Core Indicators for Monitoring the Ending the HIV Epidemic Initiative (Preliminary Data)
Core Indicators for Monitoring the Ending the HIV Epidemic Initiative (Preliminary Data)
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 March 2021 and preexposure prophylaxis (PrEP) data reported through December 2020.
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 (preliminary data): National HIV Surveillance System data reported through March 2021; and preexposure prophylaxis (PrEP) data reported through December 2020. HIV Surveillance Data Tables 2021;2(No. 3). http://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-2-no-3/index.html. Published July 2021 Accessed [date].
Technical Notes
The Ending the HIV Epidemic in the U.S. (EHE) initiative leverages 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% by 2025 and then by at least 90% by 2030. The Centers for Disease Control and Prevention (CDC) routinely releases HIV Surveillance Data Tables on the 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 reported to CDC as of March 2021 for the years 2020 and 2021, and data on preexposure prophylaxis (PrEP) coverage for the years 2019 and 2020 (preliminary). Data for the 3 indicators are provided at the national-, state-, and county-levels (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 with HIV diagnosed during January 2020 through March 2021 (Tables 1a–d). Data presented were reported (after the removal of personally identifiable information) to CDC.
An evaluation of surveillance data (2011–2015 diagnoses) found that, on average, approximately 75% of HIV diagnoses are reported to CDC during the year of diagnosis and approximately 95% of HIV diagnoses are reported to CDC by the end of the following year. Data reported to NHSS are considered preliminary until a 12-month reporting lag has been reached and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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 [2].
More information on counting diagnoses of HIV infection can be found at HIV Surveillance Report, 2019.
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 2020, 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 2020 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 2020. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to NHSS; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during 2020 and that were reported to NHSS through March 2021. 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 and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Vermont, and Puerto Rico.
Data reported to NHSS are considered preliminary until a 12-month reporting lag has been reached and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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 [2].
More information on calculating linkage to care can be found at Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2019). pdf icon[PDF – 17 MB]
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–3c). 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) was prescribed for PrEP after excluding prescriptions for HIV treatment, hepatitis B treatment, or HIV postexposure prophylaxis [3–5]. Tenofovir alafenamide and emtricitabine (TAF/FTC) was approved as an alternative drug for PrEP by the U.S. Food and Drug Administration (FDA) in October 2019. Starting in 2019, TAF/FTC was included in the algorithm to classify the number of persons prescribed PrEP.
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 database include white, black/African American, Hispanic/Latino, and other. The number of persons prescribed PrEP for each racial/ethnic group presented in this report was extrapolated by applying the racial/ethnic distribution of known records to those for which data on race/ethnicity were 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 by using data from (a) the U.S. Census Bureau’s American Community Survey (ACS) 5-year estimates by ZIP Code Tabulation Areas (ZCTAs) [6], and (b) the U.S Department of Housing and Urban Development’s ZIP Code Crosswalk Files [7]. Because of reliability concerns, subnational estimates of <40 are not included.
Persons with PrEP indications
ACS and U.S. Census Bureau files were used to estimate the number of men who have sex with men (MSM) in a jurisdiction [8, 9]. 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 [10].
The number of HIV-negative MSM with indications for PrEP was multiplied by the ratio of percentage of 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]. Jurisdictional estimates were rounded to the nearest 10.
The tables included in this report provide updated data on PrEP coverage for the year 2019 and data for the year 2020 by using the IQVIA data reported through December 2020. IQVIA conducts data quality assurance activities. As a result, the number of persons classified as having been prescribed PrEP in a given year might change from time to time. The impact of the changes may vary by demographic category nationally and by jurisdiction. The data sources used to estimate the number of persons with indications for PrEP have different schedules of availability. Consequently, the availability of a denominator lags the availability of a numerator by approximately 1 year. PrEP coverage data with a lagged denominator are considered preliminary.
For this release of HIV Surveillance Data Tables, 2018 denominators were used for 2019 and 2020 PrEP coverage data; consequently, 2019 and 2020 PrEP coverage data are considered preliminary. In addition to being preliminary, data for the year 2020 should be interpreted with awareness of the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions.
More information on calculating PrEP coverage can be found at Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018. pdf icon[PDF – 3.8 MB]
References
- HHS. What is Ending the HIV Epidemic: A Plan for America? https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview. Updated June 2, 2021. Accessed June 30, 2021.
- CDC [Schuchat A, CDC COVID-19 Response Team]. Public health response to the initiation and spread of pandemic COVID-19 in the United States, February 24–April 21, 2020. MMWR 2020;69(18):551–556. doi:http://dx.doi.org/10.15585/mmwr.mm6918e2
- Wu H, Mendoza MC, Huang YA, Hayes T, Smith DK, Hoover KW. Uptake of HIV preexposure prophylaxis among commercially insured persons—United States, 2010–2014. Clin Infect Dis 2017; 64(2):144–149. doi:10.1093/cid/ciw701
- CDC [Huang YA, Zhu W, Smith DK, Harris N, Hoover KW]. HIV preexposure prophylaxis, by race and ethnicity—United States, 2014–2016. MMWR 2018;67(41):1147–1150. doi:10.15585/mmwr.mm6741a3
- 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
- U.S. Census Bureau. American Community Survey 5-year data (2009-2018). https://www.census.gov/data/developers/data-sets/acs-5year.2016.html. Published December 19, 2019. Accessed June 30, 2021.
- U.S. Department of Housing and Urban Development (HUD). HUD USPS ZIP code crosswalk files. https://www.huduser.gov/portal/datasets/usps_crosswalk.html. Published 2019. June 30, 2021.
