillance System (NHSS) collects information about persons with diagnosed HIV infection [2], other surveillance systems provide more detailed information about care seeking, health care use, use of ancillary services, and other behaviors [3]. In 2005, in response to an Institute of Medicine (IOM) report outlining the need for representative data on persons with HIV [4], the Centers for Disease Control and Prevention (CDC) implemented the Medical Monitoring Project (MMP), which from 2009 to 2014 collected data from a 3-stage probability sample of adults receiving HIV medical care [5]. In 2015, in response to recommendations stemming from an IOM review of national HIV data systems [6], MMP sampling and weighting methods were revised to include all adults with diagnosed HIV infection regardless of HIV care status. MMP is a cross-sectional, nationally representative, complex sample survey that assesses the behavioral and clinical characteristics of adults with diagnosed HIV infection in the United States. MMP also provides information on behaviors and clinical outcomes affecting the risk of HIV transmission, morbidity, and mortality that are critical for achieving the goals of the HIV National Strategic Plan [7] and the Ending the HIV Epidemic in the U.S. (EHE) initiative [8], which seeks to reduce new HIV infections in the United States by 90% by 2030.

The 2019 MMP sample was selected in 2 consecutive stages: (1) U.S. states, the District of Columbia, and Puerto Rico and (2) persons aged ≥18 years with diagnosed HIV infection reported to NHSS as of December 31, 2018. A total of 23 project areas from 16 states and Puerto Rico were funded to conduct data collection for the 2019 cycle (Table 1).

This report presents unweighted frequencies and weighted prevalence estimates with 95% confidence intervals for selected characteristics. The estimates describe the characteristics of adults with diagnosed HIV infection who are living in the United States, hereafter referred to as persons with diagnosed HIV or persons. The period referenced for estimates is the 12 months before the participants’ interviews and medical record abstractions unless otherwise noted. Statistical software (SAS, version 9.4) was used for analysis of weighted data [9]. Data are not reported for estimates derived from a denominator size < 30 or with a coefficient of variation ≥ 0.30.

Estimates with an absolute confidence interval width ≥ 30, estimates with an absolute confidence interval width between 5 and 30 and a relative confidence interval width > 130%, and estimates of 0% or 100% are marked with an asterisk and should be interpreted with caution. No statistical tests were performed. Additional information on MMP is available at https://www.cdc.gov/hiv/statistics/systems/mmp/.

Highlights of Analyses

Response Rates

All 16 states, including 6 separately funded jurisdictions within those states, and the 1 territory sampled for MMP participated (Figure 1). In total, 9,700 persons were sampled from NHSS and 4,100 participated (Table 1). Adjusted for eligibility, the response rate was 45% (data not shown in table).

Figure 1. Participating Medical Monitoring Project Sites, Including 16 States and 6 Separately Funded Jurisdictions—United States, 2019

For the 16 states and territory selected in the first stage of sampling, 23 individual jurisdictions were funded to conduct data collection for the 2019 cycle, including 16 states, Puerto Rico, and 6 independent surveillance jurisdictions within the selected states.

Sociodemographic Characteristics

An estimated 75% of persons were male, 23% were female, and 2% were transgender (Figure 2; Table 2). Nearly half (46%) identified themselves as heterosexual or straight; 42% as lesbian or gay; 9% as bisexual; and 3% as another sexual orientation. An estimated 42% were Black or African American, 29% were White, and 22% were Hispanic or Latino. Nearly three-quarters (74%) were aged at least 40 years, and 68% had received an HIV diagnosis at least 10 years earlier.

Figure 2. Distribution of Gender, Age, Sexual Orientation, and Race/Ethnicity Among Adults with Diagnosed HIV—Medical Monitoring Project, United States, 2019

An estimated 75 percent of persons were male, 23&#37; were female, and 2 percent were transgender (defined as either self-identifying as transgender or reporting a gender identity that was different from their reported sex assigned at birth).

Nearly three-quarters (74 percent) of persons were at least 40 years of age.

Nearly half (46 percent) of persons identified themselves as heterosexual or straight; 42 percent as lesbian or gay; 9 percent as bisexual; and 3&#37; as an other sexual orientation.

An estimated 42 percent of persons were Black or African American and 29 percent were White. Additionally, 22 percent of all persons were Hispanic or Latino (Hispanics and Latinos can be of any race) and 7 percent were American Indian/Alaska Native, Asian, Native Hawaiian/Other Pacific Islander, or multiracial.

Note. Transgender persons defined as those who self-identified as transgender or who reported a gender identity different from sex assigned at birth. “Other” race/ethnicity defined as persons who were American Indian/Alaska Native, Asian, Native Hawaiian/Other Pacific Islander, or multiracial. Hispanics or Latinos can be of any race.

Over half (57%) had more than a high school education and 85% were born in a U.S. state or territory. The estimated prevalence of homelessness among all persons with diagnosed HIV was 9%. Approximately 13% had moved in with other people because of financial problems, and 3% had been evicted from housing during the past 12 months. An estimated 98% had health insurance or coverage for care or medications (including antiretroviral therapy [ART] medications): 46% had coverage through the Ryan White HIV/AIDS Program, 45% had Medicaid, 28% had Medicare, and 34% had private health insurance (Figure 3). An estimated 43% had a disability, 41% were unemployed, and 42% had household incomes at or below the federal poverty threshold. An estimated 18% received Supplemental Security Income (SSI), and 21% received Social Security Disability Insurance (SSDI).

Figure 3. Health Insurance or Coverage for Care or Medications During the 12 Months Before Interview Among Adults With Diagnosed HIV—Medical Monitoring Project, United States, 2019

46 percent of persons had health insurance or coverage for care or medications (including antiretroviral medications) through the Ryan White HIV/AIDS Program (RWHAP), 45&#37; had Medicaid, 28 percent had Medicare, and 34 percent had private health insurance. People could report more than one type of health insurance or coverage.

Note. Healthcare insurance/coverage types not mutually exclusive; people could report >1 type of coverage.
*RWHAP, Ryan White HIV/AIDS Program

Clinical Characteristics

According to the CDC stage of disease classification for HIV infection [10], an estimated 57% of persons ever had stage 3 (AIDS) disease (Table 3). An estimated 8% of persons had a geometric mean CD4 T-lymphocyte (CD4) count of 0–199 cells/µL. The estimated average geometric mean CD4 count among all persons was 637 cells/µL, and the median geometric mean CD4 count was 602 cells/µL (range, 1–2,650) (data not shown in table).

An estimated 67% of persons had an undetectable (< 200 copies/mL) viral load at the most recent measurement, while 61% had undetectable viral loads at all measurements during the past 12 months (sustained viral suppression) (Figure 4; Table 3).

Figure 4. Percentage of Adults with Diagnosed HIV Who Were Virally Suppressed During the 12 Months Before Interview—Medical Monitoring Project, United States, 2019

An estimated 67 percent of persons had an undetectable HIV viral load (&lt;200 copies/mL or undetectable) at the most recent test, and 61 percent of persons had sustained viral suppression, defined as having all viral load tests in the past 12 months &lt;200 copies/mL or undetectable in the 12 months prior to the interview.

*Viral load <200 copies/mL or undetectable based on most recent test in the past 12 months.
†Sustained viral suppression defined as having all viral load tests in the past 12 months <200 copies/mL or undetectable.

Use of Health Care Services

Overall, 97% had received outpatient HIV care during the past 12 months (Figure 5; Table 4). An estimated 79% were retained in care during the past 12 months, while 61% were retained in care during the past 24 months. An estimated 83% of persons had an ART prescription documented in the medical record during the 12 months before interview. Of persons who met the clinical criteria for Pneumocystis pneumonia (PCP) prophylaxis, 33% had a prescription for PCP prophylaxis documented in the medical record.

Figure 5. Receipt of HIV Care and Antiretroviral Therapy Prescription During the 12 Months Before Interview Among Adults with Diagnosed HIV—Medical Monitoring Project, United States, 2019

In all, 97 percent of persons received some form of outpatient HIV care in the 12 months prior to the interview. Outpatient HIV care was defined as any documentation of the following: encounter with an HIV care provider, viral load test result, CD4 test result, HIV resistance test or tropism assay, ART prescription, PCP prophylaxis, or MAC prophylaxis. Approximately 79 percent were retained in care in the 12 months prior to the interview. Retention in care was defined as at least two elements of outpatient HIV care at least 90 days apart in each 12-month period. Overall, an estimated 83 percent of persons had an antiretroviral therapy prescription documented in the medical record.

*Outpatient HIV care was defined as any documentation of the following: encounter with an HIV care provider, viral load test result, CD4 test result, HIV resistance test or tropism assay, ART prescription, PCP prophylaxis, or MAC prophylaxis.
†Two elements of outpatient HIV care at least 90 days apart in each 12-month period.

Among sexually active persons, an estimated 50% were tested for gonorrhea, 51% for chlamydia, 65% for syphilis, and 45% for all 3 sexually transmitted diseases (STDs) (Figure 6; Table 5).

