Core Indicators for Monitoring EHE (Preliminary Data): HIV Diagnoses and Linkage to HIV Medical Care, 2019 (Reported through December 2019); and Preexposure Prophylaxis (PrEP)— 2018, Updated

HIV Surveillance Data Tables

Core Indicators for Monitoring EHE (Preliminary Data): HIV Diagnoses and Linkage to HIV Medical Care, 2019 (Reported through December 2019); and Preexposure Prophylaxis (PrEP)— 2018, Updated

This issue of HIV Surveillance Data Tables is published by the Division of HIV/AIDS Prevention (DHAP), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, Georgia.

Data are presented for diagnoses of HIV infection reported to CDC through December 2019.

HIV Surveillance Data Tables is not copyrighted and may be used and copied without permission. Citation of the source is, however, appreciated.

Suggested Citation

Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative: HIV diagnoses and linkage to HIV medical care, 2019 (preliminary data, reported through December 2019); pre-exposure prophylaxis (PrEP)—2018, updated. HIV Surveillance Data Tables 2020;1(No. 2) http://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-1-no-2/index.html. Published August 2020. Accessed [date].

Download the full report pdf icon[PDF – 779 KB].

The Ending the HIV Epidemic: A Plan for America (EHE) initiative will leverage critical scientific advances in HIV prevention, diagnosis, treatment, and outbreak response [1]. The goal of the initiative is to reduce new HIV infections by 75% in 5 years and by at least 90% in 10 years. Throughout the initiative, the Centers for Disease Control and Prevention (CDC) will routinely release HIV Surveillance Data Tables on the 6 core indicators for EHE to allow for more timely monitoring of progress. The full list of EHE core indicators and their definitions can be found in the Technical Notes of the Core Indicators for Monitoring the Ending the HIV Epidemic Initiative report at https://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-1-no-1/index.html.

The tables included in this report provide preliminary data on HIV diagnoses and linkage to HIV medical care for the year 2019. Updated data on preexposure prophylaxis (PrEP) coverage for the year 2018 (and 2017 for Puerto Rico) are also included. Data for all 3 indicators are provided at the national-, state-, and county-level (EHE Phase I jurisdictions only). See Tabulation and Presentation of Data for details on how the indicators are calculated.

TABULATION AND PRESENTATION OF DATA

Diagnoses of HIV Infection

Diagnoses of HIV infection are the numbers of persons aged ≥13 years whose HIV infection was diagnosed during 2019 (Tables 1a–d).

Data presented were reported (after the removal of personally identifiable information) to CDC’s National HIV Surveillance System (NHSS) through December 31, 2019. Please use caution when inter­preting data on diagnoses of HIV infection. HIV surveil­lance reports may not be representative of all per­sons with HIV because not all infected persons have been (1) tested or (2) tested at a time when the infection could be detected and diagnosed. Also, some states offer anonymous HIV testing; the results of anonymous tests are not reported to the confidential, name-based HIV registries of state and local health departments. Therefore, reports of confidential test results may not repre­sent all persons who tested positive for HIV infection.

More information on counting diagnoses of HIV infection can be found at https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-31/index.html (HIV Surveillance Report, 2018 [Updated]).

Linkage to HIV Medical Care

Linkage to HIV medical care within 1 month of HIV diagnosis is measured for persons aged ≥ 13 years whose HIV infection was diagnosed during the spec¬ified month/year, and who resided in any of the jurisdictions (including EHE Phase I jurisdictions) with complete reporting of laboratory data to CDC at the time of diagnosis (Tables 2a–c). The numerator is the number of persons aged ≥ 13 years whose HIV infection was diagnosed during the specified month/year and who had ≥ 1 CD4 or viral load (VL) test within 1 month of HIV diagnosis. The denominator is the number of persons aged ≥ 13 years whose HIV infection was diagnosed during the specified month/year. Data are not provided for states and associated jurisdictions that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.

More information on calculating linkage to care can be found at https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-supplemental-report-vol-25-2.pdf pdf icon[PDF – 4 MB] (Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018).

Preexposure Prophylaxis (PrEP) Coverage

PrEP coverage, reported as a percentage, is defined as the number of persons aged ≥16 years classified as having been prescribed PrEP during the specified year divided by the estimated number of persons aged ≥16 years who had indications for PrEP during the specified year (Tables 3a–d).