- Grey JA, Bernstein KT, Sullivan PS, Purcell DW, Chesson HW, Gift TL, Rosenberg ES. Estimating the population sizes of men who have sex with men in US states and counties using data from the American Community Survey. JMIR public health and surveillance. 2016;2(1):e14.
- Purcell DW, Johnson CH, Lansky A, Prejean J, Stein R, Denning P, et al. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J 2012;6:98-107.
- CDC [Smith DK, Van Handel M, Wolitski RJ, et al]. Vital Signs: Estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR 2015;64(46):1291–1295. doi:10.15585/mmwr.mm6446a4
Suggested Citation
Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative (preliminary data): National HIV Surveillance System data reported through March 2021; and preexposure prophylaxis (PrEP) data reported through December 2020. HIV Surveillance Data Tables 2021;2(No. 3). http://www.cdc.gov/hiv/library/reports/surveillance-data-tables/vol-2-no-3/index.html. Published July 2021 Accessed [date].
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Acknowledgments
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, Jianmin Li, Xiaohong Hu, Baohua Wu, Kyung Lee, Weiming Zhu, Lei Yu, Saja Khader, Tameka Hayes, Norma Harris.
Michael Friend and the Web and Consumer Services Team of the Prevention Communications Branch are acknowledged for editing and desktop publishing this report.
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.
| 2020 | 2021 (January-March) |
|
|---|---|---|
| No. | No. | |
| Gender | ||
| Male | 22,514 | 3,723 |
| Female | 5,041 | 817 |
| Transgender male-to-femalea | 541 | 69 |
| Transgender female-to-malea | 35 | 6 |
| Additional gender identityb | 10 | 3 |
| Age at diagnosis (yr) | ||
| 13–24 | 5,617 | 885 |
| 25–34 | 10,386 | 1,680 |
| 35–44 | 5,494 | 953 |
| 45–54 | 3,683 | 591 |
| ≥55 | 2,961 | 509 |
| Race/ethnicity | ||
| American Indian/Alaska Native | 184 | 25 |
| Asian | 581 | 111 |
| Black/African American | 12,219 | 2,046 |
| Hispanic/Latinoc | 7,199 | 1,088 |
| Native Hawaiian/other Pacific Islander | 58 | 13 |
| White | 7,350 | 1,287 |
| Multiracial | 550 | 48 |
| Transmission categoryd | ||
| Male-to-male sexual contact | 19,131 | 3,194 |
| Injection drug use | ||
| Male | 1,105 | 161 |
| Female | 774 | 127 |
| Male-to-male sexual contact and injection drug use | 972 | 151 |
| Heterosexual contacte | ||
| Male | 1,827 | 282 |
| Female | 4,278 | 693 |
| Otherf | ||
| Male | 30 | 7 |
| Female | 25 | 4 |
| Region of residenceg | ||
| Northeast | 4,020 | 525 |
| Midwest | 3,748 | 552 |
| South | 14,814 | 2,806 |
| West | 5,559 | 735 |
| Total | 28,141 | 4,618 |
Abbreviation: CDC, the Centers for Disease Control and Prevention [footnotes only].
Note. In addition to being preliminary, data for years 2020 and 2021 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.
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 Hispanic/Latino persons 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 with a risk factor 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.
| 2020 | 2021 (Janurary–March) | |
|---|---|---|
| No. | No. | |
| Gender | ||
| Male | 22,750 | 3,770 |
| Female | 5,082 | 827 |
| Transgender male-to-femalea | 543 | 69 |
| Transgender female-to-malea | 35 | 6 |
| Additional gender identityb | 10 | 3 |
| Age at diagnosis (yr) | ||
| 13–24 | 5,664 | 893 |
| 25–34 | 10,464 | 1,699 |
| 35–44 | 5,554 | 964 |
| 45–54 | 3,731 | 604 |
| ≥55 | 3,007 | 515 |
| Race/ethnicity | ||
| American Indian/Alaska Native | 184 | 25 |
| Asian | 581 | 111 |
| Black/African American | 12,221 | 2,047 |
| Hispanic/Latinoc | 7,474 | 1,143 |
| Native Hawaiian/other Pacific Islander | 58 | 13 |
| White | 7,352 | 1,288 |
| Multiracial | 550 | 48 |
| Transmission categoryd | ||
| Male-to-male sexual contact | 19,306 | 3,232 |
| Injection drug use | ||
| Male | 1,125 | 164 |
| Female | 776 | 127 |
| Male-to-male sexual contact and injection drug use | 978 | 151 |
| Heterosexual contacte | ||
| Male | 1,865 | 288 |
| Female | 4,316 | 703 |
| Otherf | ||
| Male | 30 | 7 |
| Female | 25 | 4 |
| Region of residenceg | ||
| Northeast | 4,020 | 525 |
| Midwest | 3,748 | 552 |
| South | 14,814 | 2,806 |
| West | 5,559 | 735 |
| U.S. dependent areas | 279 | 57 |
| Total | 28,420 | 4,675 |
Abbreviation: CDC, the Centers for Disease Control and Prevention [footnotes only].
Note. Data are for cases reported to CDC through March 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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.
