Monitoring Selected National HIV Prevention and Care Objectives By Using HIV Surveillance Data United States and 6 Dependent Areas, 2020: National Profile

The use of data reported to CDC through December 31, 2021, allows for a 12-month reporting delay, but COVID-related service interruptions impact the assessment of trends through the most recent diagnosis, death, and prevalence year (2020). The statements in this section, unless otherwise indicated, are based on numbers of 12 or more diagnoses. Please use caution when interpreting data on diagnosed HIV infection (see Technical Notes for additional information on definitions and data specifications).

Data from jurisdictions that reported complete CD4 and viral load laboratory results to CDC were used for the analyses that require laboratory data (Tables 1a–4b). Data from the 50 states, the District of Columbia, and 6 U.S. dependent areas (where indicated) were used for analyses of stage 3 (AIDS) at the time of diagnosis of HIV infection (Tables 5a–5d); deaths and survival of persons with diagnosed HIV infection (Tables 6a–7f); and persons with diagnosed, perinatally acquired HIV infection (Tables 9a/b). For tables on PrEP (Tables 8a/b), the number of persons who have been prescribed PrEP, the estimated number with PrEP indications, and the percentage of PrEP coverage are presented. For tables that include data by transmission category, the data were statistically adjusted to account for missing transmission category and are presented based on sex assigned at birth. For a summary of indicators for national goals, EHE, and NHAS, see Table 10.

Please use caution when interpreting data for transgender men, AGI, American Indian/Alaska Native persons, and Native Hawaiian/other Pacific Islander persons: the numbers are small.

Please read all titles and footnotes carefully to ensure a complete understanding of the displayed data. Please note that we highlight an important point with the magnifying glass icon search light icon or call attention to an important finding with the exclamation icon exclamation circle light icon in the text.

Status of Laboratory Reporting

Monitoring stage of disease at time of diagnosis, linkage to HIV medical care, retention in HIV medical care, and viral suppression (on the basis of NHSS data) is dependent upon complete reporting of HIV-related laboratory results (including CD4+ T-lymphocyte [CD4] and viral load results; see Technical Notes) to HIV surveillance programs and CDC. Although most jurisdictions have regulations that require laboratories and providers to report at least a subset of CD4 and viral load test results to health departments, not all jurisdictions have mandatory reporting of all levels of CD4 and viral load (i.e., detectable and undetectable) results.

As of December 2021, 46 jurisdictions (45 states and the District of Columbia) had complete laboratory reporting for all data years examined and specimens collected from at least January 2019 through September 2021 (Figure 1). In comparison with the 2019 report, the 2020 report includes data from 1 additional state (Kansas) that met the criteria. Data for Maryland should be interpreted with caution due to incomplete reporting of case information to CDC during December 2021. Please note that due to incomplete reporting of deaths for the year 2020, data for Kansas, North Carolina, and South Carolina should be interpreted with caution.

Figure 1. Status Of CD4 and Viral Load Reporting, by Area of Residence as of December 2021—United States and Dependent Areas

Figure 1. Status of CD4 and viral load reporting, by area of residence as of December 2021—United States and dependent areas

Note. Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Technical Notes for more information on areas with complete laboratory reporting.

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Diagnosis-based HIV Care Continuum—Overview

The diagnosis-based HIV care continuum describes each step of the continuum as a percentage of the number of people living with diagnosed HIV. The denominator is the number of persons aged ≥ 13 years living with diagnosed HIV infection at year-end 2020.

Note. Denominator for stage of disease, linkage to care within 1 month, and viral suppression within 6 months of diagnosis is limited to people with HIV diagnosed in a single year.

Stage of disease at time of diagnosis of HIV infection

Among 28,422 persons aged ≥ 13 years with HIV infection diagnosed during 2020 in 46 jurisdictions with complete reporting of laboratory data to CDC, the stage of disease at time of diagnosis was classified as follows: stage 0 (6.9%), stage 1 (25.8%), stage 2 (30.4%), stage 3 (AIDS) (21.5%), and stage unknown (15.4%).