Figure 6. Percentage of Sexually Active Adults with Diagnosed HIV Who Tested for Gonorrhea, Chlamydia, or Syphilis During the 12 Months Before Interview—Medical Monitoring Project, United States, 2019

Among sexually active persons, an estimated 50&#37; were tested for gonorrhea, 51&#37; for chlamydia, 65&#37; for syphilis, and 45&#37; for all 3 sexually transmitted diseases (STDs), for screening or diagnostic purposes. Percentages for gonorrhea and chlamydia include testing at any anatomical site.

An estimated 42% of persons were seen in an emergency department at least once, and 4% were seen at least 5 times (Figure 7; Table 6). An estimated 19% of persons were admitted to a hospital for an illness at least once.

Figure 7. Percentage of Adults with Diagnosed HIV Who Had At Least One Visit to the Emergency Room Or At Least One Hospital Admission During the 12 Months Before interview—Medical Monitoring Project, United States, 2019

In all, 42 percent of persons had at least 1 visit to an emergency department in the 12 months prior to the interview and 19 percent were admitted to the hospital in the 12 months prior to the interview.

Self-reported ART Medication Use and Adherence

An estimated 98% of persons had ever taken ART and 94% of persons were currently taking ART, based on self-report (Table 7). Among the estimated 4% of persons with a history of ART use but who were not currently taking ART, 51% were not taking ART due to money or insurance problems and 29% were not taking ART because the person’s health care provider never discussed restarting ART with them (Table 7).

Among persons taking ART, 61% took all of their ART doses in the past 30 days (Table 8). Among persons taking ART, 76% had never been troubled by ART side effects during the past 30 days; 14% had rarely been troubled. Among persons who had ever missed a dose, the most common reasons given for not taking one’s most recently missed ART dose were forgetting (60%), a change in one’s daily routine or being out of town (40%), and falling asleep early or oversleeping (35%) (Figure 8).

Figure 8. Reasons for Missing Last Antiretroviral Therapy Dose Among Adults with Diagnosed HIV Who Have Ever Missed a Dose—Medical Monitoring Project, United States, 2019*

Among persons who were currently taking antiretroviral therapy (ART) and ever missed a dose, 60&#37; reported that the reason for their most recently missed dose was because they forgot, 40&#37; reported it was because of a change in daily routine or being out of town, 35&#37; reported the reason was because they fell asleep early or overslept, 20&#37; had a problem getting a  prescription or refill for HIV medicine or overwhelmed, and 17&#37; because they felt depressed.

*Participants may report more than one reason for last missed dose.

Clinical Characteristics by Selected Populations

The estimated prevalence of ART prescription documented in a medical record was 83% among males and 83% among females (Table 9). An estimated 80% of Blacks or African Americans were prescribed ART, compared with 86% of Hispanics or Latinos and 85% of Whites. The estimated prevalence of ART prescription was 76% among persons aged 18 to 29 years and 85% among those aged 50 years or older.

The estimated prevalence of sustained viral suppression was 62% among males and 59% among females. An estimated 56% of Blacks or African Americans had sustained viral suppression, compared with 67% of Hispanics or Latinos and 66% of Whites. The estimated prevalence of sustained viral suppression was 49% among persons aged 18 to 29 years and 67% among those aged 50 years or older.

Depression and Substance Use

The estimated prevalence of major or other depression in the past 2 weeks based on the Patient Health Questionnaire (PHQ-8) algorithm [11] was 16%, including 9% with major depression (Figure 9; Table 10). Based on the total PHQ-8 symptom score (see the appendix), an estimated 13% of persons had moderate or severe depression. The estimated prevalence of mild, moderate, or severe anxiety in the past 2 weeks based on the Generalized Anxiety Disorder Scale (GAD-7) [12] was 21%, including 7% with severe anxiety.

Figure 9. Percentage of Adults with Diagnosed HIV Who Experienced Symptoms of Major or Other Depression* and Generalized Anxiety Disorder† During the Two Weeks Before interview—Medical Monitoring Project, United States, 2019

9&#37; of adults with diagnosed HIV reported symptoms of major depression, and 7&#37; reported symptoms of other depression, during the past 2 weeks.

 

Of all adults with diagnosed HIV, 5 percent reported symptoms of mild anxiety, 9 percent reported symptoms of moderate anxiety, and 7 percent reported symptoms of severe anxiety in the past 2 weeks.

 

*Responses to the items on the PHQ-8 were used to define “major depression” and “other depression” according to criteria from the DSM-IV. “Major depression” was defined as having at least 5 symptoms of depression; “other depression” was defined as having 2–4 symptoms of depression. The PHQ-8 classification “other depression” comprises the DSM-IV categories of dysthymia and depressive disorder, not otherwise specified, which includes minor or subthreshold depression.

†Responses to the GAD-7 were used to define “mild anxiety,” “moderate anxiety,” and “severe anxiety,” according to criteria from the DSM-IV. “Severe anxiety” was defined as having a score of ≥ 15; “moderate anxiety” was defined as having a score of 10–14; and “mild anxiety” was defined as having a score of 5–9.

The estimated prevalence of current smoking was 32%: 26% of persons smoked daily, 3% weekly, 1% monthly, and 2% less than monthly (Figure 10; Table 11). The estimated prevalence of alcohol use was 61%: 6% of persons drank alcohol daily, 18% weekly, 12% monthly, and 25% less than monthly (Figure 10; Table 12). An estimated 15% of persons engaged in binge drinking during the past 30 days.

Figure 10. Percentage of Adults with Diagnosed HIV Who Smoked Cigarettes and Drank Alcohol During the 12 Months Before interview—Medical Monitoring Project, United States, 2019

The estimated prevalence of cigarette smoking in the past 12 months was 32 percent. An estimated 26 percent of persons smoked daily, 3&#37; weekly, 1&#37; monthly, and 2 percent less than monthly.

The estimated prevalence of any alcohol use in the past 12 months was 61 percent. An estimated 6 percent of persons reported drinking alcohol daily, 18 percent weekly, 12 percent monthly, and 25 percent reported less than monthly in the 12 months before the interview.  An estimated 15 percent of persons engaged in binge drinking, defined as 5 or more alcoholic beverages in one sitting for men or 4 or more alcoholic beverages for women, during the past 30 days.

*5 or more alcoholic beverages in one sitting for men or 4 or more alcoholic beverages for women

An estimated 32% of persons used noninjection drugs for nonmedical purposes (Table 13). In total, an estimated 29% used marijuana, 7% used poppers (amyl nitrite), 6% used cocaine, 5% used methamphetamines, 4% used club drugs, 3% used crack, and 3% used prescription opioids. An estimated 3% of persons used injection drugs for nonmedical purposes (Table 14). In total, an estimated 2% injected methamphetamines and 1% injected heroin.

Gynecologic and Reproductive Health

Among females, 88% reported receiving a Papanicolaou (Pap) test in the past 3 years (Figure 11; Table 15). An estimated 28% of females reported being pregnant at least once since receiving an HIV diagnosis.

Figure 11. Percentage of Female Adults with Diagnosed HIV Who Had a Papanicolaou Test During the Three Years Before interview Or Became Pregnant Since Receiving an HIV Diagnosis—Medical Monitoring Project, United States, 2019

An estimated 88 percent of all women received a Pap test in the past 3 years. An estimated 28 percent of women had been pregnant at least once since receiving an HIV diagnosis.

Sexual Behavior

An estimated 35% of men had receptive anal sex with men, 32% had insertive anal sex with men, and 18% had vaginal sex (Table 16). An estimated 39% of men did not have vaginal or anal sex. Among women, an estimated 5% had receptive anal sex, 50% had vaginal sex, and 50% did not have vaginal or anal sex. Among transgender persons, 75% had vaginal or anal sex (Table 17).

Among men who had sex with men, an estimated 9% engaged in high-risk sex, compared with 5% of men who had sex only with women and 7% of women who had sex with men (Figure 12; Table 18).

Figure 12. Percentage of Adults with Diagnosed HIV Who Engaged in High-Risk Sex* During the 12 Months Before Interview by Sexual Behavior/Orientation—Medical Monitoring Project, United States, 2019

Among men who had sex with men (MSM), an estimated 9 percent engaged in high-risk sex, compared with 5 percent for men who only had sex with women (MSW), and 7 percent for women had sex with men (WSM).

Note. MSM, men who have sex with men; MSW, men who have sex only with women; WSM, women who have sex with men.
*Vaginal or anal sex with at least 1 HIV-negative or unknown status partner while not having sustained viral suppression (all viral load measurements in the past 12 months undetectable or <200 copies/mL), when a condom was not used, and the partner was not known to be taking preexposure prophylaxis (PrEP).

In terms of prevention strategies among sexually active persons, an estimated 63% of men who had sex with men engaged in sex and had sustained viral suppression, 56% had condom-protected sex, 17% had condomless sex with a partner on preexposure prophylaxis (PrEP), and 57% had sex with a person with HIV (Figure 13; Table 18). Among sexually active men who had sex only with women, 60% engaged in sex and had sustained viral suppression, 69% had condom-protected sex, 4% had condomless sex with a partner on PrEP, and 20% had sex with a person with HIV. Among sexually active women who had sex with men, 56% engaged in sex and had sustained viral suppression, 54% had condom-protected sex, 2% had condomless sex with a partner on PrEP, and 23% had sex with a person with HIV.