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 Hispanic/Latino persons 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 with a risk factor 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.
| 2020 | 2021 (January–March) |
|
|---|---|---|
| Area of residence | No. | No. |
| Alabama | 578 | 24 |
| Alaska | 29 | 2 |
| Arizona | 687 | 76 |
| Arkansas | 247 | 54 |
| California | 3,270 | 388 |
| Colorado | 309 | 62 |
| Connecticut | 153 | 18 |
| Delaware | 97 | 21 |
| District of Columbia | 205 | 31 |
| Florida | 3,569 | 962 |
| Georgia | 1,699 | 251 |
| Hawaii | 43 | 2 |
| Idaho | 29 | 0 |
| Illinois | 777 | 96 |
| Indiana | 431 | 63 |
| Iowa | 99 | 21 |
| Kansas | 139 | 25 |
| Kentucky | 293 | 64 |
| Louisiana | 742 | 205 |
| Maine | 17 | 4 |
| Maryland | 722 | 113 |
| Massachusetts | 373 | 22 |
| Michigan | 532 | 105 |
| Minnesota | 221 | 59 |
| Mississippi | 380 | 52 |
| Missouri | 361 | 95 |
| Montana | 14 | 2 |
| Nebraska | 67 | 3 |
| Nevada | 372 | 60 |
| New Hampshire | 29 | 2 |
| New Jersey | 733 | 77 |
| New Mexico | 69 | 10 |
| New York | 1,894 | 255 |
| North Carolina | 1,088 | 276 |
| North Dakota | 23 | 1 |
| Ohio | 855 | 37 |
| Oklahoma | 208 | 30 |
| Oregon | 178 | 40 |
| Pennsylvania | 765 | 146 |
| Rhode Island | 49 | 1 |
| South Carolina | 727 | 160 |
| South Dakota | 34 | 6 |
| Tennessee | 638 | 136 |
| Texas | 2,877 | 238 |
| Utah | 129 | 22 |
| Vermont | 7 | 0 |
| Virginia | 623 | 178 |
| Washington | 416 | 70 |
| West Virginia | 121 | 11 |
| Wisconsin | 209 | 41 |
| Wyoming | 14 | 1 |
| Subtotal | 28,141 | 4,618 |
| U.S. dependent areas | ||
| American Samoa | 0 | 0 |
| Guam | 0 | 1 |
| Northern Mariana Islands | 0 | 0 |
| Puerto Rico | 277 | 56 |
| Republic of Palau | 0 | 0 |
| U.S. Virgin Islands | 2 | 0 |
| Subtotal | 279 | 57 |
| Total | 28,420 | 4,675 |
Abbreviation: CDC, the Centers for Disease Control and Prevention [footnotes only].
Note. Data are based on residence at time of diagnosis of HIV infection. Data are for cases reported to CDC through March 2021 are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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.
| 2020 | 2021 (January–March) |
|
|---|---|---|
| Area of residence | No. | No. |
| Arizona | ||
| Maricopa County | 491 | 61 |
| California | ||
| Alameda County | 149 | 24 |
| Los Angeles County | 1,145 | 132 |
| Orange County | 261 | 48 |
| Riverside County | 228 | 33 |
| Sacramento County | 24 | 1 |
| San Bernardino County | 214 | 16 |
| San Diego County | 249 | 5 |
| San Francisco County | 152 | 26 |
| District of Columbia | 205 | 31 |
| Florida | ||
| Broward County | 489 | 124 |
| Duval County | 236 | 70 |
| Hillsborough County | 259 | 68 |
| Miami-Dade County | 834 | 235 |
| Orange County | 398 | 98 |
| Palm Beach County | 227 | 46 |
| Pinellas County | 158 | 45 |
| Georgia | ||
| Cobb County | 126 | 12 |
| DeKalb County | 226 | 37 |
| Fulton County | 481 | 67 |
| Gwinnett County | 111 | 15 |
| Illinois | ||
| Cook County | 592 | 72 |
| Indiana | ||
| Marion County | 168 | 30 |
| Louisiana | ||
| East Baton Rouge Parish | 127 | 25 |
| Orleans Parish | 109 | 45 |
| Maryland | ||
| Baltimore City | 171 | 21 |
| Montgomery County | 87 | 21 |
| Prince George’s County | 212 | 31 |
| Massachusetts | ||
| Suffolk County | 119 | 9 |
| Michigan | ||
| Wayne County | 228 | 50 |
| Nevada | ||
| Clark County | 323 | 53 |
| New Jersey | ||
| Essex County | 183 | 26 |
| Hudson County | 118 | 9 |
| New York | ||
| Bronx County | 334 | 37 |
| Kings County | 426 | 58 |
| New York County | 289 | 34 |
| Queens County | 306 | 27 |
| North Carolina | ||
| Mecklenburg County | 210 | 66 |
| Ohio | ||
| Cuyahoga County | 184 | 8 |
| Franklin County | 199 | 14 |
| Hamilton County | 128 | 1 |
| Pennsylvania | ||
| Philadelphia County | 321 | 54 |
| Puerto Rico | ||
| San Juan Municipio | 68 | 17 |
| Tennessee | ||
| Shelby County | 223 | 45 |
| Texas | ||
| Bexar County | 283 | 22 |
| Dallas County | 608 | 68 |
| Harris County | 647 | 20 |
| Tarrant County | 231 | 10 |
| Travis County | 157 | 26 |
| Washington | ||
| King County | 202 | 34 |
Abbreviation: CDC, the Centers for Disease Control and Prevention [footnotes only].