  • A higher percentage of persons had HIV diagnosed at an earlier stage (stages 0 or 1, 32.7%) than at the late stage (stage 3 [AIDS]: 21.5%) (Figure 2, Table 1a).
Figure 2. Stage of Disease at HIV Diagnosis During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years—45 States and the District of Columbia

 

Figure 2. Stage of disease at HIV diagnosis during 2020 (COVID-19 pandemic) among persons aged ≥13 years—45 states and the District of Columbia

Note. Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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  • Percentage of persons with HIV diagnosed at an earlier stage (0 or 1) compared to the percentage with a late-stage diagnosis, respectively, by selected characteristics were as follows (Figure 3, Table 1a):
  • Gender—
    • Male: 32.0% vs 21.4%
    • Female: 34.5% vs 23.0%
    • Transgender women: 41.2% vs 12.4%
    • Transgender men: 55.3% vs 5.3%
    • AGI persons: 31.3% vs 12.5%
  • Age group—
    • Persons aged 13–24 years: 37.8% vs 9.0%
    • Persons aged 25–34 years: 35.6% vs 17.4%
    • Persons aged 35–44 years: 30.6% vs 25.1%
    • Persons aged 45–54 years: 26.7% vs 34.8% exclamation circle light icon
    • Persons aged ≥ 55 years: 23.6% vs 37.1% exclamation circle light icon
  • Race/ethnicity—
    • American Indian/Alaska Native persons: 33.8% vs 21.5%
    • Asian persons: 27.8% vs 26.8%
    • Black/African American persons: 30.8% vs 20.1%
    • Hispanic/Latino persons: 32.9% vs 22.8%
    • Native Hawaiian/other Pacific Islander persons: 23.8% vs 20.6%
    • White persons: 36.0% vs 22.1%
    • Multiracial persons: 32.7% vs 20.9%
  • Sex assigned at birth and transmission category—
    • Among males (based on sex assigned at birth)
      • Male-to-male sexual contact (MMSC): 32.9% vs 20.0%
      • Injection drug use (IDU): 32.1% vs 22.2%
      • MMSC-IDU: 39.1% vs 16.6%
      • Heterosexual contact: 22.1% vs 35.1% exclamation circle light icon
    • Among females (based on sex assigned at birth)
      • IDU: 33.8% vs 20.2%
      • Heterosexual contact: 34.7% vs 23.4%
Figure 3. Stage of Disease at HIV Diagnosis During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years, by Selected Characteristics—45 States and the District of Columbia

 

Figure 3. Stage of disease at HIV diagnosis during 2020 (COVID-19 pandemic) among persons aged ≥13 years, by selected characteristics—45 states and the District of Columbia

Note. Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.
a Hispanic/Latino persons can be of any race.

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  • Area of residence—
    • Five jurisdictions had an equivalent or higher percentage of persons that received a late-stage diagnosis compared to the percentage that received an earlier-stage diagnosis, respectively. exclamation circle light icon
        • Arkansas: 24.4% vs 24.8%
        • Delaware: 26.9% vs 26.9%
        • Maine: 50.0% vs 25.0%
        • Mississippi: 22.4% vs 18.4%
        • North Dakota: 41.7% vs 16.6%

Linkage to HIV Medical Care Within 1 Month and Viral Suppression Within 6 Months After Diagnosis of HIV Infection

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Linkage to HIV Medical Care

Among 28,422 persons with HIV infection diagnosed during 2020 in the 46 jurisdictions with complete reporting of laboratory data to CDC, 82.4% were linked to HIV medical care within 1 month of diagnosis (Table 2a).