Number of persons prescribed, which is reported as a case count, is defined as the number of persons aged ≥16 years classified as having been prescribed PrEP during the specified year.

PrEP coverage is an EHE indicator that is not a reportable disease or condition and is not reported to NHSS. Multiple data sources, described below, are used to calculate PrEP coverage. Please use caution when interpreting PrEP data. Different data sources were used in the numerator and denominator to calculate PrEP coverage.

Persons prescribed PrEP

National pharmacy data from the IQVIA Real World Data-Longitudinal Prescriptions database (hereafter, IQVIA database) are used to classify persons aged ≥16 years who have been prescribed PrEP in the specific year. The IQVIA database captures prescriptions from all payers and represents approximately 92% of all prescriptions from retail pharmacies and 60%–86% from mail-order outlets in the United States. The database does not include prescriptions from some closed health care systems that do not make their prescription data available to IQVIA. Therefore, these are minimum estimates of PrEP coverage. The annual number of persons classified as having been prescribed PrEP was based on a validated algorithm that discerns whether tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) were prescribed for PrEP after excluding prescriptions for HIV treatment, hepatitis B treatment, or HIV postexposure prophylaxis [2–4].

The number of persons classified as having been prescribed PrEP is reported by sex, age group, and race/ethnicity. Transmission category data are not available in the IQVIA database and race/ethnicity data are available for <40% of persons with PrEP prescriptions. Please use caution when interpreting PrEP data by race/ethnicity. Race/ethnicity categories available in the IQVIA data include white, black/African American, Hispanic/Latino, and other. The number of persons prescribed PrEP for each racial/ethnic group presented was extrapolated by applying the racial/ethnic distribution of known records to those for which data on race/ethnicity was unknown.

Geographic Designations

In the IQVIA database, a person’s location is reported as a 3-digit ZIP code prefix (hereafter, ZIP3) assigned by the U.S. Postal Service. To estimate the number of persons prescribed PrEP at the state or county level, a probability-based approach is used to crosswalk between ZIP3s and states/counties using data from (a) the U.S Census Bureau’s American Community Survey (ACS) 5-year estimates by ZIP Code Tabulation Areas (ZCTAs) [5], and (b) the U.S Department of Housing and Urban Development’s ZIP Code Crosswalk Files [6]. Because of reliability concerns, subnational estimates of <40 are not included.

Persons with PrEP indications

ACS and U.S. Census Bureau datasets were used to estimate the number of men who have sex with men (MSM) in a jurisdiction. Next, behavioral data from the National Health and Nutrition Examination Survey (NHANES) were used to estimate the proportion of HIV-negative MSM with indications for PrEP [7].

The number of HIV-negative MSM with indications for PrEP was multiplied by the ratio of percentage of HIV diagnoses during the specified year attributed to other major transmission risk groups compared to the percentage among MSM in a given state or county. The estimated numbers of persons with indications for PrEP in the 3 major transmission risk groups (MSM, heterosexuals, persons who inject drugs) in each jurisdiction were then summed to yield a state- or county-specific estimate. State estimates were then summed for a national total of persons with indications for PrEP [8].

The number of MSM in a jurisdiction is determined using the ACS as one of the 3 data sources used to estimate the number of persons with indications for PrEP (i.e., PrEP coverage denominator). However, prior to 2018, the ACS did not include data needed to estimate the number of persons with indications for PrEP in Puerto Rico; consequently, the number of persons with indications for PrEP in Puerto Rico in 2017 was not available. In 2018, the ACS conducted a separate Puerto Rico survey and these data were used to determine the number of persons with indications for PrEP in 2018 for Puerto Rico. In addition, 2017 PrEP coverage for Puerto Rico is now provided using the 2018 denominator for Puerto Rico.

The data sources used to estimate the number of persons with indications for PrEP have different schedules of data availability. Consequently, the availability of a denominator lags the availability of a numerator by approximately 1 year. For this release of the HIV Surveillance Data Tables, 2018 PrEP coverage data have been updated for all jurisdictions and added for Puerto Rico. Data tables for 2018 include updated 2018 denominators and updated 2018 PrEP coverage for national-, state-, and EHE county- level data.