Note. Data are based on residence at time of diagnosis of HIV infection. Data are for cases reported to CDC through March 2021 are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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.
| Total diagnoses | ≥1 CD4 or VL tests | No CD4 or VL test | |||
|---|---|---|---|---|---|
| No. | No. | % | No. | % | |
| Gender | |||||
| Male | 20,960 | 17,262 | 82.4 | 3,698 | 17.6 |
| Female | 4,666 | 3,823 | 81.9 | 843 | 18.1 |
| Transgender male-to-femalea | 508 | 413 | 81.3 | 95 | 18.7 |
| Transgender female-to-malea | 32 | 30 | 93.8 | 2 | 6.3 |
| Additional gender identityb | 9 | 8 | 88.9 | 1 | 11.1 |
| Age at diagnosis (yr) | |||||
| 13–24 | 5,257 | 4,215 | 80.2 | 1,042 | 19.8 |
| 25–34 | 9,676 | 7,916 | 81.8 | 1,760 | 18.2 |
| 35–44 | 5,108 | 4,198 | 82.2 | 910 | 17.8 |
| 45–54 | 3,391 | 2,895 | 85.4 | 496 | 14.6 |
| ≥55 | 2,743 | 2,312 | 84.3 | 431 | 15.7 |
| Race/ethnicity | |||||
| American Indian/Alaska Native | 179 | 145 | 81.0 | 34 | 19.0 |
| Asian | 557 | 491 | 88.2 | 66 | 11.8 |
| Black/African American | 11,434 | 9,135 | 79.9 | 2,299 | 20.1 |
| Hispanic/Latinoc | 6,717 | 5,658 | 84.2 | 1,059 | 15.8 |
| Native Hawaiian/other Pacific Islander | 57 | 49 | 86.0 | 8 | 14.0 |
| White | 6,726 | 5,633 | 83.7 | 1,093 | 16.3 |
| Multiracial | 505 | 425 | 84.2 | 80 | 15.8 |
| Transmission categoryd | |||||
| Male-to-male sexual contact | 17,946 | 14,839 | 82.7 | 3,106 | 17.3 |
| Injection drug use | 1,673 | 1,321 | 79.0 | 353 | 21.1 |
| Male injection drug use | 963 | 760 | 78.9 | 204 | 21.1 |
| Female injection drug use | 710 | 561 | 79.0 | 149 | 21.0 |
| Male-to-male sexual contact and injection drug use | 898 | 726 | 80.9 | 171 | 19.1 |
| Heterosexual contacte | 5,607 | 4,606 | 82.1 | 1,001 | 17.9 |
| Male Heterosexual contact | 1,643 | 1,336 | 81.3 | 307 | 18.7 |
| Female Heterosexual contact | 3,964 | 3,270 | 82.5 | 694 | 17.5 |
| Totalf | 26,175 | 21,536 | 82.3 | 4,639 | 17.7 |
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]; NHSS, National HIV Surveillance System [footnotes only].
Note. Data are based on residence at diagnosis of HIV infection. Data are for cases reported to CDC through March 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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. Linkage to HIV medical care was measured by documentation of ≥ 1 CD4 or VL tests ≤ 1 month after HIV diagnosis. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to NHSS; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during 2020 and reported to NHSS through March 2021. 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 and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Puerto Rico, and Vermont.
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 Hispanic/Latino persons can be of any race.
d Data have been statistically adjusted to account for missing transmission category; therefore, values may not sum to column total. Data presented based on sex at birth and may include transgender persons.
e Heterosexual contact with a person known to have, or with a risk factor 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.
| Total diagnoses | ≥1 CD4 or VL tests | ≥1 CD4 or VL tests | |||
|---|---|---|---|---|---|
| Area of residence | No. | No. | % | No. | % |
| Alabama | 578 | 465 | 80.4 | 113 | 19.6 |
| Alaska | 29 | 28 | 96.6 | 1 | 3.4 |
| Arizona | 687 | 583 | 84.9 | 104 | 15.1 |
| Arkansas | 247 | 210 | 85.0 | 37 | 15.0 |
| California | 3,270 | 2,767 | 84.6 | 503 | 15.4 |
| Colorado | 309 | 271 | 87.7 | 38 | 12.3 |
| Connecticut | 153 | 132 | 86.3 | 21 | 13.7 |
| Delaware | 97 | 78 | 80.4 | 19 | 19.6 |
| District of Columbia | 205 | 180 | 87.8 | 25 | 12.2 |
| Florida | 3,569 | 3,001 | 84.1 | 568 | 15.9 |
| Georgia | 1,699 | 1,446 | 85.1 | 253 | 14.9 |
| Hawaii | 43 | 38 | 88.4 | 5 | 11.6 |
| Illinois | 777 | 656 | 84.4 | 121 | 15.6 |
| Indiana | 431 | 313 | 72.6 | 118 | 27.4 |
| Iowa | 99 | 88 | 88.9 | 11 | 11.1 |
| Louisiana | 742 | 565 | 76.1 | 177 | 23.9 |
| Maine | 17 | 16 | 94.1 | 1 | 5.9 |
| Maryland | 722 | 638 | 88.4 | 84 | 11.6 |
| Massachusetts | 373 | 324 | 86.9 | 49 | 13.1 |
| Michigan | 532 | 446 | 83.8 | 86 | 16.2 |
| Minnesota | 221 | 194 | 87.8 | 27 | 12.2 |
| Mississippi | 380 | 278 | 73.2 | 102 | 26.8 |
| Missouri | 361 | 284 | 78.7 | 77 | 21.3 |
| Montana | 14 | 12 | 85.7 | 2 | 14.3 |
| Nebraska | 67 | 61 | 91.0 | 6 | 9.0 |
| Nevada | 372 | 318 | 85.5 | 54 | 14.5 |
| New Hampshire | 29 | 23 | 79.3 | 6 | 20.7 |
| New Mexico | 69 | 57 | 82.6 | 12 | 17.4 |
| New York | 1,894 | 1,634 | 86.3 | 260 | 13.7 |
| North Carolina | 1,088 | 897 | 82.4 | 191 | 17.6 |
| North Dakota | 23 | 18 | 78.3 | 5 | 21.7 |
| Ohio | 855 | 748 | 87.5 | 107 | 12.5 |
| Oklahoma | 208 | 160 | 76.9 | 48 | 23.1 |
| Oregon | 178 | 151 | 84.8 | 27 | 15.2 |
| Rhode Island | 49 | 45 | 91.8 | 4 | 8.2 |
| South Carolina | 727 | 640 | 88.0 | 87 | 12.0 |
| South Dakota | 34 | 30 | 88.2 | 4 | 11.8 |
| Tennessee | 638 | 471 | 73.8 | 167 | 26.2 |
| Texas | 2,877 | 1,989 | 69.1 | 888 | 30.9 |
| Utah | 129 | 112 | 86.8 | 17 | 13.2 |
| Virginia | 623 | 509 | 81.7 | 114 | 18.3 |
| Washington | 416 | 371 | 89.2 | 45 | 10.8 |
| West Virginia | 121 | 91 | 75.2 | 30 | 24.8 |
| Wisconsin | 209 | 185 | 88.5 | 24 | 11.5 |
| Wyoming | 14 | 13 | 92.9 | 1 | 7.1 |
| Total | 26,175 | 21,536 | 82.3 | 4,639 | 17.7 |
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]; NHSS, National HIV Surveillance System [footnotes only].