Figure 13. Prevention Strategies Used During the Past 12 Months Among Sexually Active Men Who Have Sex with Men, Men Who Have Sex with Only Women, and Women Who Have Sex with Men with Diagnosed HIV— Medical Monitoring Project, United States, 2019

During the past 12 months, an estimated 63&#37; of sexually active men with diagnosed HIV who had sex with men engaged in sex and had viral suppression. An estimated 56&#37; of persons had condom-protected sex; 17&#37; had condomless sex with a partner on PrEP; and 57&#37; had sex with a person with HIV.  During the past 12 months, an estimated 60&#37; of sexually active men with diagnosed HIV who only had sex with women engaged in sex and had viral suppression. An estimated 69&#37; of persons had condom-protected sex; 4&#37; had condomless sex with a partner on PrEP; and 20&#37; had sex with a person with HIV.  During the past 12 months, an estimated 56&#37; of sexually active women with diagnosed HIV who had sex with men engaged in sex and had viral suppression. An estimated 54&#37; of persons had condom-protected sex; 2&#37; had condomless sex with a partner on PrEP; and 23&#37; had sex with a person with HIV.

Note. MSM, men who have sex with men; MSW, men who have sex only with women; WSM, women who have sex with men.

Met and Unmet Need for Ancillary Services

Among all HIV support services, the most commonly reported service received in the 12 months before interview was HIV case management (57%); estimated unmet need for HIV case management services was 7% (Figure 14; Table 19). Of all non-HIV medical care services, the most commonly reported service received was dental care (61%); 22% reported an unmet need for dental care. Among all subsistence services, the most commonly reported services received were obtained through the Supplemental Nutrition Assistance Program (SNAP) or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (37%); unmet need for SNAP or WIC services was 11%.

Figure 14a. Percentage of Adults with Diagnosed HIV Who Received and Needed Ancillary Care Services Related to HIV Support During the 12 Months Before Interview—Medical Monitoring Project, United States, 2019

For HIV support services, an estimated 57&#37; of persons received HIV case management services, 47&#37; received medicine through Ryan White/ADAP, 35&#37; received ART adherence support services, 15&#37; received patient navigation services, and 12&#37; received HIV peer support services.  In total, 7&#37; of persons had unmet needs for HIV case management, 3&#37; had unmet needs for medicine through Ryan White or ADAP, 1&#37; had unmet needs for adherence support services, 4&#37; had unmet needs for patient navigation services, and 7&#37; had unmet needs for HIV peer support services.

Figure 14b. Percentage of Adults with Diagnosed HIV Who Received and Needed Ancillary Care Services Related to Non-HIV Medical Services During the 12 Months Before Interview—Medical Monitoring Project, United States, 2019

For non-HIV medical care services, an estimated 61&#37; of person received dental care, 32&#37; received mental health services, and 7&#37; received drug or alcohol counseling or treatment.  In total, 22&#37; had unmet needs for dental care, 8&#37; had unmet needs for mental health services, and 2&#37; had unmet needs for drug or alcohol counseling or treatment.

Figure 14c. Percentage of Adults with Diagnosed HIV Who Received and Needed Ancillary Care Services Related to  Subsistence During the 12 Months Before Interview—Medical Monitoring Project, United States, 2019

For subsistence services, an estimated 37&#37; received SNAP or WIC, 25&#37; received transportation assistance, 21&#37; received meal or food services, and 17&#37; received shelter or housing services.  In total, 11&#37; had unmet needs for SNAP or WIC, 7&#37; had unmet needs for transportation assistance, 8&#37; had unmet needs for meal or food services, and 9&#37; had unmet needs for shelter or housing services.

*AIDS Drug Assistance Program
†ART: Antiretroviral therapy
‡SNAP: Supplemental Nutrition Assistance Program; WIC: Special Supplemental Nutrition Program for Women, Infants, and Children
§Includes services such as soup kitchens, food pantries, food banks, church dinners, or food delivery services.

Physical Violence and Forced Sex

An estimated 25% of persons had ever been physically hurt by a romantic or sexual partner, including 4% who experienced this in the past 12 months (Figure 15; Table 20). An estimated 17% of persons had ever been threatened with harm or physically forced to have unwanted sex, including 1% who experienced this in the past 12 months.

Figure 15. Percentage of Adults with Diagnosed HIV Who Experienced Physical Violence by an Intimate Partner or Forced Sex During Their Lifetime or the 12 Months Before Interview—Medical Monitoring Project, United States, 2019

Over one-quarter (25 percent) of persons were ever slapped, punched, shoved, kicked, choked, or otherwise physically hurt by a romantic or sexual partner and 4 percent of persons experienced this in the 12 months prior to the interview. In all, 17 percent were ever threatened with harm or physically forced to have unwanted vaginal, anal, or oral sex and 1 percent of persons experienced this in the 12 months prior to the interview.

Prevention Activities

An estimated 61% of persons received counseling from a physician, nurse, or other health care worker about HIV and STD risk reduction; 32% had a one-on-one conversation with an outreach worker, a counselor, or a prevention program worker about prevention; and 12% participated in a small-group session (excluding discussions with friends) to discuss the prevention of HIV and other STDs (Figure 16; Table 21). An estimated 46% of persons received free condoms from various organizations.

Figure 16. Receipt of HIV and Sexually Transmitted Disease Prevention Services During the 12 Months Before Interview—Medical Monitoring Project, United States, 2019

During the past 12 months, an estimated 61 percent of persons received counseling  from a physician, nurse, or other healthcare worker about HIV and sexually transmitted disease (STD) prevention; 32 percent had a one-on-one conversation with an outreach worker, a counselor, or a prevention program worker about HIV and STD prevention; and 12 percent participated in a small-group session (excluding discussions with friends) to discuss the prevention of HIV and other STDs in the past 12 months. An estimated 46 percent of persons received free condoms.

Centers for Disease Control and Prevention National Indicators

The estimated prevalence of homelessness among persons who received outpatient HIV care in the past 12 months was 9% (Table 22). The median HIV stigma score (see the appendix for more details on how the score was derived and its validity) among all persons was 38. When the personalized stigma dimension was limited to the past 12 months, the median HIV stigma score was 31. An estimated 7% of persons engaged in high-risk sex.

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Data Tables

Table 1. Participants, by project area—Medical Monitoring Project, United States, 2019
Project area No. sampled No. participating % participatinga % of total
California (excluding Los Angeles County and San Francisco) 500 218 43.6 5.3
Chicago, IL 400 161 40.3 3.9
Delaware 400 189 47.3 4.6
Florida 800 315 39.4 7.7
Georgia 500 218 43.6 5.3
Houston, TX 400 181 45.3 4.4
Illinois (excluding Chicago) 200 67 33.5 1.6
Indiana 400 171 42.8 4.2
Los Angeles County, CA 400 167 41.8 4.1
Michigan 400 180 45.0 4.4
Mississippi 400 154 38.5 3.8
New Jersey 500 220 44.0 5.4
New York (excluding New York City) 200 82 41.0 2.0
New York City, NY 800 347 43.4 8.5
North Carolina 400 186 46.5 4.5
Oregon 400 180 45.0 4.4
Pennsylvania (excluding Philadelphia) 200 81 40.5 2.0
Philadelphia, PA 400 147 36.8 3.6
Puerto Rico 400 177 44.3 4.3
San Francisco, CA 400 165 41.3 4.0
Texas (excluding Houston) 400 157 39.3 3.8
Virginia 400 152 38.0 3.7
Washington 400 185 46.3 4.5
Total 9,700 4,100 42.3 100

Note. Percentages might not sum to 100 because of rounding.
a Not adjusted for eligibility.