References

  1. HHS. What is ‘Ending the HIV Epidemic: A Plan for America’? https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overviewexternal icon. Published October 4, 2019. Accessed July 13, 2020.
  2. Wu H, Mendoza MC, Huang YA, Hayes T, Smith DK, Hoover KW. Uptake of HIV pre-exposure prophylaxis among commercially insured persons—United States, 2010–2014. Clin Infect Dis 2017;64(2):144–149. doi:10.1093/cid/ciw701.
  3. CDC [Huang YA, Zhu W, Smith DK, Harris N, Hoover KW]. HIV pre-exposure prophylaxis, by race and ethnicity—United States, 2014–2016. MMWR 2018;67(41):1147–1150. doi:10.15585/mmwr.mm6741a3.
  4. Furukawa NW, Smith DK, Gonzalez CJ, et al. Evaluation of algorithms used for PrEP surveillance using a reference population from New York City, July 2016–June 2018. Public Health Rep 2020;135(2):202–210. doi:10.1177/0033354920904085
  5. U.S. Census Bureau. American Community Survey 5-year data (2009-2018). https://www.census.gov/data/developers/data-sets/acs-5year.2018.htmlexternal icon. Published December 19, 2019. Accessed July 13, 2020.
  6. HUD. HUD USPS ZIP code crosswalk files. https://www.huduser.gov/portal/datasets/usps_crosswalk.htmlexternal icon. Published 2019. Accessed July 13, 2020.
  7. CDC [Smith DK, Van Handel M, Wolitski RJ, et al]. Vital Signs: Estimated percentages and numbers of adults with indications for pre-exposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR 2015;64(46):1291–1295. doi:10.15585/mmwr.mm6446a4.
  8. Smith DK, Van Handel M, Grey J. Estimates of adults with indications for HIV pre-exposure prophylaxis by jurisdiction, transmission risk group, and race/ethnicity, United States, 2015. Ann Epidemiol 2018;28(12):850–857.e9. doi:10.1016/j.annepidem.2018.05.003.

Suggested Citation

Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative: HIV diagnoses and linkage to HIV medical care, 2019 (preliminary data, reported through December 2019); pre-exposure prophylaxis (PrEP)—2018, updated. HIV Surveillance Data Tables 2020;1(No. 2) http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published August 2020. Accessed [date].

On the Web: http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html

Confidential information, referrals, and educational material on HIV infection and AIDS

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http://wwwn.cdc.gov/dcs/ContactUs/Form

Acknowledgments

Publication of HIV Surveillance Data Tables was made possible by the contributions of the state and territorial health departments and the HIV surveillance programs that provided surveillance data to CDC.

HIV Surveillance Data Tables was prepared by the following staff and contractors of the Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC: Anna Satcher Johnson, Zanetta Gant, Ya-lin Huang, Dawn Smith, Norma Harris, Xiaohong Hu, Jianmin Li, Baohua Wu, Daneisha Hawkins, Chan Jin, Shihua Wang, Chenchen Yu, Irene Hall, and Michael Friend and the Web and Consumer Services Team of the Prevention Communications Branch (editing and desktop publishing).

Table 1a. Diagnoses of HIV Infection among Persons Aged ≥13 Years, by Selected Characteristics, 2019—United States (Preliminary)
2019
Total No.
Gender
Male 25,147
Female 6,013
Transgender male-to-femalea 463
Transgender female-to-malea 30
Additional gender identityb 17
Age at diagnosis (yr)
13–24 6,466
25–34 11,402
35–44 6,139
45–54 4,303
≥55 3,360
Race/ethnicity
American Indian/Alaska Native 202
Asian 651
Black/African American 13,926
Hispanic/Latinoc 8,097
Native Hawaiian/Other Pacific Islander 66
White 8,156
Multiple races 572
Transmission categoryd
Male-to-male sexual contact 21,047
Injection drug use
      Male 1,223
      Female 945
Male-to-male sexual contact and injection drug use 1,120
Heterosexual contacte
      Male 2,197
      Female 5,066
Otherf
      Male 37
      Female 36
Region of residenceg
Northeast 4,608
Midwest 4,308
South 16,653
West 6,101
Total 31,670

a Transgender male-to-female” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender female-to-male” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
b Additional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
c Hispanics/Latinos can be of any race.
dData have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total. Data presented based on sex at birth and may include transgender persons.
eHeterosexual contact with a person known to have, or to be at high risk for, HIV infection.
fIncludes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
g Data are based on residence at time of diagnosis of HIV infection.