Note. Data are based on residence at diagnosis of HIV infection. Data are for cases reported to CDC through March 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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. Linkage to HIV medical care was measured by documentation of ≥ 1 CD4 or VL tests ≤ 1 month after HIV diagnosis. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to NHSS; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during 2020 and reported to NHSS through March 2021. 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 and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Puerto Rico, and Vermont.
| Total diagnoses | ≥1 CD4 or VL tests | No CD4 or VL test | |||
|---|---|---|---|---|---|
| Area of residence | No. | No. | % | No. | % |
| Arizona | |||||
| Maricopa County | 491 | 419 | 85.3 | 72 | 14.7 |
| California | |||||
| Alameda County | 149 | 127 | 85.2 | 22 | 14.8 |
| Los Angeles County | 1,145 | 963 | 84.1 | 182 | 15.9 |
| Orange County | 261 | 235 | 90.0 | 26 | 10.0 |
| Riverside County | 228 | 188 | 82.5 | 40 | 17.5 |
| Sacramento County | 24 | 20 | 83.3 | 4 | 16.7 |
| San Bernardino County | 214 | 157 | 73.4 | 57 | 26.6 |
| San Diego County | 249 | 218 | 87.6 | 31 | 12.4 |
| San Francisco County | 152 | 144 | 94.7 | 8 | 5.3 |
| District of Columbia | 205 | 180 | 87.8 | 25 | 12.2 |
| Florida | |||||
| Broward County | 489 | 426 | 87.1 | 63 | 12.9 |
| Duval County | 236 | 190 | 80.5 | 46 | 19.5 |
| Hillsborough County | 259 | 220 | 84.9 | 39 | 15.1 |
| Miami-Dade County | 834 | 700 | 83.9 | 134 | 16.1 |
| Orange County | 398 | 336 | 84.4 | 62 | 15.6 |
| Palm Beach County | 227 | 183 | 80.6 | 44 | 19.4 |
| Pinellas County | 158 | 132 | 83.5 | 26 | 16.5 |
| Georgia | |||||
| Cobb County | 126 | 111 | 88.1 | 15 | 11.9 |
| DeKalb County | 226 | 196 | 86.7 | 30 | 13.3 |
| Fulton County | 481 | 419 | 87.1 | 62 | 12.9 |
| Gwinnett County | 111 | 88 | 79.3 | 23 | 20.7 |
| Illinois | |||||
| Cook County | 592 | 498 | 84.1 | 94 | 15.9 |
| Indiana | |||||
| Marion County | 168 | 124 | 73.8 | 44 | 26.2 |
| Louisiana | |||||
| East Baton Rouge Parish | 127 | 103 | 81.1 | 24 | 18.9 |
| Orleans Parish | 109 | 86 | 78.9 | 23 | 21.1 |
| Maryland | |||||
| Baltimore City | 171 | 149 | 87.1 | 22 | 12.9 |
| Montgomery County | 87 | 77 | 88.5 | 10 | 11.5 |
| Prince George’s County | 212 | 192 | 90.6 | 20 | 9.4 |
| Massachusetts | |||||
| Suffolk County | 119 | 106 | 89.1 | 13 | 10.9 |
| Michigan | |||||
| Wayne County | 228 | 188 | 82.5 | 40 | 17.5 |
| Nevada | |||||
| Clark County | 323 | 276 | 85.4 | 47 | 14.6 |
| New York | |||||
| Bronx County | 334 | 286 | 85.6 | 48 | 14.4 |
| Kings County | 426 | 359 | 84.3 | 67 | 15.7 |
| New York County | 289 | 248 | 85.8 | 41 | 14.2 |
| Queens County | 306 | 272 | 88.9 | 34 | 11.1 |
| North Carolina | |||||
| Mecklenburg County | 210 | 175 | 83.3 | 35 | 16.7 |
| Ohio | |||||
| Cuyahoga County | 184 | 168 | 91.3 | 16 | 8.7 |
| Franklin County | 199 | 178 | 89.4 | 21 | 10.6 |
| Hamilton County | 128 | 114 | 89.1 | 14 | 10.9 |
| Pennsylvania | |||||
| Philadelphia County | 321 | 280 | 87.2 | 41 | 12.8 |
| Tennessee | |||||
| Shelby County | 223 | 149 | 66.8 | 74 | 33.2 |
| Texas | |||||
| Bexar County | 283 | 171 | 60.4 | 112 | 39.6 |
| Dallas County | 608 | 420 | 69.1 | 188 | 30.9 |
| Harris County | 647 | 460 | 71.1 | 187 | 28.9 |
| Tarrant County | 231 | 148 | 64.1 | 83 | 35.9 |
| Travis County | 157 | 105 | 66.9 | 52 | 33.1 |
| Washington | |||||
| King County | 202 | 182 | 90.1 | 20 | 9.9 |
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]; NHSS, National HIV Surveillance System [footnotes only].