  • Highest percentages of linkage to HIV medical care were as follows (Figures 4 and 5, Tables 2a/b):
    • Gender—AGI persons: 93.8% and transgender men: 92.1%
    • Age group—persons aged ≥ 45 years (45–54 years and ≥ 55 years): 84.5%
    • Race/ethnicity—Asian persons: 87.9%
    • Sex assigned at birth and transmission category—females with infection attributed to heterosexual contact: 83.1% and males with infection attributed to MMSC: 82.9%
    • Area of residence—Alaska, Colorado, Iowa, Maine, Massachusetts, Minnesota, Montana, Nebraska, Rhode Island, South Carolina, Washington, and Wyoming were in the highest quartile (≥ 87.7%) of persons linked to HIV medical care within 1 month of diagnosis (Figure 5)
  • Lowest percentages of linkage to HIV medical care were as follows (Figures 4 and 5, Tables 2a/b):
    • Gender—transgender women: 80.8%
    • Age group—persons aged 13–24 years: 80.0%
    • Race/ethnicity—Black/African American persons: 79.7% exclamation circle light icon
    • Sex assigned at birth and transmission category—females and males with infection attributed to IDU: 78.1% and 77.8%, respectively exclamation circle light icon
    • Area of residence—Alabama, Arkansas, Delaware, Indiana, Louisiana, Mississippi, Missouri, New Hampshire, Oklahoma, Tennessee, Texas, and West Virginia were in the lowest quartile (≤ 80.8%) of persons linked to HIV medical care within 1 month of diagnosis (Figure 5)

search light iconA closer look at linkage to HIV medical care within 1 month of diagnosis reveals that among 28,422 persons with HIV infection diagnosed during 2020, no demographic group or group with infection attributed to any of the transmission categories met the forthcoming EHE target of 95% by 2025 (Figure 4).

Figure 4. Linkage to HIV Medical Care Within 1 Month of HIV Diagnosis During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years, by Selected Characteristics—45 States and the District of Columbia

 

Figure 4. Linkage to HIV Medical Care Within 1 Month of HIV Diagnosis During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years, by Selected Characteristics—45 States and the District of Columbia

Note. Gray line indicates the overall percentage of persons linked to care within 1 month of diagnosis. Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.
a Hispanic/Latino persons can be of any race.

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Figure 5. Linkage to HIV Medical Care Within 1 Month of HIV Diagnosis During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years, by Area Of Residence—45 States and the District of Columbia

 

Figure 5. Linkage to HIV Medical Care Within 1 Month of HIV Diagnosis During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years, by Area Of Residence—45 States and the District of Columbia

Note. Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.
a Data for Maryland should be interpreted with caution due to incomplete reporting of case information to CDC during December 2021.

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Viral Suppression Within 6 Months

Among 28,422 persons with HIV infection diagnosed during 2020 in the 46 jurisdictions with complete reporting of laboratory data to CDC, viral load was suppressed in 67.8% of persons within 6 months of HIV diagnosis (Table 2a).

  • Highest percentages of viral suppression ≤ 6 months after HIV diagnosis were as follows (Tables 2a/b):
    • Gender—transgender men: 78.9%
    • Age group—persons aged 13–24 years: 69.4%
    • Race/ethnicity—Asian persons: 79.1%
    • Sex assigned at birth and transmission category—males with infection attributed to MMSC: 69.6% and females with infection attributed to heterosexual contact: 69.5%
    • Area of residence—Alaska, Hawaii, Iowa, Kansas, Maine, Massachusetts, New York, Oregon, Rhode Island, South Carolina, Utah, and Washington were in the highest quartile (≥ 74.5%) of persons who had viral suppression within 6 months after HIV diagnosis
  • Lowest percentages of viral suppression ≤ 6 months after HIV diagnosis were as follows (Tables 2a/b):
    • Gender—transgender women: 64.3%
    • Age group—persons aged ≥ 55 years: 64.6%
    • Race/ethnicity—American Indian/Alaska Native persons: 60.0%
    • Sex assigned at birth and transmission category—males and females with infection attributed to IDU: 53.4%
    • Area of residence—Arkansas, Georgia, Illinois, Mississippi, Missouri, New Mexico, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia were in the lowest quartile (≤ 66.1%) of persons who had viral suppression within 6 months after HIV diagnosis
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Receipt of HIV Medical Care and Viral Suppression

During 2020, 74.1% of 944,247 persons alive at year-end 2020 received any HIV medical care (at least 1 CD4 or viral load test), 50.6% of persons were retained in HIV medical care, and 64.6% of persons had viral suppression at the most recent viral load test in 46 jurisdictions with complete reporting of laboratory data to CDC (Tables 3a and 4a).