Table 1b. Diagnoses of HIV Infection among Persons Aged ≥13 years, by Selected Characteristics, 2019—United States and 6 Dependent Areas (Preliminary)
Table 1b. Diagnoses of HIV Infection among Persons Aged ≥13 years, by Selected Characteristics, 2019—United States and 6 Dependent Areas (Preliminary)
2019
Total No.
Gender
Male 25,426
Female 6,076
Transgender male-to-femalea 466
Transgender female-to-malea 30
Additional gender identityb 17
Age at diagnosis (yr)
13–24 6,517
25–34 11,494
35–44 6,209
45–54 4,361
≥55 3,434
Race/ethnicity
American Indian/Alaska Native 202
Asian 657
Black/African American 13,926
Hispanic/Latinoc 8,428
Native Hawaiian/Other Pacific Islander 70
White 8,160
Multiple races 572
Transmission categoryd
Male-to-male sexual contact 21,241
Injection drug use
      Male 1,243
      Female 950
Male-to-male sexual contact and injection drug use 1,130
Heterosexual contacte
      Male 2,255
      Female 5,123
Otherf
      Male 37
      Female 36
Region of residenceg
Northeast 4,608
Midwest 4,308
South 16,653
West 6,101
U.S. dependent areas 345
Total 32,015

a Transgender male-to-female” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender female-to-male” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
b Additional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
c Hispanics/Latinos can be of any race.
d have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total. Data presented based on sex at birth and include transgender persons.
e Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
f Includes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
g Data are based on residence at time of diagnosis of HIV infection.

Table 1c. Diagnoses of HIV infection among persons aged ≥13 years, by area of residence, 2019—United States and Puerto Rico (preliminary)
2019
Area of residence Total No.
Alabama 536
Alaska 27
Arizona 644
Arkansas 264
California 3,529
Colorado 427
Connecticut 164
Delaware 88
District of Columbia 231
Florida 4,334
Georgia 1,966
Hawaii 57
Idaho 21
Illinois 1,106
Indiana 464
Iowa 92
Kansas 118
Kentucky 231
Louisiana 901
Maine 29
Maryland 783
Massachusetts 436
Michigan 652
Minnesota 265
Mississippi 421
Missouri 470
Montana 25
Nebraska 78
Nevada 442
New Hampshire 27
New Jersey 859
New Mexico 121
New York 2,102
North Carolina 1,335
North Dakota 31
Ohio 820
Oklahoma 188
Oregon 186
Pennsylvania 927
Puerto Rico 334
Rhode Island 54
South Carolina 664
South Dakota 19
Tennessee 721
Texas 3,064
Utah 126
Vermont 10
Virginia 804
Washington 483
West Virginia 122
Wisconsin 193
Wyoming 13

Note. Data are based on residence at time of diagnosis of HIV infection.

Table 1d. Diagnoses of HIV infection among persons aged ≥13 years, by area of residence, 2019—Ending the HIV Epidemic Phase I jurisdictions (preliminary)
Area of residence Total No.
Arizona
Maricopa County 428
California
Alameda County 204
Los Angeles County 1,182
Orange County 231
Riverside County 231
Sacramento County 89
San Bernardino County 235
San Diego County 169
San Francisco County 202
District of Columbia 231
Florida
Broward County 588
Duval County 269
Hillsborough County 275
Miami-Dade County 1,126
Orange County 469
Palm Beach County 214
Pinellas County 196
Georgia
Cobb County 142
DeKalb County 297
Fulton County 494
Gwinnett County 142
Illinois
Cook County 801
Indiana
Marion County 196
Louisiana
East Baton Rouge Parish 151
Orleans Parish 161
Maryland
Baltimore City 157
Montgomery County 133
Prince George’s County 220
Massachusetts
Suffolk County 108
Michigan
Wayne County 273
Nevada
Clark County 397
New Jersey
Essex County 185
Hudson County 117
New York
Bronx County 431
Kings County 420
New York County 300
Queens County 325
North Carolina
Mecklenburg County 255
Ohio
Cuyahoga County 134
Franklin County 135
Hamilton County 160
Pennsylvania
Philadelphia County 353
Puerto Rico
San Juan Municipio 71
Tennessee
Shelby County 244
Texas
Bexar County 329
Dallas County 640
Harris County 785
Tarrant County 212
Travis County 159
Washington
King County 263

Note. Data are based on residence at time of diagnosis of HIV infection.