Note. Data are based on residence at diagnosis of HIV infection. Data are for cases reported to CDC through March 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 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. Linkage to HIV medical care was measured by documentation of ≥ 1 CD4 or VL tests ≤ 1 month after HIV diagnosis. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to NHSS; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during 2020 and reported to NHSS through March 2021. 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 and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Puerto Rico, and Vermont.
| 2019 | 2020 | |||||
|---|---|---|---|---|---|---|
| Persons prescribed PrEPa | Persons with PrEP indicationsb | PrEP coveragec | Persons prescribed PrEPa | Persons with PrEP indicationsb | PrEP coveragec | |
| No. | No. | % | No. | No. | & | |
| Sex at birth | ||||||
| Male | 248,106 | 989,200 | 25.1 | 257,141 | 989,200 | 26.0 |
| Female | 20,856 | 227,010 | 9.2 | 21,872 | 227,010 | 9.6 |
| Age (yr) | ||||||
| 16–24 | 37,244 | 246,290 | 15.1 | 34,452 | 246,290 | 14.0 |
| 25–34 | 109,593 | 434,680 | 25.2 | 111,444 | 434,680 | 25.6 |
| 35–44 | 62,374 | 238,470 | 26.2 | 66,804 | 238,470 | 28.0 |
| 45–54 | 36,273 | 173,420 | 20.9 | 37,845 | 173,420 | 21.8 |
| ≥55 | 23,538 | 123,350 | 19.1 | 28,489 | 123,350 | 23.1 |
| Race/ethnicityd | ||||||
| Black/African American | 36,578 | 468,540 | 7.8 | 39,499 | 468,540 | 8.4 |
| Hispanic/Latinoe | 42,270 | 312,820 | 13.5 | 45,648 | 312,820 | 14.6 |
| Other | 11,423 | 131,180 | 8.7 | 11,357 | 131,180 | 8.7 |
| White | 178,834 | 300,650 | 59.5 | 182,626 | 300,650 | 60.7 |
| Total | 269,106 | 1,216,210 | 22.1 | 279,130 | 1,216,210 | 23.0 |
Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].
Note: Data for year 2020 are preliminary and should be interpreted with caution due to the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions.
a Estimated using data from IQVIA pharmacy database reported through December 2020 based on an algorithm that included FDA approved drugs for PrEP. 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 are rounded to the nearest 10. Data for which values are unknown were not reported thus values may not sum to column total. 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 may lag the availability of a numerator. In this table, 2018 denominators were used for 2019 and 2020 PrEP coverage data.
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 each year. Number prescribed PrEP and PrEP coverage for race/ethnicity reported in the table were adjusted by applying the distribution of records with known race/ethnicity to records with missing race/ethnicity.
e Hispanic/Latino persons can be of any race.
| 2019 | 2020 | |||||
|---|---|---|---|---|---|---|
| Persons prescribed PrEPa | Persons with PrEP indicationsb | PrEP coveragec | Persons prescribed PrEPa | Persons with PrEP indicationsb | PrEP coveragec | |
| No. | No. | % | No. | No. | % | |
| Alabama | 1,826 | 11,020 | 16.6 | 1,840 | 11,020 | 16.7 |
| Alaska | 228 | 1,780 | 12.8 | 216 | 1,780 | 12.1 |
| Arizona | 4,468 | 25,780 | 17.3 | 4,707 | 25,780 | 18.3 |
| Arkansas | 731 | 5,130 | 14.2 | 783 | 5,130 | 15.3 |
| California | 40,844 | 165,030 | 24.7 | 39,572 | 165,030 | 24.0 |
| Colorado | 4,223 | 25,120 | 16.8 | 4,198 | 25,120 | 16.7 |
| Connecticut | 2,625 | 9,560 | 27.5 | 2,289 | 9,560 | 23.9 |