  • Highest percentages of persons who received any HIV medical care and had viral suppression at the most recent viral load test were as follows (Figures 6a/b–7a/b, Table 3a):
    • Gender—AGI persons: 87.0%, 71.5%, respectively
    • Age group—persons aged 13–24 years: 78.1%; persons aged ≥ 55 years: 66.3%, respectively
    • Race/ethnicity—multiracial persons: 84.0%, 72.2%, respectively
    • Sex assigned at birth and transmission category—males with infection attributed to MMSC-IDU: 77.2% and females with infection attributed to heterosexual contact: 74.3%; males with infection attributed to MMSC: 67.2% and females with infection attributed to heterosexual contact: 64.4%, respectively
    • Area of residence—
      • Alaska, Hawaii, Iowa, Kansas, Maine, Montana, Oregon, South Carolina, South Dakota, Tennessee, Washington, and Wyoming were in the highest quartile (≥ 80.4%) of persons who received any HIV medical care (Figure 8)
      • Alaska, Delaware, Hawaii, Iowa, Kansas, Maine, Montana, New Hampshire, Oregon, South Carolina, Washington, and Wisconsin were in the highest quartile (≥ 71.8%) of persons who had viral suppression at the most recent viral load test (Figure 9)
  • Lowest percentages of persons who received any HIV medical care and had viral suppression at the most recent viral load test were as follows (Figures 6a/b–7a/b, Table 3a): exclamation circle light icon
    • Gender—females: 73.6%, 63.2%, respectively
    • Age group—persons aged ≥ 55 years: 73.2%; persons aged 25–34 years: 62.0%, respectively
    • Race/ethnicity—Native Hawaiian/other Pacific Islander persons: 71.2%; Black/African American persons: 60.4%, respectively
    • Sex assigned at birth and transmission category—males with infection attributed to IDU: 61.5% and females with infection attributed to IDU: 71.0%; males with infection attributed to IDU: 52.0% and females with infection attributed to IDU: 59.6%, respectively
    • Area of residence—
      • Arkansas, Colorado, Georgia, Maryland, Mississippi, Nevada, New York, Oklahoma, Texas, Virginia, West Virginia, and the District of Columbia were in the lowest quartile (≤ 73.5) of persons who received any HIV medical care (Figure 8)
      • Arkansas, Colorado, Georgia, Maryland, Mississippi, Nebraska, New Mexico, Oklahoma, South Dakota, Texas, West Virginia, and the District of Columbia were in the lowest quartile (≤ 62.3%) of persons who had viral suppression at the most recent viral load test (Figure 9)
Figure 6a. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Gender—45 States and the District of Columbia

 

Figure 6a. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Gender—45 States and the District of Columbia

Note. Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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Figure 6b. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Age Group—45 States and the District of Columbia

 

Figure 6b. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Age Group—45 States and the District of Columbia

Note. Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021. Data for Maryland should be interpreted with caution due to incomplete reporting of case information to CDC during December 2021. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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Figure 7a. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Race/Ethnicity—45 States and the District of Columbia

 

Figure 7a. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Race/Ethnicity—45 States and the District of Columbia

Note. Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.
a Includes Asian/Pacific Islander legacy cases.
b Hispanic/Latino persons can be of any race.