Table 2a. Linkage to HIV medical care within 1 month after HIV diagnosis, among persons aged ≥13 years with HIV diagnosed January through September 2019, by selected characteristics—41 states and the District of Columbia (preliminary)
≥1 CD4 or VL tests No CD4 or VL test
Total No. No. % >No. %
Gender
Male 19,042 15,485 81.3 3,557 18.7
Female 4,471 3,594 80.4 877 19.6
Transgender male-to-femalea 357 290 81.2 67 18.8
Transgender female-to-malea 23 18 78.3 5 21.7
Additional gender identityb 11 11 100 0 0.0
Age at diagnosis (yr)
13–24 4,969 3,911 78.7 1,058 21.3
25–34 8,616 6,932 80.5 1,684 19.5
35–44 4,585 3,756 81.9 829 18.1
45–54 3,261 2,724 83.5 537 16.5
≥55 2,473 2,075 83.9 398 16.1
Race/ethnicity
American Indian/Alaska Native 121 104 86.0 17 14.0
Asian 477 404 84.7 73 15.3
Black/African American 10,687 8,425 78.8 2,262 21.2
Hispanic/Latinoc 6,136 5,104 83.2 1,032 16.8
Native Hawaiian/Other Pacific Islander 47 37 78.7 10 21.3
White 5,960 4,928 82.7 1,032 17.3
Multiple races 476 396 83.2 80 16.8
Transmission categoryd
Male-to-male sexual contact 16,005 13,081 81.7 2,924 18.3
Injection drug use
      Male 843 647 76.7 196 23.3
      Female 697 537 77.1 160 22.9
Male-to-male sexual contact and injection drug use 838 672 80.1 166 19.9
Heterosexual contacte
      Male 1,694 1,361 80.3 333 19.7
      Female 3,774 3,054 80.9 720 19.1
Totalf 23,904 19,398 81.1 4,506 18.9

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL). CDC, the Centers for Disease Control and Prevention [footnotes only].
Note. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month after HIV diagnosis. Data not provided for jurisdictions that do not have laws requiring reporting of all CD4 and viral loads or for areas with incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete lab reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
a Transgender male-to-female” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender female-to-male” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
b Additional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
c Hispanics/Latinos can be of any race.
d Data have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total. Data presented based on sex at birth and include transgender persons.
e Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
f Includes persons whose infection was attributed to hemophilia, blood transfusion, or perinatal exposure or whose risk factor was not reported or not identified. Data not displayed because the numbers were too small to be meaningful.