Table 2. Selected characteristics of persons with diagnosed HIV infection—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Gender
Male 2,965 74.7 71.9–77.6
Female 1,042 23.2 20.3–26.1
Transgenderd 87 2.1 1.5–2.7
Sexual orientation
Lesbian or gay 1,675 41.9 37.7–46.0
Heterosexual or straight 1,912 45.9 41.6–50.2
Bisexual 359 9.2 7.7–10.7
Other 120 3.0 2.1–3.9
Race/ethnicity
American Indian/Alaska Native
Asian 38 1.0 0.6–1.4
Black/African American 1,708 41.5 32.5–50.5
Hispanic/Latinoe 933 22.4 14.5–30.4
Native Hawaiian/other Pacific Islander
White 1,195 29.2 24.3–34.1
Multiple races 191 4.6 3.4–5.8
Age at time of interview (years)
18–24 85 1.9 1.5–2.4
25–29 258 6.4 5.2–7.5
30–34 323 8.9 7.7–10.0
35–39 323 8.8 7.6–10.1
40–44 342 9.1 8.1–10.1
45–49 455 11.3 10.2–12.3
50–54 658 15.4 14.1–16.6
55–59 714 16.4 15.1–17.7
60–64 490 12.2 10.8–13.7
≥ 65 452 9.7 8.8–10.6
Education
Less than high school 688 16.3 15.0–17.6
High school diploma or GED 1,103 26.7 25.0–28.5
More than high school 2,296 57.0 54.7–59.2
Country or territory of birth
United States or U.S. territory 3,479 84.9 82.9–87.0
Foreign born 609 15.1 13.0–17.1
Time since HIV diagnosis (years)
< 5 556 13.8 12.1–15.4
5–9 726 18.7 16.9–20.5
≥10 2,814 67.5 65.8–69.2
Homeless at any time, past 12 monthsf
Yes 372 9.3 8.1–10.5
No 3,717 90.7 89.5–91.9
Moved in with other people because of financial problems, past 12 months
Yes 511 13.0 11.7–14.3
No 3,578 87.0 85.7–88.3
Number of times moved, past 12 months
0 3,004 72.7 70.6–74.7
1 679 17.5 16.1–18.8
≥ 2 400 9.9 8.6–11.1
Evicted from housing, past 12 months
Yes 106 2.8 1.9–3.6
No 3,983 97.2 96.4–98.1
Incarcerated >24 hours, past 12 months
Yes 148 3.9 3.0–4.8
No 3,938 96.1 95.2–97.0
Health insurance or coverage for care or medications, past 12 monthsg
Yes 4,024 97.9 97.1–98.6
No 47 2.1 1.4–2.9
Type of health insurance or coverage for care or medications, past 12 months
Ryan White HIV/AIDS Program
Yes 1,950 46.1 43.4–48.8
No 2,030 53.9 51.2–56.6
Medicaid
Yes 1,886 45.3 43.1–47.5
No 2,149 54.7 52.5–56.9
Medicare
Yes 1,176 27.8 26.1–29.6
No 2,813 72.2 70.4–73.9
Private health insurance
Yes 1,388 34.0 31.2–36.7
No 2,599 66.0 63.3–68.8
Other public insurance
Yes
No
Tricare/CHAMPUS or Veterans Administration
Yes 122 4.2 3.3–5.1
No 3,844 95.8 94.9–96.7
Insurance type unknownh
Yes 35 0.7 0.3–1.1
No 3,940 99.3 98.9–99.7
Any disabilityi
Yes 1,797 42.6 40.7–44.4
No 2,288 57.4 55.6–59.3
Received Supplemental Security Income (SSI), past 12 months
Yes 776 17.8 15.7–19.8
No 3,278 82.2 80.2–84.3
Received Social Security Disability Insurance (SSDI), past 12 months
Yes 843 20.7 18.4–23.0
No 3,197 79.3 77.0–81.6
Perception of general health
Poor 226 5.3 4.1–6.6
Fair 1,007 24.0 22.6–25.4
Good 1,428 35.6 34.0–37.2
Very good 865 21.4 19.7–23.1
Excellent 555 13.6 12.2–15.1
Went without food due to lack of money, past 12 months
Yes 781 19.9 18.0–21.8
No 3,302 80.1 78.2–82.0
Employment statusj
Employed 1,941 48.6 46.9–50.3
Unemployed 1,710 41.1 38.9–43.3
Student 42 1.3 0.8–1.7
Retired 385 9.1 7.7–10.4
Combined yearly household income (U.S.$)k
0–19,999 1,956 51.1 48.3–53.8
20,000–39,999 820 23.1 21.5–24.8
40,000–74,999 534 14.8 13.3–16.2
≥75,000 430 11.0 9.4–12.6
Poverty guidelinesl
Above poverty threshold 2,145 58.4 55.1–61.6
At or below poverty threshold 1,593 41.6 38.4–44.9
Total 4,100 100

Abbreviations: CI, confidence interval; GED, general educational development; CHAMPUS, Civilian Health and Medical Program of the Uniformed Services; U.S.$, U.S. dollar; HHS, Department of Health and Human Services [footnotes only].
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding.
Excluded are estimates with a coefficient of variation ≥ 0.30, estimates based on a denominator sample size < 30, “don’t know” responses, and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Persons were classified as transgender if sex at birth and gender reported by the person were different, or if the person chose “transgender” in response to the question about self-identified gender.
e Hispanics or Latinos can be of any race. Persons are classified in only 1 race/ethnicity category.
f Living on the street, in a shelter, in a single-room–occupancy hotel, or in a car.
g Persons could select more than 1 response for health insurance or coverage for care or medications.
h Unknown insurance type means that the person had insurance or coverage for care or medications, but the type of insurance or coverage could not be determined.
i Includes physical, mental, and emotional disabilities.
j Employed includes employed for wages, self-employed, or homemaker.
k Income from all sources, before taxes, in the last calendar year.
l Poverty guidelines as defined by HHS; the 2018 guidelines were used for persons interviewed in 2019 and the 2019 guidelines were used for persons interviewed in 2020. More information regarding HHS poverty guidelines can be found at https://aspe.hhs.gov/frequently-asked-questions-related-poverty-guidelines-and-poverty.external icon

Table 3. Stage of disease, CD4 counts, and viral suppression during the 12 months before interview among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
HIV infection stage 3 (AIDS)d
Yes 2,440 57.3 55.4–59.1
No 1,659 42.7 40.9–44.6
Geometric mean CD4 count (cells/µL)
0–199 267 8.3 7.3–9.2
200–349 361 10.6 9.2–12.0
350–499 549 17.7 16.3–19.0
≥500 2,095 63.5 61.5–65.4
Lowest CD4 count (cells/µL), past 12 months
0–49 93 2.9 2.3–3.6
50–199 252 7.6 6.8–8.5
200–349 442 13.3 11.8–14.8
350–499 609 19.1 17.7–20.5
≥500 1,876 57.1 55.2–58.9
Viral suppression
Most recent viral load documented undetectable or <200 copies/mL 2,984 66.9 61.8–72.0
Most recent viral load documented detectable, ≥200 copies/mL, or missing/unknown 1,116 33.1 28.0–38.2
Sustained viral suppression
All viral load measurements documented undetectable or <200 copies/mL 2,707 61.0 56.4–65.5
Any viral load ≥200 copies/mL or missing/unknown 1,393 39.0 34.5–43.6
Total 4,100 100

Abbreviations: CD4, CD4 T-lymphocyte count (cells/µL); CI, confidence interval; CDC, Centers for Disease Control and Prevention [footnotes only].
Source of disease stage information: CDC. Revised surveillance case definition for HIV infection—United States, 2014. MMWR 2014;63(RR-03):1–10. https://www.cdc.gov/mmwr/indrr_2014.html. Accessed June 23, 2021.
Note. CD4 counts and viral load measurements are from medical record abstraction.
Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d HIV infection, stage 3 (AIDS): documentation of an AIDS-defining condition or either a CD4 count of <200 cells/µL or a CD4 percentage of total lymphocytes of <14. Documentation of an AIDS-defining condition supersedes a CD4 count or percentage that would not, by itself, be the basis for a stage 3 (AIDS) classification.

Table 4. Receipt of HIV care, ART prescription, PCP prophylaxis, and influenza vaccination among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Ever received outpatient HIV cared
Yes
No
Received outpatient HIV care, past 12 monthsd
Yes 4,032 96.5 95.1–97.8
No 64 3.5 2.2–4.9
Received outpatient HIV care, past 24 monthsd
Yes
No
Retained in care, past 12 monthse
Yes 3,253 79.2 76.5–81.9
No 589 20.8 18.1–23.5
Retained in care, past 24 monthse
Yes 2,535 61.1 57.7–64.5
No 1,304 38.9 35.5–42.3
Prescribed ART, past 12 monthsf
Yes 3,542 82.6 80.9–84.3
No 558 17.4 15.7–19.1
Prescribed PCP prophylaxis, past 12 monthsg
Yes 99 33.4 23.2–43.5
No 193 66.6 56.5–76.8
Received influenza vaccination, past 12 months
Yes 3,140 75.8 73.7–77.9
No 915 24.2 22.1–26.3
Total 4,100 100

Abbreviations: CI, confidence interval; ART, antiretroviral therapy; PCP, Pneumocystis pneumonia; CD4, CD4 T-lymphocyte count (cells/µL) [footnotes only].
Note. CD4 counts, viral load measurements, and prophylaxes are from medical record abstraction. Influenza vaccination was obtained through interview. Measurement period is the 12 months before interview unless otherwise noted.
Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding.
Excluded are estimates with a coefficient of variation ≥ 0.30, estimates based on a denominator sample size < 30, “don’t know” responses, and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Outpatient HIV care was defined as any documentation of the following: encounter with an HIV care provider, viral load test result, CD4 test result, HIV resistance test or tropism assay, ART prescription, PCP prophylaxis, or MAC prophylaxis.
e Two elements of outpatient HIV care at least 90 days apart in each 12-month period.
f ART prescription documented in medical record; persons with no medical record abstraction were considered to have no documentation of ART prescription.
g Among persons with CD4 cell count < 200 cells/µL.