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Figure 7b. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Transmission Category—45 States and the District of Columbia

 

Figure 7b. Receipt of HIV Medical Care and Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Transmission Category—45 States and the District of Columbia

Note. Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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Figure 8. Receipt of HIV Medical Care During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Area of Residence—45 States and the District of Columbia

Figure 8. Receipt of HIV Medical Care During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Area Of Residence—45 States and the District of Columbia

Note. Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. Data for Maryland should be interpreted with caution due to incomplete reporting of case information to CDC during December See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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Figure 9. Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Area of Residence—45 States and the District of Columbia

 

Figure 9. Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Area Of Residence—45 States and the District of Columbia

Note. Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021. Data for Maryland should be interpreted with caution due to incomplete reporting of case information to CDC during December 2021. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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search light iconA closer look at viral suppression at the most recent viral load test reveals that among 944,247 persons aged ≥ 13 years living with diagnosed HIV infection at year-end 2020, no demographic group or group with infection attributed to any of the transmission categories met the forthcoming EHE target of 95% by 2025 (Figure 10).

Figure 10. Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Selected Characteristics—45 States and the District of Columbia

 

Figure 10. Viral Suppression During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years Living with Diagnosed HIV Infection, by Selected Characteristics—45 States and the District of Columbia

Note. Gray line indicates overall percentage of persons who had viral suppression at the most recent viral load test. Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.
a Includes Asian/Pacific Islander legacy cases.
b Hispanic/Latino persons can be of any race.

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Stage 3 (AIDS) at Time of Diagnosis of HIV Infection, and Death and Survival after Diagnosis of HIV Infection

Data from the 50 states, the District of Columbia, and 6 U.S. dependent areas (where indicated) were used for analyses of stage 3 (AIDS) at the time of diagnosis of HIV infection (even when not all CD4 values are reportable), and deaths and survival of persons aged ≥ 13 years with diagnosed HIV infection.

Stage 3 (AIDS) Classification at Time of Diagnosis of HIV Infection

Among the 30,346 persons who received an HIV diagnosis during 2020 in the United States, more than 1 in 5 persons (21.6%) received a late-stage diagnosis (stage 3, AIDS) (Table 5a).

  • Highest percentages of a late-stage diagnosis were as follows (Table 5a/c): exclamation circle light icon
    • Gender—female: 23.2%
    • Age group—persons aged ≥ 55 years: 37.1%
    • Race/ethnicity—Asian persons: 27.7%
    • Transmission category—males with infection attributed to heterosexual contact: 35.5%
    • Area of residence—Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Maine, Montana, Nebraska, North Dakota, South Carolina, Vermont, and Virginia had the highest quartile (≥ 24.6%) of persons who received a late-stage diagnosis (Figure 11)
    • Region of residence—Northeast: 22.5%
    • Population area of residence—Rural areas: 26.9%
  • Lowest percentages of a late-stage diagnosis were as follows (Table 5a/c):
    • Gender—transgender men: 5.0%
    • Age group—persons aged 13–24 years: 9.1%
    • Race/ethnicity—Black/African American persons: 20.0% and Native Hawaiian/other Pacific Islander persons: 20.0%
    • Transmission category—males with infection attributed to MMSC-IDU: 16.9%
    • Area of residence—Alaska, Illinois, Michigan, Missouri, Nevada, New Mexico, North Carolina, Oregon, Rhode Island, South Dakota, Tennessee, Texas, Washington, West Virginia, Wyoming, and the District of Columbia had the lowest quartile (≤ 20.9%) of persons who received a late-stage diagnosis (Figure 14)
    • Region of residence—Midwest: 21.2%
    • Population area of residence—metropolitan areas: 20.9%
Figure 11. Stage 3 (AIDS) at Time of Diagnosis of HIV Infection During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years, by Area of Residence—United States

 

Figure 11. Stage 3 (AIDS) at Time of Diagnosis of HIV Infection During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 13 Years, by Area of Residence—United States

Note. Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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Deaths

Annual rates of death among persons aged ≥ 13 years were calculated per 100,000 population and per 1,000 persons with diagnosed HIV infection or with infection ever classified as stage 3 (AIDS). Age-adjusted rates per 100,000 population and per 1,000 persons with diagnosed HIV infection or with infection ever classified as stage 3 (AIDS) were also calculated and are presented by area of residence (Tables 6a–f).