Table 2b. Linkage to HIV medical care within 1 month after HIV diagnosis, among persons aged ≥13 years with HIV diagnosed January through September 2019, by area of residence—41 states and the District of Columbia (preliminary)
≥1 CD4 or VL tests No CD4 or VL test
Area of residence Total No. No. % >No. %
Alabama 453 359 79.2 94 20.8
Alaska 23 19 82.6 4 17.4
California 3,046 2,544 83.5 502 16.5
Colorado 352 291 82.7 61 17.3
Delaware 76 58 76.3 18 23.7
District of Columbia 190 163 85.8 27 14.2
Florida 3,459 2,895 83.7 564 16.3
Georgia 1,749 1,460 83.5 289 16.5
Hawaii 51 42 82.4 9 17.6
Illinois 955 798 83.6 157 16.4
Indiana 381 227 59.6 154 40.4
Iowa 69 65 94.2 4 5.8
Louisiana 716 591 82.5 125 17.5
Maine 24 22 91.7 2 8.3
Maryland 680 619 91.0 61 9.0
Massachusetts 405 367 90.6 38 9.4
Michigan 499 418 83.8 81 16.2
Minnesota 209 193 92.3 16 7.7
Mississippi 336 235 69.9 101 30.1
Missouri 378 283 74.9 95 25.1
Montana 19 18 94.7 1 5.3
Nebraska 60 48 80.0 12 20.0
Nevada 388 321 82.7 67 17.3
New Hampshire 22 21 95.5 1 4.5
New Mexico 97 88 90.7 9 9.3
New York 1,772 1,560 88.0 212 12.0
North Carolina 1,039 823 79.2 216 20.8
North Dakota 29 28 96.6 1 3.4
Ohio 712 591 83.0 121 17.0
Oklahoma 170 108 63.5 62 36.5
Oregon 141 123 87.2 18 12.8
Rhode Island 54 49 90.7 5 9.3
South Carolina 562 498 88.6 64 11.4
South Dakota 16 13 81.3 3 18.8
Tennessee 583 372 63.8 211 36.2
Texas 2,776 1,932 69.6 844 30.4
Utah 94 75 79.8 19 20.2
Virginia 663 515 77.7 148 22.3
Washington 376 329 87.5 47 12.5
West Virginia 115 86 74.8 29 25.2
Wisconsin 153 139 90.8 14 9.2
Wyoming 12 12 100 0 0.0
Total 23,904 19,398 81.1 4,506 18.9

Abbreviations: CD4, CD4+ T -lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL). CDC, the Centers for Disease Control and Prevention [footnotes only].
Note. Data are based on residence at diagnosis of HIV infection. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month after HIV diagnosis. Data not provided for states and associated counties that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete lab reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.

Table 2c. Linkage to HIV medical care within 1 month after HIV diagnosis, among persons aged ≥13 years with HIV diagnosed January through September 2019, by area of residence—Ending the HIV Epidemic Phase I jurisdictions (preliminary)
≥1 CD4 or VL tests No CD4 or VL test
Area of residence Total No. No. % >No. %
California
Alameda County 163 149 91.4 14 8.6
Los Angeles County 1,042 849 81.5 193 18.5
Orange County 189 149 78.8 40 21.2
Riverside County 186 152 81.7 34 18.3
Sacramento County 76 67 88.2 9 11.8
San Bernardino County 215 158 73.5 57 26.5
San Diego County 162 140 86.4 22 13.6
San Francisco County 167 162 97.0 5 3.0
District of Columbia 190 163 85.8 27 14.2
Florida
Broward County 458 400 87.3 58 12.7
Duval County 202 159 78.7 43 21.3
Hillsborough County 202 176 87.1 26 12.9
Miami-Dade County 932 777 83.4 155 16.6
Orange County 373 297 79.6 76 20.4
Palm Beach County 170 132 77.6 38 22.4
Pinellas County 161 137 85.1 24 14.9
Georgia
Cobb County 131 113 86.3 18 13.7
DeKalb County 264 222 84.1 42 15.9
Fulton County 436 366 83.9 70 16.1
Gwinnett County 123 105 85.4 18 14.6
Illinois
Cook County 685 571 83.4 114 16.6
Indiana
Marion County 165 82 49.7 83 50.3
Louisiana
East Baton Rouge Parish 121 107 88.4 14 11.6
Orleans Parish 135 113 83.7 22 16.3
Maryland
Baltimore City 142 130 91.5 12 8.5
Montgomery County 117 109 93.2 8 6.8
Prince George’s County 192 175 91.1 17 8.9
Massachusetts
Suffolk County 102 94 92.2 8 7.8
Michigan
Wayne County 209 184 88.0 25 12.0
Nevada
Clark County 353 289 81.9 64 18.1
New York
Bronx County 372 322 86.6 50 13.4
Kings County 360 318 88.3 42 11.7
New York County 269 241 89.6 28 10.4
Queens County 270 229 84.8 41 15.2
North Carolina
Mecklenburg County 194 151 77.8 43 22.2
Ohio
Cuyahoga County 110 97 88.2 13 11.8
Franklin County 134 123 91.8 11 8.2
Hamilton County 132 114 86.4 18 13.6
Pennsylvania
Philadelphia County 320 271 84.7 49 15.3
Tennessee
Shelby County 200 119 59.5 81 40.5
Texas
Bexar County 278 178 64.0 100 36.0
Dallas County 550 406 73.8 144 26.2
Harris County 764 512 67.0 252 33.0
Tarrant County 176 119 67.6 57 32.4
Travis County 142 124 87.3 18 12.7
Washington
King County 193 171 88.6 22 11.4

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL). CDC, the Centers for Disease Control and Prevention [footnotes only].
Note. Data are based on residence at diagnosis of HIV infection. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month after HIV diagnosis. Data not provided for states and associated counties that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: New Jersey and Pennsylvania (excluding Philadelphia County). Areas with incomplete reporting: Arizona and Puerto Rico.