Table 5. Sexually transmitted disease testing during the 12 months before interview among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
Total population Sexually activea persons only
No.b %c 5% CId No.b %c 5% CId
Gonorrheae
Yes, received test 1,749 45.1 40.5–49.7 1,115 50.4 45.7–55.1
No test documented 1,994 54.9 50.3–59.5 1,002 49.6 44.9–54.3
Chlamydiaf
Yes, received test 1,749 45.1 40.3–49.8 1,119 50.5 45.6–55.4
No test documented 1,994 54.9 50.2–59.7 998 49.5 44.6–54.4
Syphilisg
Yes, received test 2,408 61.6 58.0–65.1 1,458 65.3 61.8–68.8
No test documented 1,335 38.4 34.9–42.0 659 34.7 31.2–38.2
Gonorrhea, chlamydia, and syphilis
Yes, received all 3 tests 1,560 40.2 36.0–44.4 1,005 45.3 40.8–49.7
Fewer than 3 tests documented 2,183 59.8 55.6–64.0 1,112 54.7 50.3–59.2
Total 4,100 100 2,307 100

Abbreviations: CI, confidence interval; DFA, direct fluorescent antibody [footnotes only]; EIA, enzyme immunoassay [footnotes only]; ELISA, enzyme- linked immunoassay [footnotes only]; FTA-ABS, fluorescent treponemal antibody absorbed [footnotes only]; MHA-TP, microhemagglutination assay for antibody to Treponema pallidum [footnotes only]; NAAT, nucleic acid amplification test [footnotes only]; RPR, rapid plasma reagin [footnotes only]; TP- PA, T. pallidum particle agglutination [footnotes only]; TPHA, T. pallidum hemagglutination assay [footnotes only]; VDRL, Venereal Disease Research Laboratory [footnotes only].
Note. Information on laboratory testing for sexually transmitted diseases was based on medical record abstraction. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Sexual activity was reported in the interview component of the Medical Monitoring Project and was defined as anal or vaginal intercourse.
b Numbers are unweighted.
c Percentages are weighted percentages.
d CIs incorporate weighted percentages.
e Testing for Neisseria gonorrhoeae was defined as documentation of a result from culture, gram stain, EIA, NAAT, or nucleic acid probe performed on a specimen from any anatomical site for screening or diagnostic purposes.
f Chlamydia trachomatis testing was defined as a result from culture, DFA, EIA or ELISA, NAAT, or nucleic acid probe performed on a specimen from any anatomical site for screening or diagnostic purposes.
g Syphilis testing was defined as a result from nontreponemal syphilis tests (RPR or VDRL), treponemal syphilis tests (TPHA, TP-PA, MHA-TP, or FTA- ABS tests), or dark-field microscopy performed for screening or diagnostic purposes.

Table 6. Emergency department visits and hospital admissions during the 12 months before interview among persons with diagnosed HIV—Medical Monitoring Project,
United States, 2019
No.a %b 95% CIc
Number of visits to emergency department
0 2,360 58.1 55.5–60.7
1 763 18.2 17.1–19.3
2–4 772 19.3 17.4–21.3
≥5 183 4.4 3.6–5.2
Number of hospital admissions
0 3,271 80.9 79.5–82.2
1 456 11.0 10.0–12.0
2–4 298 7.1 6.2–7.9
≥5 49 1.1 0.7–1.5
Total 4,100 100

Abbreviation: CI, confidence interval.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.

Table 7. Antiretroviral therapy (ART) use and reasons for not taking ART among persons with diagnosed HIV— Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Ever taken ART
Yes 4,026 98.2 97.5–98.9
No 48 1.8 1.1–2.5
Currently taking ART
Yes 3,930 94.4 93.1–95.8
No 144 5.6 4.2–6.9
Reasons for never taking ARTd
Health care provider never discussed taking ART with person
Yes
No
Health care provider said person should not start taking ART
Yes
No
Money or insurance problems
Yes
No
Person did not believe they needed ART
Yes 19 57.5* 36.4–78.5
No 13 42.5* 21.5–63.6
Person thinks ART would make them feel sick or harm them
Yes
No
Person decided not to take ART for some other reason
Yes 12 34.5* 14.3–54.7
No 20 65.5* 45.3–85.7
Reasons for not currently taking ART, among those persons with a history of ART used
Health care provider never discussed restarting ART with person
Yes 23 29.4 17.8–41.1
No 73 70.6 58.9–82.2
Health care provider said person should not take ART
Yes
No
Money or insurance problems
Yes 42 50.5 39.4–61.6
No 54 49.5 38.4–60.6
Person did not believe they needed ART
Yes
No
Person thinks ART would make them feel sick or harm them
Yes 23 30.1* 15.0–45.1
No 73 69.9* 54.9–85.0
Person decided not to take ART for some other reason
Yes 43 43.7 29.5–57.9
No 53 56.3 42.1–70.5
Total 4,100 100

Abbreviation: CI, confidence interval.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding.
Excluded are estimates with a coefficient of variation ≥0.30, estimates based on a denominator sample size <30, “don’t know” responses, and skipped (missing) responses. Estimates with an absolute CI width ≥ 0.30, estimates with an absolute CI width between 5 and 30 and a relative CI width >130%, and estimates of 0% or 100% are marked with an asterisk (*) and should be interpreted with caution.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Persons could select more than 1 response for reasons not taking ART.

Table 8. Antiretroviral therapy (ART) adherence and reasons for missing ART doses among persons with diagnosed HIV taking ART—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
ART adherence in the past 30 days
How many days did you miss at least 1 dose of any of your HIV medicines?
0 2,385 61.1 58.5–63.8
1–2 992 25.0 23.3–26.8
3–5 340 8.6 7.4–9.8
6–10 120 3.2 2.6–3.9
11+ 74 2.0 1.5–2.5
How well did you do at taking your HIV medicines in the way you were supposed to?
Very poor 38 0.9 0.6–1.2
Poor 52 1.3 0.9–1.8
Fair 194 5.3 4.5–6.0
Good 444 11.4 10.1–12.7
Very good 1,043 26.4 24.2–28.6
Excellent 2,157 54.7 52.5–56.9
How often did you take your HIV medicines in the way you were supposed to?
Never 24 0.6 0.3–0.8
Rarely 34 0.9 0.5–1.2
Sometimes 91 2.5 2.0–3.1
Usually 179 4.7 4.1–5.4
Almost always 876 22.6 20.8–24.4
Always 2,722 68.7 66.6–70.9
How often were you troubled by ART side effects?
Never 2,961 75.9 72.8–79.0
Rarely 514 13.6 11.8–15.5
About half the time 183 4.9 3.9–6.0
Most of the time 114 2.7 2.1–3.3
Always 124 2.9 2.3–3.5
Reasons for last missed ART dose among persons who ever missed a dosed
Had a problem paying for HIV medicines
Yes 146 5.1 4.1–6.1
No 2,762 94.9 93.9–95.9
Had a problem getting a prescription or a refill for HIV medicines
Yes 530 19.5 16.1–22.9
No 2,378 80.5 77.1–83.9
In the hospital or too sick to take HIV medicines
Yes 252 8.3 7.4–9.1
No 2,656 91.7 90.9–92.6
Fell asleep early or overslept
Yes 1,038 35.2 33.2–37.3
No 1,868 64.8 62.7–66.8
Change in your daily routine or were out of town
Yes 1,190 40.2 37.7–42.8
No 1,717 59.8 57.2–62.3
Had side effects from your HIV medicines
Yes 300 9.9 8.7–11.2
No 2,602 90.1 88.8–91.3
Felt depressed or overwhelmed
Yes 509 17.1 15.7–18.5
No 2,397 82.9 81.5–84.3
Was drinking or using drugs
Yes 310 9.7 8.6–10.8
No 2,597 90.3 89.2–91.4
Forgot to take HIV medicines
Yes 1,768 60.0 57.5–62.5
No 1,137 40.0 37.5–42.5
Did not feel like taking HIV medicines
Yes 366 11.9 10.4–13.4
No 2,538 88.1 86.6–89.6
Total 3,930 100

Abbreviation: CI, confidence interval.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Persons could report more than 1 reason for missed last dose.