| Delaware | 460 | 4,400 | 10.5 | 424 | 4,400 | 9.6 |
| District of Columbia | 5,701 | 12,950 | 44.0 | 5,454 | 12,950 | 42.1 |
| Florida | 21,479 | 125,330 | 17.1 | 33,458 | 125,330 | 26.7 |
| Georgia | 8,427 | 39,030 | 21.6 | 9,078 | 39,030 | 23.3 |
| Hawaii | 806 | 4,360 | 18.5 | 841 | 4,360 | 19.3 |
| Idaho | 450 | 4,790 | 9.4 | 562 | 4,790 | 11.7 |
| Illinois | 16,368 | 55,860 | 29.3 | 15,001 | 55,860 | 26.9 |
| Indiana | 2,915 | 22,170 | 13.1 | 2,919 | 22,170 | 13.2 |
| Iowa | 1,385 | 4,760 | 29.1 | 1,350 | 4,760 | 28.4 |
| Kansas | 892 | 5,060 | 17.6 | 863 | 5,060 | 17.1 |
| Kentucky | 1,568 | 12,990 | 12.1 | 1,482 | 12,990 | 11.4 |
| Louisiana | 3,881 | 15,920 | 24.4 | 3,349 | 15,920 | 21.0 |
| Maine | 624 | 3,950 | 15.8 | 584 | 3,950 | 14.8 |
| Maryland | 4,867 | 27,300 | 17.8 | 4,429 | 27,300 | 16.2 |
| Massachusetts | 9,113 | 24,900 | 36.6 | 8,535 | 24,900 | 34.3 |
| Michigan | 4,312 | 29,570 | 14.6 | 4,259 | 29,570 | 14.4 |
| Minnesota | 4,106 | 21,720 | 18.9 | 3,842 | 21,720 | 17.7 |
| Mississippi | 927 | 4,530 | 20.5 | 1,049 | 4,530 | 23.2 |
| Missouri | 3,387 | 18,370 | 18.4 | 3,260 | 18,370 | 17.7 |
| Montana | 261 | 2,290 | 11.4 | 272 | 2,290 | 11.9 |
| Nebraska | 601 | 2,180 | 27.6 | 650 | 2,180 | 29.8 |
| Nevada | 2,124 | 11,390 | 18.6 | 2,221 | 11,390 | 19.5 |
| New Hampshire | 597 | 3,020 | 19.8 | 568 | 3,020 | 18.8 |
| New Jersey | 5,572 | 25,280 | 22.0 | 5,413 | 25,280 | 21.4 |
| New Mexico | 1,061 | 6,800 | 15.6 | 1,151 | 6,800 | 16.9 |
| New York | 34,321 | 72,640 | 47.2 | 30,658 | 72,640 | 42.2 |
| North Carolina | 5,288 | 32,490 | 16.3 | 5,737 | 32,490 | 17.7 |
| North Dakota | 194 | 1,520 | 12.8 | 200 | 1,520 | 13.2 |
| Ohio | 5,986 | 40,320 | 14.8 | 6,227 | 40,320 | 15.4 |
| Oklahoma | 1,133 | 11,030 | 10.3 | 1,454 | 11,030 | 13.2 |
| Oregon | 3,289 | 19,750 | 16.7 | 3,308 | 19,750 | 16.7 |
| Pennsylvania | 9,950 | 36,490 | 27.3 | 9,914 | 36,490 | 27.2 |
| Puerto Rico | 327 | 9,700 | 3.4 | 358 | 9,700 | 3.7 |
| Rhode Island | 1,053 | 3,880 | 27.1 | 1,030 | 3,880 | 26.5 |
| South Carolina | 1,701 | 10,390 | 16.4 | 1,989 | 10,390 | 19.1 |
| South Dakota | 144 | 910 | 15.8 | 115 | 910 | 12.6 |
| Tennessee | 3,814 | 22,460 | 17.0 | 4,852 | 22,460 | 21.6 |
| Texas | 22,754 | 123,790 | 18.4 | 26,467 | 123,790 | 21.4 |
| Utah | 1,983 | 6,840 | 29.0 | 2,175 | 6,840 | 31.8 |
| Vermont | 335 | 1,060 | 31.6 | 287 | 1,060 | 27.1 |
| Virginia | 4,329 | 31,430 | 13.8 | 4,627 | 31,430 | 14.7 |
| Washington | 9,441 | 40,050 | 23.6 | 8,735 | 40,050 | 21.8 |
| West Virginia | 563 | 5,250 | 10.7 | 491 | 5,250 | 9.4 |
| Wisconsin | 2,415 | 12,980 | 18.6 | 2,271 | 12,980 | 17.5 |
| Wyoming | 93 | 890 | 10.4 | 86 | 890 | 9.7 |
Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].
Note: Data for year 2020 are preliminary and should be interpreted with caution due to the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions
a Estimated using data from IQVIA pharmacy database reported through December 2020 based on an algorithm that included FDA approved drugs for PrEP. 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 are rounded to the nearest 10. Data for which values are unknown were not reported thus values may not sum to column total. 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 may lag the availability of a numerator. In this table, 2018 denominators were used for 2019 and 2020 PrEP coverage data.
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.