Table 3a. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage in 2018, among persons aged ≥16 years, by selected characteristics—United States
Persons prescribed PrEPa Persons with PrEP indicationsb PrEP coveragec
No. No. %
Sex at birth
Male 204,812 981,089 20.9
Female 14,770 225,573 6.5
Age (yr)
16–24 28,860 244,663 11.8
25–34 91,077 431,142 21.1
35–44 51,083 236,275 21.6
45–54 31,300 170,734 18.3
≥55 17,371 121,833 14.3
Race/ethnicityd
Asian/other 9,437 n/a n/a
Black/African American 28,243 460,807 6.1
Hispanic/Latino 33,503 319,962 10.5
White 147,454 332,748 44.3
Total 219,691 1,206,662 18.2

Abbreviations: PrEP, preexposure propphylaxis; n/a, not available.
a Estimated using 2018 data from IQVIA pharmacy database. Data for which values are unknown were not reported thus values may not sum to column total.
b Estimated using 2018 data from National HIV Surveilance System, National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey. Data for which values are unknown were not reported thus values may not sum to column total.
c PrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.
d Race/ethnicity data were only available for <40% of persons prescribed PrEP in 2018. Number prescribed PrEP and PrEP coverage for race/ethnicity reported in the table were adjusted applying the distribution of records with known race/ethnicity to records with missing race/ethnicity.

Table 3b. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage in 2018, among persons aged ≥16 years, by area of residence—United States and Puerto Rico
Persons prescribed PrEPa Persons with PrEP indicationsb PrEP coveragec
Area of residence No. No. %
Alabama 1,513 11,049 13.7
Alaska 189 1,966 9.6
Arizona 3,521 25,487 13.8
Arkansas 611 5,060 12.1
California 36,272 164,148 22.1
Colorado 3,428 25,229 13.6
Connecticut 2,292 9,189 24.9
Delaware 402 4,355 9.2
District of Columbia 5,014 12,830 39.1
Florida 13,623 125,880 10.8
Georgia 6,154 38,868 15.8
Hawaii 668 4,417 15.1
Idaho 377 4,733 8.0
Illinois 14,438 55,092 26.2
Indiana 2,170 22,303 9.7
Iowa 1,184 4,735 25.0
Kansas 759 5,034 15.1
Kentucky 1,231 13,237 9.3
Louisiana 3,468 15,610 22.2
Maine 390 3,569 10.9
Maryland 4,008 26,683 15.0
Massachusetts 8,195 24,738 33.1
Michigan 3,453 29,141 11.8
Minnesota 3,542 21,194 16.7
Mississippi 654 4,470 14.6
Missouri 2,781 18,230 15.3
Montana 173 2,290 7.6
Nebraska 487 2,179 22.3
Nevada 1,477 11,341 13.0
New Hampshire 497 2,014 24.7
New Jersey 4,652 25,467 18.3
New Mexico 790 6,835 11.6
New York 30,572 73,346 41.7
North Carolina 3,682 32,390 11.4
North Dakota 166 1,516 10.9
Ohio 4,715 40,347 11.7
Oklahoma 827 11,162 7.4
Oregon 2,753 20,154 13.7
Pennsylvania 8,402 36,012 23.3
Puerto Rico 225 9,931 2.3
Rhode Island 842 3,852 21.9
South Carolina 1,198 10,329 11.6
South Dakota 106 934 11.3
Tennessee 2,602 22,008 11.8
Texas 17,628 123,350 14.3
Utah 1,496 6,768 22.1
Vermont 264 1,136 23.2
Virginia 3,177 31,192 10.2
Washington 8,798 39,199 22.4
West Virginia 358 4,961 7.2
Wisconsin 2,017 12,779 15.8
Wyoming 70 888 7.9

Abbreviation: PrEP, preexposure prophylaxis.
Note. Total number prescribed PrEP included persons from the United States and Puerto Rico and 1,605 with unknown ZIP codes.
aEstimated using 2018 data from IQVIA pharmacy database.
bEstimated using data from National HIV Surveillance System, National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey, and Puerto Rico Community Survey.
cPrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.