Table 9. Antiretroviral therapy (ART) prescription, ART dose adherence, sustained viral suppression, and geometric mean CD4 count among persons with diagnosed HIV, by selected characteristics—Medical Monitoring Project, United States, 2019
Prescription of ARTa ART dose adherenceb Sustained viral suppressionc Geometric mean CD4 count ≥ 200d
No.e Row %f 95% CIg No.e Row %f 95% CIg No.e Row %f 95% CIg No.e Row %f 95% CIg
Gender
Male 2,567 82.6 80.6–84.6 1,728 61.1 58.3–63.8 1,994 62.0 56.6–67.4 2,204 92.3 91.1–93.4
Female 903 83.2 80.3–86.1 615 61.9 57.8–66.0 661 59.2 55.8–62.5 744 90.2 88.0–92.3
Transgenderh 68 76.0 64.5–87.5 39 52.6 41.3–63.8 50 49.8 39.5–60.2 55 93.1 86.8–99.4
Sexual orientation
Lesbian or gay 1,466 83.6 80.9–86.3 963 60.0 56.5–63.5 1,170 63.7 56.8–70.5 1,274 94.5 93.2–95.8
Heterosexual or straight 1,635 81.5 79.5–83.5 1,163 63.9 61.2–66.6 1,216 58.8 55.2–62.4 1,358 88.9 87.3–90.5
Bisexual 307 81.7 76.4–86.9 189 57.9 48.2–67.7 226 59.3 52.1–66.5 259 93.6 91.0–96.1
Other 105 86.6 77.6–95.6 53 42.7 32.6–52.8 71 57.8 49.3–66.3 88 90.5 84.1–96.8
Race/ethnicity
American Indian/Alaska Native
Asian 33 84.6 71.4–97.7 25 69.8* 54.5–85.1 29 69.7* 50.6–88.9 30 100*
Black/African American 1,444 80.2 77.5–82.9 964 60.5 56.6–64.5 1,043 55.9 51.4–60.4 1,213 90.0 88.4–91.6
Hispanic/Latinoi 827 86.2 83.2–89.2 524 57.2 52.7–61.7 654 66.8 61.4–72.3 716 91.3 89.1–93.5
Native Hawaiian/other Pacific Islander
White 1,050 84.5 81.7–87.3 765 66.8 61.7–71.8 854 65.6 58.4–72.9 891 95.1 93.8–96.4
Multiple races 159 77.9 69.5–86.3 93 50.4 40.5–60.3 108 51.0 39.9–62.1 134 87.6 81.8–93.5
Age at time of interview (years)
18–29 278 76.4 70.0–82.8 132 44.2 36.2–52.2 186 49.3 41.4–57.2 250 92.2 88.6–95.8
30–39 560 79.9 76.1–83.6 314 51.3 45.2–57.3 380 52.8 46.8–58.9 473 91.6 88.9–94.3
40–49 683 81.9 78.8–84.9 466 61.8 56.6–66.9 487 56.2 50.6–61.7 557 89.2 87.1–91.2
≥50 2,021 84.7 82.7–86.8 1,473 66.4 63.7–69.2 1,654 67.2 62.3–72.2 1,725 92.7 91.2–94.1
Total 3,542 82.6 80.9–84.3 2,385 61.1 58.5–63.8 2,707 61.0 56.4–65.5 3,005 91.7 90.8–92.7

Abbreviations: CD4, CD4 T-lymphocyte count (cells/µL); CI, confidence interval.
Note. Numbers might not add to total because of missing data.
Excluded are estimates with a coefficient of variation ≥ 0.30, estimates based on a denominator sample size <30, “don’t know” responses, and skipped (missing) responses. Estimates with an absolute CI width ≥ 0.30, estimates with an absolute CI width between 5 and 30 and a relative CI width >130%, and estimates of 0% or 100% are marked with an asterisk (*) and should be interpreted with caution.
a Prescription of ART was based on documentation in the medical record in the 12 months before interview.
b In past 30 days, 100% adherence to ART doses.
c All viral load measurements in the 12 months before interview documented undetectable or <200 copies/mL.
d Geometric mean CD4 count was abstracted from medical records and based on the 12 months before interview.
e Numbers are unweighted.
f Percentages are weighted percentages.
g CIs incorporate weighted percentages.
h Persons were classified as transgender if sex at birth and gender reported by the person were different, or if the person chose “transgender” in response to the question about self-identified gender.
i Hispanics or Latinos might be of any race. Persons are classified in only 1 race/ethnicity category.

Table 10. Depression and anxiety during the 2 weeks before interview among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Depression based on DSM-IV criteriad
No depression 3,377 83.9 82.0–85.8
Other depression 296 7.3 6.3–8.3
Major depression 361 8.8 7.4–10.1
Moderate or severe depression (PHQ-8 score ≥ 10)
Yes 547 13.3 11.4–15.2
No 3,491 86.7 84.8–88.6
Anxietye
No anxiety 3,201 78.7 75.9–81.4
Mild anxiety 222 5.4 4.6–6.1
Moderate anxiety 331 8.7 7.1–10.3
Severe anxiety 296 7.2 5.7–8.8
Total 4,100 100

Abbreviations: CI, confidence interval; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, 4th edition; GAD-7, Generalized Anxiety Disorder 7-item Scale [footnotes only]; PHQ-8, Patient Health Questionnaire.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Responses to the items on the PHQ-8 were used to define “major depression” and “other depression” according to criteria from the DSM-IV. “Major depression” was defined as having at least 5 symptoms of depression; “other depression” was defined as having 2–4 symptoms of depression.
e Responses to the GAD-7 were used to define “mild anxiety,” “moderate anxiety,” and “severe anxiety” according to criteria from the DSM-IV. “Severe anxiety” was defined as having a score of ≥ 15; “moderate anxiety” was defined as having a score of 10–14; and “mild anxiety” was defined as having a score of 5–9.

Table 11. Tobacco and electronic cigarette use among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Smoked ≥ 100 cigarettes (lifetime)
Yes 2,152 52.6 49.3–56.0
No 1,910 47.4 44.0–50.7
Cigarette smoking status
Never smoked 1,910 47.4 44.0–50.7
Former smoker 889 21.2 19.0–23.3
Current smoker 1,261 31.5 29.0–33.9
Frequency of current cigarette smoking
Never 2,799 68.5 66.1–71.0
Daily 1,029 25.9 23.8–28.0
Weekly 122 2.8 2.3–3.3
Monthly 38 1.0 0.6–1.5
Less than monthly 72 1.7 1.3–2.1
Smoked ≥ 50 cigars, cigarillos, or little filtered cigars (lifetime)
Yes 553 14.3 12.6–16.0
No 3,515 85.7 84.0–87.4
Cigars, cigarillos, or little filtered cigars smoking status
Never smoked 3,515 85.7 84.0–87.4
Former smoker 275 6.9 6.0–7.7
Current smoker 278 7.5 6.0–8.9
Frequency of current cigars, cigarillos, or little filtered cigars smoking
Never 3,790 92.5 91.1–94.0
Daily 77 2.1 1.4–2.9
Some days 72 1.9 1.4–2.5
Rarely 129 3.4 2.7–4.1
Electronic cigarette smoking status
Never used electronic cigarettes 3,042 73.5 69.7–77.3
Used electronic cigarettes, but not in the past 30 days 817 21.0 17.7–24.3
Used electronic cigarettes in the past 30 days 210 5.5 4.6–6.5
Total 4,100 100

Abbreviation: CI, confidence interval.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.

Table 12. Alcohol use during the 12 months before interview among persons with diagnosed HIV— Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Any alcohol used
Yes 2,481 61.0 58.2–63.9
No 1,588 39.0 36.1–41.8
Frequency of alcohol use
Daily 248 6.1 5.2–6.9
Weekly 747 18.1 16.5–19.6
Monthly 506 12.4 11.4–13.5
Less than monthly 980 24.5 23.1–25.8
Never 1,588 39.0 36.1–41.8
Binge drinking, past 30 dayse
Yes 601 14.8 12.7–16.9
No 3,449 85.2 83.1–87.3
Total 4,100 100

Abbreviation: CI, confidence interval.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Persons who drank at least 1 alcoholic beverage during the 12 months before interview. Alcoholic beverage was defined as a 12-ounce beer, 5-ounce glass of wine, or 1.5-ounce shot of liquor.
e Persons who drank ≥ 5 alcoholic beverages in a single sitting (≥ 4 for women) during the 30 days before interview.

Table 13. Noninjection drug use during the 12 months before interview among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Use of any noninjection drugsd
Yes 1,310 31.9 29.3–34.4
No 2,744 68.1 65.6–70.7
Noninjection drugs usedd
Marijuana
Yes 1,170 28.5 26.0–30.9
No 2,884 71.5 69.1–74.0
Crack
Yes 121 3.1 2.3–3.9
No 3,933 96.9 96.1–97.7
Cocaine that is smoked or snorted
Yes 237 6.0 5.0–7.0
No 3,817 94.0 93.0–95.0
Methamphetamine (e.g., crystal meth, tina, crank, ice)
Yes 218 5.4 4.1–6.6
No 3,833 94.6 93.4–95.9
Amphetamine (e.g., speed, bennies, uppers)
Yes 66 1.5 1.0–1.9
No 3,985 98.5 98.1–99.0
Club drugs (e.g., Ecstasy or X, ketamine or Special K, GHB or Liquid Ecstasy)
Yes 159 3.7 2.8–4.5
No 3,895 96.3 95.5–97.2
Amyl nitrite (poppers)
Yes 293 6.9 5.5–8.4
No 3,761 93.1 91.6–94.5
Prescription opioids (e.g., oxycodone, hydrocodone, Vicodin, Percocet)e
Yes 102 2.7 2.0–3.4
No 3,952 97.3 96.6–98.0
Prescription tranquilizers (e.g., Valium, Ativan, Xanax, downers, nerve pills)e
Yes 75 1.8 1.3–2.3
No 3,978 98.2 97.7–98.7
Total 4,100 100

Disclaimer: The use of trade names is for identification only and does not imply endorsement by the Department of Health and Human Services or the Centers for Disease Control and Prevention.
Abbreviations: CI, confidence interval; GHB, gamma hydroxybutyrate.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
Persons could report taking more than 1 noninjection drug.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Includes all drugs that were not injected (i.e., administered by any route other than injection), including legal drugs that were not used for medical purposes.
e Not prescribed, or prescribed but taken more than directed.