| 2019 | 2020 | |||||
|---|---|---|---|---|---|---|
| Persons prescribed PrEPa | Persons with PrEP indicationsb | PrEP coveragec | Persons prescribed PrEPa | Persons with PrEP indicationsb | PrEP coveragec | |
| No. | No. | % | No. | No. | % | |
| Arizona | ||||||
| Maricopa County | 3,456 | 22,720 | 15.2 | 3,639 | 22,720 | 16.0 |
| California | ||||||
| Alameda County | 2,152 | 8,930 | 24.1 | 1,912 | 8,930 | 21.4 |
| Los Angeles County | 13,464 | 67,450 | 20.0 | 13,901 | 67,450 | 20.6 |
| Orange County | 1,990 | 10,510 | 18.9 | 2,040 | 10,510 | 19.4 |
| Riverside County | 1,719 | 11,080 | 15.5 | 1,793 | 11,080 | 16.2 |
| Sacramento County | 931 | 5,920 | 15.7 | 898 | 5,920 | 15.2 |
| San Bernardino County | 751 | 11,890 | 6.3 | 775 | 11,890 | 6.5 |
| San Diego County | 3,626 | 14,500 | 25.0 | 3,520 | 14,500 | 24.3 |
| San Francisco County | 8,639 | 10,840 | 79.7 | 7,511 | 10,840 | 69.3 |
| District of Columbia | 5,701 | 12,950 | 44.0 | 5,454 | 12,950 | 42.1 |
| Florida | ||||||
| Broward County | 3,682 | 20,470 | 18.0 | 6,512 | 20,470 | 31.8 |
| Duval County | 496 | 8,970 | 5.5 | 703 | 8,970 | 7.8 |
| Hillsborough County | 1,370 | 12,910 | 10.6 | 1,423 | 12,910 | 11.0 |
| Miami-Dade County | 6,476 | 21,760 | 29.8 | 10,075 | 21,760 | 46.3 |
| Orange County | 2,752 | 15,310 | 18.0 | 3,719 | 15,310 | 24.3 |
| Palm Beach County | 874 | 9,170 | 9.5 | 2,966 | 9,170 | 32.3 |
| Pinellas County | 1,085 | 9,530 | 11.4 | 1,130 | 9,530 | 11.9 |
| Georgia | ||||||
| Cobb County | 548 | 3,070 | 17.9 | 600 | 3,070 | 19.5 |
| DeKalb County | 1,522 | 6,290 | 24.2 | 1,605 | 6,290 | 25.5 |
| Fulton County | 3,203 | 13,120 | 24.4 | 3,344 | 13,120 | 25.5 |
| Gwinnett County | 674 | 3,240 | 20.8 | 742 | 3,240 | 22.9 |
| Illinois | ||||||
| Cook County | 13,383 | 39,060 | 34.3 | 12,162 | 39,060 | 31.1 |
| Indiana | ||||||
| Marion County | 1,107 | 9,150 | 12.1 | 1,105 | 9,150 | 12.1 |
| Louisiana | ||||||
| East Baton Rouge Parish | 489 | 1,810 | 27.0 | 493 | 1,810 | 27.2 |
| Orleans Parish | 1,475 | 4,590 | 32.1 | 1,230 | 4,590 | 26.8 |
| Maryland | ||||||
| Baltimore City | 880 | 6,330 | 13.9 | 799 | 6,330 | 12.6 |
| Montgomery County | 897 | 5,770 | 15.5 | 851 | 5,770 | 14.7 |
| Prince George’s County | 789 | 4,040 | 19.5 | 731 | 4,040 | 18.1 |
| Massachusetts | ||||||
| Suffolk County | 2,705 | 6,520 | 41.5 | 2,560 | 6,520 | 39.3 |
| Michigan | ||||||
| Wayne County | 1,194 | 9,270 | 12.9 | 1,131 | 9,270 | 12.2 |
| Nevada | ||||||
| Clark County | 1,816 | 11,670 | 15.6 | 1,872 | 11,670 | 16.0 |
| New Jersey | ||||||
| Essex County | 672 | 4,090 | 16.4 | 650 | 4,090 | 15.9 |
| Hudson County | 1,019 | 4,650 | 21.9 | 963 | 4,650 | 20.7 |
| New York | ||||||
| Bronx County | 2,199 | 5,570 | 39.5 | 1,832 | 5,570 | 32.9 |
| Kings County | 7,319 | 15,650 | 46.8 | 6,611 | 15,650 | 42.2 |
| New York County | 13,583 | 15,540 | 87.4 | 12,253 | 15,540 | 78.8 |
| Queens County | 3,796 | 9,230 | 41.1 | 3,454 | 9,230 | 37.4 |
| North Carolina | ||||||
| Mecklenburg County | 1,318 | 8,450 | 15.6 | 1,481 | 8,450 | 17.5 |
| Ohio | ||||||
| Cuyahoga County | 932 | 7,520 | 12.4 | 869 | 7,520 | 11.6 |
| Franklin County | 1,986 | 11,620 | 17.1 | 2,126 | 11,620 | 18.3 |
| Hamilton County | 546 | 7,720 | 7.1 | 580 | 7,720 | 7.5 |
| Pennsylvania | ||||||
| Philadelphia County | 3,578 | 9,840 | 36.4 | 3,221 | 9,840 | 32.7 |
| Puerto Rico | ||||||
| San Juan Municipio | −d | 2,190 | n/a | −d | 2,190 | n/a |
| Tennessee | ||||||
| Shelby County | 630 | 6,450 | 9.8 | 772 | 6,450 | 12.0 |
| Texas | ||||||
| Bexar County | 1,468 | 11,920 | 12.3 | 1,689 | 11,920 | 14.2 |
| Dallas County | 3,997 | 28,670 | 13.9 | 4,944 | 28,670 | 17.2 |
| Harris County | 4,838 | 40,670 | 11.9 | 5,768 | 40,670 | 14.2 |
| Tarrant County | 1,443 | 11,340 | 12.7 | 1,579 | 11,340 | 13.9 |
| Travis County | 4,501 | 11,590 | 38.8 | 4,916 | 11,590 | 42.4 |
| Washington | ||||||
| King County | 6,576 | 17,890 | 36.8 | 6,067 | 17,890 | 33.9 |
Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].
Note: Data for year 2020 are preliminary and should be interpreted with caution due to the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions
a Estimated using data from IQVIA pharmacy database reported through December 2020 based on an algorithm that included FDA approved drugs for PrEP. 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 are rounded to the nearest 10. Data for which values are unknown were not reported thus values may not sum to column total. 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 may lag the availability of a numerator. In this table, 2018 denominators were used for 2019 and 2020 PrEP coverage data.
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.