Table 3c. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage in 2018, among persons aged ≥16 years, by area of residence—Ending the HIV Epidemic Phase I jurisdictions
Persons prescribed PrEPa Persons with PrEP indicationsb PrEP coveragec
Area of residence No. No. %
Arizona
Maricopa County 2,860 13,770 20.8
California
Alameda County 1,844 6,142 30.0
Los Angeles County 12,121 35,749 33.9
Orange County 1,607 10,633 15.1
Riverside County 1,287 11,179 11.5
Sacramento County 740 4,352 17.0
San Bernardino County 579 11,671 5.0
San Diego County 3,347 11,397 29.4
San Francisco County 8,121 10,844 74.9
District of Columbia 5,014 12,830 39.1
Florida
Broward County 2,701 10,091 26.8
Duval County 365 4,243 8.6
Hillsborough County 751 12,965 5.8
Miami-Dade County 3,801 21,885 17.4
Orange County 1,711 15,452 11.1
Palm Beach County 555 3,909 14.2
Pinellas County 704 9,562 7.4
Georgia
Cobb County 375 2,360 15.9
DeKalb County 1,159 4,227 27.4
Fulton County 2,502 11,073 22.6
Gwinnett County 449 2,141 21.0
Illinois
Cook County 11,897 38,671 30.8
Indiana
Marion County 836 4,998 16.7
Louisiana
East Baton Rouge Parish 441 689 64.0
Orleans Parish 1,399 4,459 31.4
Maryland
Baltimore City 548 3,200 17.1
Montgomery County 803 2,782 28.9
Prince George’s County 658 1,981 33.2
Massachusetts
Suffolk County 2,628 6,500 40.4
Michigan
Wayne County 982 6,183 15.9
Nevada
Clark County 1,251 7,433 16.8
New Jersey
Essex County 628 1,991 31.5
Hudson County 867 2,958 29.3
New York
Bronx County 1,998 5,667 35.3
Kings County 6,249 13,696 45.6
New York County 12,661 11,770 107.6
Queens County 3,342 6,456 51.8
North Carolina
Mecklenburg County 894 8,375 10.7
Ohio
Cuyahoga County 805 5,799 13.9
Franklin County 1,588 11,982 13.3
Hamilton County 442 7,561 5.8
Pennsylvania
Philadelphia County 3,143 4,854 64.8
Puerto Rico
San Juan Municipio d 1,950 n/a
Tennessee
Shelby County 469 6,328 7.4
Texas
Bexar County 1,054 12,106 8.7
Dallas County 3,172 16,586 19.1
Harris County 3,987 22,080 18.1
Tarrant County 1,187 11,273 10.5
Travis County 3,438 11,498 29.9
Washington
King County 6,140 8,407 73.0

Abbreviations: PrEP, preexposure propphylaxis; n/a, not available.
aEstimated using 2018 data from IQVIA pharmacy database.
bEstimated using data from National HIV Ssurveillance System, National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey, and Puerto Rico Community Survey.
cPrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.
dData value <40 was not reported due to unreliability.

Table 3d. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage in 2017, among persons aged ≥16 years, Puerto Rico
Persons prescribed PrEPa Persons with PrEP indicationsb PrEP coveragec
Area of residence No. No. %
Puerto Rico 116 9,931 1.2
San Juan Municipio d 1,950 n/a

Abbreviations: PrEP, preexposure propphylaxis; n/a, not available.
Note. PrEP coverage for 2017 for the 50 states and the District of Columbia can be found at: https://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-1-no-1/index.html.
a Estimated using 2017 data from IQVIA pharmacy database.
b Estimated using data from National HIV Surveuillance System, National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey, and Puerto Rico Community Survey.
c PrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.
d Data value <40 was not reported due to unreliability.