Table 14. Injection drug use during the 12 months before interview among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Use of any injection drugs
Yes 109 2.7 1.9–3.4
No 3,949 97.3 96.6–98.1
Injection drugs used
Cocaine
Yes
No
Heroin
Yes 28 0.5 0.2–0.7
No 4,029 99.5 99.3–99.8
Heroin and cocaine (speedball)
Yes
No
Methamphetamine (e.g., crystal meth, tina, crank, ice)
Yes 84 2.3 1.5–3.0
No 3,972 97.7 97.0–98.5
Amphetamine (e.g., speed, bennies, uppers)
Yes
No
Prescription opioids (e.g., OxyContin, oxycodone, hydrocodone)
Yes
No
Total 4,100 100

Disclaimer: The use of trade names is for identification only and does not imply endorsement by the Department of Health and Human Services or the Centers for Disease Control and Prevention.
Abbreviation: CI, confidence interval.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding.
Excluded are estimates with a coefficient of variation ≥ 0.30, estimates based on a denominator sample size < 30, “don’t know” responses, and skipped (missing) responses.
Persons could report taking more than 1 injection drug.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.

Table 15. Gynecological care and reproductive health among women with diagnosed HIV— Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Papanicolaou (Pap) test, past 3 yearsd
Yes 903 87.5 84.2–90.9
No 128 12.5 9.1–15.8
Pregnant since HIV diagnosis
Yes 283 28.4 23.0–33.8
No 747 71.6 66.2–77.0
Total 1,042 100

Abbreviation: CI, confidence interval.
Note. Measures are self-reported. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding.
Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Or since HIV diagnosis for women with a diagnosis within the past 3 years.

Table 16. Sexual behavior during the 12 months before interview among cisgender men and women with diagnosed HIV—Medical Monitoring Project, United States, 2019
Men Women
Behavior No.a %b 95% CIc No.a %b 95% CIc
Engaged in anal sex with men
Receptive
Yes 997 34.7 31.6–37.8 51 4.8 3.2–6.4
No 1,872 65.3 62.2–68.4 972 95.2 93.6–96.8
Insertive
Yes 923 32.3 30.2–34.4 NA NA NA
No 1,945 67.7 65.6–69.8 NA NA NA
Engaged in anal sex with women
Yes 59 2.0 1.5–2.4 NA NA NA
No 2,892 98.0 97.6–98.5 NA NA NA
Engaged in vaginal sex
Yes 516 18.2 15.5–20.9 512 50.0 45.6–54.4
No 2,378 81.8 79.1–84.5 514 50.0 45.6–54.4
Engaged in vaginal or anal sex
Yes 1,733 60.6 58.3–63.0 514 50.2 45.7–54.6
No 1,150 39.4 37.0–41.7 512 49.8 45.4–54.3
Number of vaginal or anal sex partners among
MSMd
Mean 7 NA
Median 2 NA
Range 1–300 NA
MSWe
Mean 2 NA
Median 1 NA
Range 1–90 NA
WSMf
Mean NA 1
Median NA 1
Range NA 1–70
Total 2,965 100 1,042 100

Abbreviations: CI, confidence interval; NA, not applicable; MSM, men who had sex with men; MSW, men who had sex only with women; WSM, women who had sex with men.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Among men who had anal sex with men in the 12 months before interview.
e Among men who had vaginal or anal sex only with women in the 12 months before interview.
f Among women who had vaginal or anal sex with men in the 12 months before interview.

Table 17. Sexual behavior during the 12 months before interview among transgender persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
Transgendera,b Transgender womena Transgender menb
Behavior No.c %d 95% CIe No.c %d 95% CIe No.c %d 95% CIe
Engaged in vaginal or anal sex
Yes 56 74.7 62.1–87.3 51 77.4 64.8–90.1
No 27 25.3 12.7–37.9 22 22.6 9.9–35.2
Engaged in vaginal or anal sex with men
Yes 52 70.4 58.2–82.6 50 77.0 64.2–89.7
No 31 29.6 17.4–41.8 23 23.0 10.3–35.8
Engaged in vaginal or anal sex with women
Yes
No
Engaged in vaginal or anal sex with transgender partners
Yes
No
Reported any high-risk sexf
Yes
No
Number of vaginal or anal sex partnersg
Mean 5 5 7
Median 2 2 1
Range 1–100 1–100 1–30
Total 87 100 77 100 8 100

Abbreviations: CI, confidence interval; PrEP, preexposure prophylaxis [footnotes only].
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding.
Excluded are estimates with a coefficient of variation ≥ 0.30, estimates based on a denominator sample size <30, “don’t know” responses, and skipped (missing) responses.
a Persons were classified as transgender if sex at birth and gender reported by the person were different, or if the person chose “transgender” in response to the question about self-identified gender. When reported sex at birth and gender were different, persons who reported that their sex assigned at birth was male, but identified as female or transgender, were classified as transgender women.
b Persons were classified as transgender if sex at birth and gender reported by the person were different, or if the person chose “transgender” in response to the question about self-identified gender. When reported sex at birth and gender were different, persons who reported that their sex assigned at birth was female, but identified as male or transgender, were classified as transgender men.
c Numbers are unweighted.
d Percentages are weighted percentages.
e CIs incorporate weighted percentages.
f Vaginal or anal sex with at least 1 partner with an HIV-negative or unknown status while not having sustained viral suppression (defined as HIV viral load <200 copies/mL documented in the medical record at every measure in the 12 months before interview), a condom was not used, and the partner was not on PrEP. PrEP use was only measured among the 5 most recent partners.
g Among persons who had vaginal or anal sex in the 12 months before interview.

Table 18. Sexual behavior during the 12 months before interview among men who had sex with men (MSM), men who had sex only with women (MSW), and women who had sex with men (WSM) with diagnosed HIV—Medical Monitoring Project, United States, 2019
MSM MSW WSM
Behavior No.a %b 95% CIc No.a %b 95% CIc No.a %b 95% CIc
Engaged in any high-risk sexd
Yes 153 8.8 6.8–10.7 32 4.6 3.1–6.1 69 7.1 5.2–8.9
No 1,841 91.2 89.3–93.2 834 95.4 93.9–96.9 930 92.9 91.1–94.8
Engaged in any high-risk sex (among sexually active persons)d
Yes 153 13.6 10.7–16.5 32 8.8 5.8–11.9 69 14.0 11.0–17.0
No 1,120 86.4 83.5–89.3 411 91.2 88.1–94.2 437 86.0 83.0–89.0
Percentages of sexually active persons who used a prevention strategy with at least 1 partner
Sex while having sustained viral suppressione
Yes 865 62.7 57.3–68.1 290 60.0 54.3–65.6 316 56.2 50.9–61.4
No 416 37.3 31.9–42.7 158 40.0 34.4–45.7 198 43.8 38.6–49.1
Condom-protected sexf
Yes 684 55.8 52.9–58.6 297 68.9 64.8–73.0 261 53.9 49.6–58.1
No 572 44.2 41.4–47.1 137 31.1 27.0–35.2 238 46.1 41.9–50.4
Condomless sex with a partner on PrEPg
Yes 237 16.8 14.4–19.1 20 4.0 1.8–6.1 12 2.3 1.0–3.6
No 1,033 83.2 80.9–85.6 427 96.0 93.9–98.2 502 97.7 96.4–99.0
Sex with a partner with HIVh
Yes 745 57.3 53.8–60.7 105 20.4 16.6–24.2 122 22.6 18.5–26.7
No 536 42.7 39.3–46.2 343 79.6 75.8–83.4 392 77.4 73.3–81.5
Total 2,023 100 880 100 1,015 100

Abbreviations: CI, confidence interval; PrEP, preexposure prophylaxis.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Persons who reported no anal, vaginal, or oral sex in the 12 months before interview were categorized according to self-reported sexual orientation. This table does not include information on women who had sex with women only, women who had sex with transgender persons only, or men who had sex with transgender persons only.
Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Vaginal or anal sex with at least 1 partner with an HIV-negative or unknown status while not having sustained viral suppression (defined as HIV viral load <200 copies m/L documented in the medical record at every measure in the 12 months before interview), a condom was not used, and the partner was not on PrEP. PrEP use was only measured among the 5 most recent partners.
e HIV viral load <200 copies/mL documented in the medical record at every measure in the 12 months before interview.
f Condoms were consistently used with at least 1 vaginal or anal sex partner.
g At least 1 condomless-sex partner without HIV was on PrEP. PrEP use was only measured among the 5 most recent partners and was reported by the partner with HIV.
h Sex with at least 1 partner with HIV.