Deaths of Persons with Diagnosed HIV Infection

In 2020, the age-adjusted rates in the United States were 6.5 per 100,000 population and 16.9 per 1,000 persons with diagnosed HIV infection (Table 6a).

Deaths of Persons with stage 3 (AIDS) Classification

In 2020, the age-adjusted rates in the United States were 5.0 per 100,000 population and 25.4 per 1,000 persons with infection ever classified as stage 3 (AIDS) (Table 6d).

Survival for > 3 years After Diagnosis of HIV Infection

In the United States and 6 dependent areas, survival for > 3 years after a diagnosis of HIV infection was above 94% and remained stable for diagnoses that were made during 2012–2017 (Table 7a).

  • Lowest percentages of survival (< 90%) for > 3 years after diagnosis of HIV infection—persons aged ≥ 55 years, males with infection attributed to IDU, and among persons residing in Puerto Rico (Tables 7a/c). exclamation circle light icon

Survival for > 3 years after stage 3 (AIDS) classification was below 90% and remained stable over time (Table 7d).

  • Lowest percentages of survival (< 90%) for > 3 years after stage 3 (AIDS) classification—males, females, persons aged ≥ 35 years, each racial/ethnic group (except for American Indian/Alaska Native persons), males and females with infection attributed to any transmission category, and all areas of residence (Tables 7d/f).

Preexposure Prophylaxis (PrEP) Coverage and Persons Prescribed PrEP

The number of persons in the United States and Puerto Rico classified as having been prescribed PrEP, the estimated number of persons with PrEP indications, and the percentage of PrEP coverage were produced by using data from several sources: the IQVIA Real-World Longitudinal Prescriptions database, NHSS, National Health and Nutrition Examination Survey (NHANES), and the U.S. Census American Community Survey (ACS). For more information, see Technical Notes.

By using pharmacy and other national data sources, we estimated 1.2 million persons in the United States and Puerto Rico had indications for PrEP and 24.7% were prescribed PrEP in 2020 (Table 8a).

  • Highest percentages of PrEP coverage were as follows (Figure 12, Tables 8a/b):
    • Sex assigned at birth—males: 28.0%
    • Age group—persons aged 35–44 years: 30.2%
    • Race/ethnicity—White persons: 65.4%
    • Area of residence—California, Connecticut, Florida, Illinois, Iowa, Massachusetts, Nebraska, New York, Pennsylvania, Rhode Island, Utah, Vermont, and District of Columbia were in the highest quartile (≥ 25.3%) of PrEP coverage (Figure 13)
  • Lowest percentages of PrEP coverage were as follows (Figure 12, Tables 8a/b): exclamation circle light icon
    • Sex assigned at birth—females: 10.4%
    • Age group—persons aged 16–24 years: 15.6%
    • Race/ethnicity—Black/African American persons: 9.1%
    • Area of residence—Alaska, Delaware, Idaho, Indiana, Kentucky, Michigan, Montana, North Dakota, Oklahoma, South Dakota, Virginia, West Virginia, Wyoming, and Puerto Rico were in the lowest quartile (≤ 16.3%) of PrEP coverage (Figure 13)
Figure 12. PrEP Coverage During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 16 Years, by Selected Characteristics—United States and Puerto Rico

 

Figure 12. PrEP Coverage During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 16 Years, by Selected Characteristics—United States and Puerto Rico

Note. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.
a Hispanic/Latino persons can be of any race.
b Includes American Indian/Alaska Native, Asian, Native Hawaiian/other Pacific Islander, and multiracial persons.

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Figure 13. PrEP Coverage During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 16 Years, by Area of Residence—United States and Puerto Rico

 

Figure 13. PrEP Coverage During 2020 (COVID-19 Pandemic) Among Persons Aged ≥ 16 Years, by Area of Residence—United States and Puerto Rico

Note. Data for 2020 should also be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. See Guide to Acronyms and Initialisms, Data Tables, and Technical Notes for more information on definitions and data specifications.

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