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

All Figures

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.

Figure 2a: Gender Distribution Among Adults with Diagnosed HIV—Medical Monitoring Project, United States, 2019

An estimated 75 percent of persons were male, 23% 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).

Note. Transgender persons defined as those who self-identified as transgender or who reported a gender identity different from sex assigned at birth. 

Figure 2b: Age Distribution Among Adults with Diagnosed HIV—Medical Monitoring Project, United States, 2019

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

Figure 2c: Sexual Orientation Among Adults with Diagnosed HIV—Medical Monitoring Project, United States, 2019

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

Figure 2d: Racial/Ethnic Distribution Among Adults with Diagnosed HIV—Medical Monitoring Project, United States, 2019

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. “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.

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% 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

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 (<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 <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.

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.

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.

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.

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.

Figure 9a. Percentage of Adults with Diagnosed HIV Who Experienced Symptoms of Major or Other Depression* 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.

 

*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.

Figure 9b. Percentage of Adults with Diagnosed HIV Who Experienced Symptoms of Generalized Anxiety Disorder† During the Two Weeks Before Interview—Medical Monitoring Project, United States, 2019

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 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.

Figure 10a. Percentage of Adults with Diagnosed HIV Who Smoked Cigarettes 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.

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

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

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.

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).

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.

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.

*AIDS Drug Assistance Program
†ART: Antiretroviral therapy

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.

‡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.

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.

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.