Table 19. Met and unmet needs for ancillary services during the 12 months before interview among persons with diagnosed HIV— Medical Monitoring Project, United States, 2019
Persons who received services Persons who needed but did not
receive services by time of interview
No.a %b 95% CIc No.a %b 95% CIc
HIV support services
HIV case management services
Yes 2,393 56.7 52.8–60.7 241 7.0 5.8–8.3
No 1,658 43.3 39.3–47.2 3,810 93.0 91.7–94.2
Medicine through ADAP
Yes 1,950 46.5 43.9–49.1 98 3.0 2.4–3.6
No 2,009 53.5 50.9–56.1 3,861 97.0 96.4–97.6
Professional help remembering to take HIV medicines on time or correctly (adherence support services)
Yes 1,453 35.1 32.6–37.7 25 0.7 0.4–0.9
No 2,593 64.9 62.3–67.4 4,021 99.3 99.1–99.6
Patient navigation services
Yes 668 15.2 13.0–17.5 157 4.2 3.3–5.2
No 3,386 84.8 82.5–87.0 3,897 95.8 94.8–96.7
HIV peer group support
Yes 528 12.4 10.9–13.8 259 6.7 5.4–8.0
No 3,525 87.6 86.2–89.1 3,794 93.3 92.0–94.6
Non-HIV medical services
Dental care
Yes 2,541 60.6 57.8–63.3 836 21.8 19.9–23.7
No 1,519 39.4 36.7–42.2 3,224 78.2 76.3–80.1
Mental health services
Yes 1,352 32.0 28.0–36.0 336 8.4 7.2–9.6
No 2,708 68.0 64.0–72.0 3,724 91.6 90.4–92.8
Drug or alcohol counseling or treatment
Yes 305 7.0 5.7–8.2 71 1.7 1.1–2.4
No 3,760 93.0 91.8–94.3 3,994 98.3 97.6–98.9
Domestic violence services
Yes 50 1.2 0.8–1.7 33 0.9 0.5–1.2
No 4,017 98.8 98.3–99.2 4,034 99.1 98.8–99.5
Subsistence services
SNAP or WIC
Yes 1,576 37.3 34.6–40.0 416 10.9 8.9–12.9
No 2,489 62.7 60.0–65.4 3,649 89.1 87.1–91.1
Transportation assistance
Yes 1,061 24.9 23.4–26.4 274 7.3 6.2–8.3
No 3,004 75.1 73.6–76.6 3,791 92.7 91.7–93.8
Meal or food servicesd
Yes 879 21.0 18.3–23.8 303 7.6 6.5–8.6
No 3,186 79.0 76.2–81.7 3,762 92.4 91.4–93.5
Shelter or housing services
Yes 739 17.0 15.3–18.7 348 8.8 7.0–10.6
No 3,322 83.0 81.3–84.7 3,713 91.2 89.4–93.0
Total 4,100 100 4,100 100

Abbreviations: CI, confidence interval; ADAP, AIDS Drug Assistance Program; SNAP, Supplemental Nutrition Assistance Program; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children.
Note. Persons could report receiving or needing more than 1 service. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.
d Includes services such as soup kitchens, food pantries, food banks, church dinners, or food delivery services.

Table 20. Physical violence by an intimate partner and forced sex among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
Was ever slapped, punched, shoved, kicked, choked, or otherwise physically hurt by a romantic or sexual partner
Yes 1,043 25.2 23.0–27.3
No 2,993 74.8 72.7–77.0
Was slapped, punched, shoved, kicked, choked, or otherwise physically hurt by a romantic or sexual partner, past 12 months
Yes 175 4.4 3.7–5.1
No 3,856 95.6 94.9–96.3
Was ever threatened with harm or physically forced to have unwanted vaginal, anal, or oral sex
Yes 709 16.8 15.3–18.4
No 3,322 83.2 81.6–84.7
Was threatened with harm or physically forced to have unwanted vaginal, anal, or oral sex, past 12 months
Yes 58 1.3 1.0–1.6
No 3,968 98.7 98.4–99.0
Total 4,100 100

Abbreviation: CI, confidence interval.
Note. Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.

Table 21. Prevention services received during the 12 months before interview among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
No.a %b 95% CIc
One-on-one HIV/STD risk-reduction conversation with physician, nurse, or other health care worker
Yes 2,465 60.7 57.2–64.1
No 1,606 39.3 35.9–42.8
One-on-one HIV/STD risk-reduction conversation with outreach worker, counselor, or prevention program worker
Yes 1,323 31.8 27.3–36.3
No 2,748 68.2 63.7–72.7
Attended an organized HIV/STD risk-reduction session involving a small group of people
Yes 517 12.1 9.9–14.2
No 3,555 87.9 85.8–90.1
Received free condoms
Yes 1,906 46.3 42.4–50.2
No 2,164 53.7 49.8–57.6
Total 4,100 100

Abbreviation: CI, confidence interval.
Note. Persons could report receiving more than 1 prevention service.
Numbers might not add to total because of missing data. Percentages might not sum to 100 because of rounding. Excluded are estimates with “don’t know” responses and skipped (missing) responses.
a Numbers are unweighted.
b Percentages are weighted percentages.
c CIs incorporate weighted percentages.

Table 22. National indicators: homelessness, HIV stigma, and high-risk sex among persons with diagnosed HIV—Medical Monitoring Project, United States, 2019
Homeless in the 12 months before interview among persons receiving HIV care in the past 12 monthsa HIV stigmab HIV stigma, past 12 monthsc Engaged in any sex without using an HIV prevention strategy in the 12 months before interviewd
No.e %f 95% CIg No.e Row median score 95% CI No.e Row median score 95% CI No.e %f 95% CIg
Gender
Male 250 8.5 7.2–9.8 2,831 36.2 33.8–38.6 2,824 28.9 27.5–30.3 186 7.3 5.9–8.8
Female 85 8.2 6.0–10.5 978 44.7 42.0–47.4 990 37.3 35.0–39.6 69 6.9 5.1–8.7
Transgenderh 21 27.3 15.0–39.7 85 40.5 29.8–51.3 84 32.3 24.4–40.1
Sexual orientation
Lesbian or gay 105 6.7 5.0–8.3 1,623 36.0 32.6–39.4 1,611 27.8 25.4–30.3 121 8.6 6.5–10.7
Heterosexual or straight 169 8.5 7.1–9.8 1,794 39.7 38.3–41.1 1,811 33.3 31.3–35.4 103 6.0 4.4–7.5
Bisexual 57 17.7 12.2–23.1 345 41.1 33.4–48.7 344 32.1 29.2–34.9 30 7.2 4.6–9.7
Other 23 18.8 10.2–27.5 115 36.8 31.1–42.5 115 31.0 26.0–36.0 12 12.5 5.8–19.2
Race/ethnicity
American Indian/Alaska Native
Asian 38 40.4 27.9–53.0 38 32.4 21.8–43.1 0 0*
Black/African American 171 10.6 7.8–13.3 1,630 37.8 35.6–40.1 1,633 30.8 29.5–32.2 105 6.5 4.9–8.0
Hispanic/Latinoi 68 6.8 4.5–9.0 872 39.0 36.4–41.5 875 32.7 30.2–35.2 63 6.5 4.6–8.4
Native Hawaiian/other Pacific Islander
White 85 7.7 5.4–9.9 1,147 38.3 35.1–41.6 1,142 29.0 27.1–31.0 80 8.4 6.5–10.2
Multiple races 31 16.6 10.8–22.5 179 44.0 35.0–53.0 182 35.3 26.1–44.4
Age at time of interview (years)
18–29 54 16.5 11.3–21.7 333 42.9 39.2–46.6 329 38.2 35.5–40.9 49 14.9 10.0–19.9
30–39 79 11.9 9.2–14.7 616 41.3 37.8–44.8 615 33.9 31.0–36.8 71 12.7 9.5–15.8
40–49 72 9.7 7.2–12.1 765 40.6 37.7–43.4 765 32.4 30.4–34.4 51 7.4 5.3–9.4
≥50 153 6.6 5.3–8.0 2,186 35.8 34.1–37.5 2,195 28.4 27.4–29.4 96 4.5 3.4–5.7
Total 358 8.9 7.6–10.3 3,900 38.3 36.3–40.2 3,904 30.7 29.2–32.1 267 7.4 6.1–8.6

Abbreviations: CI, confidence interval; PrEP, preexposure prophylaxis [footnotes only].
Note. Numbers might not add to total because of missing data.
Excluded are estimates with a coefficient of variation ≥ 0.30, estimates based on a denominator sample size <30, “don’t know” responses, and skipped (missing) responses. Estimates with an absolute CI width≥ 30, estimates with an absolute CI width between 5 and 30 and a relative CI width >130%, and estimates of 0% or 100% are marked with an asterisk (*) and should be interpreted with caution.
a Living on the street, in a shelter, in a single-room–occupancy hotel, or in a car.
b Ten-item scale ranging from 0 (no stigma) to 100 (high stigma) that measures 4 dimensions of HIV stigma: personalized stigma since HIV diagnosis, current disclosure concerns, current negative self-image, and current perceived public attitudes about people living with HIV.
c Ten-item scale ranging from 0 (no stigma) to 100 (high stigma) that measures 4 dimensions of HIV stigma: personalized stigma during the past 12 months, current disclosure concerns, current negative self-image, and current perceived public attitudes about people living with HIV.
d Vaginal or anal sex with at least 1 partner of HIV-negative or unknown status while not having sustained viral load suppression, a condom was not used, and the partner was not on PrEP. PrEP use was only measured among the 5 most recent partners.
e Numbers are unweighted.
f Percentages are weighted percentages.
g CIs incorporate weighted percentages.
h Persons were classified as transgender if sex at birth and gender reported by the person were different, or if the person chose “transgender” in response to the question about self-identified gender.
i Hispanics or Latinos can be of any race. Persons are classified in only 1 race/ethnicity category.