Core Indicators for Monitoring the Ending the HIV Epidemic Initiative (Preliminary Data): National HIV Surveillance System Data Reported through June 2021; and Preexposure Prophylaxis (PrEP) Data Reported through March 2021

HIV Surveillance Data Tables

Core Indicators for Monitoring the Ending the HIV Epidemic Initiative (Preliminary Data):
National HIV Surveillance System Data Reported through June 2021; and Preexposure Prophylaxis (PrEP) Data Reported through March 2021

This issue of HIV Surveillance Data Tables is published by the Division of HIV Prevention (DHP), National Center for HIV, 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 June 2021 and preexposure prophylaxis (PrEP) data reported through March 2021.

IV 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 June 2021; and preexposure prophylaxis (PrEP) data reported through March 2021. HIV Surveillance Data Tables 2021;2(No. 4). http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published October 2021. Accessed [date].

Download the full report pdf icon[PDF – 1 MB].

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/pdf/library/reports/surveillance-data-tables/vol-1-no-1/cdc-hiv-surveillance-tables-vol-1-no-1.pdfpdf icon

The tables included in this report provide prelimi­nary data on HIV diagnoses and linkage to HIV medi­cal care reported to CDC as of June 2021 for the years 2020 and 2021, and data on preexposure prophy­laxis (PrEP) coverage for the years 2019, 2020, and 2021 (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 June 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 the National HIV Sur­veillance System (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 infection was diagnosed during January 2020 through March 2021, 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 January 2020 through March 2021 and who had ≥ 1 CD4 T-lymphocyte (CD4) or viral load (VL) tests within 1 month of HIV diagno­sis. The denominator is the number of persons aged ≥ 13 years whose HIV infection was diagnosed during January 2020 through March 2021. 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 2021 and that were reported to NHSS through June 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.

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

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 with the 2019 data, TAF/FTC was included in the algorithm to classify the number of persons prescribed PrEP. In addition, generic TDF/FTC for PrEP became available in the United States in October 2020. Starting with the 2020 data, generic TDF/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 years 2019 through March 2021 by using the IQVIA data reported through March 2021. 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, 2020, and 2021 PrEP coverage data; consequently, 2019 through March 2021 PrEP coverage data are considered preliminary. In addition to being preliminary, data for the year 2020 through March 2021 should be interpreted with caution and the 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, 2019).

References

  1. HHS. What is Ending the HIV Epidemic in the U.S.? https://www.hiv.gov/federal-response/ending-the-hivepidemic/overviewexternal icon. Updated June 2, 2021. Accessed September 23, 2021.
  2. 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.mm6918e2external icon.
  3. 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.
  4. 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.
  5. 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.
  6. U.S. Census Bureau. American Community Survey 5- year data (2009–2019). https://www.census.gov/data/developers/data-sets/acs-5year.2019.htmlexternal icon. Published December 10, 2020. Accessed September 23, 2021.
  7. U.S. Department of Housing and Urban Development (HUD). HUD USPS ZIP code crosswalk files. https://www.huduser.gov/portal/datasets/usps_crosswalk.htmlexternal icon. Updated June 2021. Accessed September 23, 2021.
  8. Grey JA, Bernstein KT, Sullivan PS, et al. 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 Surveill 2016;2(1):e14.
  9. Purcell DW, Johnson CH, Lansky A, 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.
  10. 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 June 2021; and preexposure prophylaxis (PrEP) data reported through March 2021. HIV Surveillance Data Tables 2021;2(No. 4). http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published October 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 Prevention, National Center for HIV, 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, 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.

Table 1a. Diagnoses of HIV infection among persons aged ≥13 years, by selected characteristics, January 2020 through June 2021—United States (preliminary)
2020 2021
(Janurary–June)
No. No.
Gender
Male 23,384 10,716
Female 5,236 2,313
Transgender male-to-femalea 589 221
Transgender female-to-malea 39 12
Additional gender identityb 13 13
Age at diagnosis (yr)
13–24 5,867 2,522
25–34 10,867 4,830
35–44 5,684 2,802
45–54 3,805 1,680
≥55 3,038 1,441
Race/ethnicity
American Indian/Alaska Native 184 82
Asian 603 266
Black/African American 12,557 5,720
Hispanic/Latinoc 7,636 3,443
Native Hawaiian/other Pacific Islander 61 32
White 7,562 3,548
Multiracial 658 184
Transmission categoryd
Male-to-male sexual contact 19,954 9,168
Injection drug use
      Male 1,131 508
      Female 812 342
Male-to-male sexual contact and injection drug use 1,014 451
Heterosexual contacte
      Male 1,858 805
      Female 4,436 1,974
Otherf
      Male 29 17
      Female 28 11
Region of residenceg
Northeast 4,187 1,682
Midwest 3,925 1,653
South 15,297 7,543
West 5,852 2,397
Total 29,261 13,275

Abbreviation: CDC, Centers for Disease Control and Prevention [footnotes only].
Note. Data are for cases reported to CDC through June 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.
bAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
cHispanic/Latino persons 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 include transgender persons.
eHeterosexual contact with a person known to have, or with a risk factor for, HIV infection.
fIncludes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
gData 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, January 2020 through June 2021—United States and 6 dependent areas (preliminary)
2020 2021
(Janurary–June)
No. No.
Gender
Male 23,633 10,836
Female 5,276 2,338
Transgender male-to-femalea 591 221
Transgender female-to-malea 39 12
Additional gender identityb 13 13
Age at diagnosis (yr)
13–24 5,918 2,548
25–34 10,948 4,873
35–44 5,746 2,833
45–54 3,852 1,706
≥55 3,088 1,460
Race/ethnicity
American Indian/Alaska Native 184 82
Asian 603 266
Black/African American 12,559 5,721
Hispanic/Latinoc 7,925 3,583
Native Hawaiian/other Pacific Islander 61 32
White 7,562 3,552
Multiracial 658 184
Transmission categoryd
Male-to-male sexual contact 20,139 9,266
Injection drug use
      Male 1,151 512
      Female 814 343
Male-to-male sexual contact and injection drug use 1,019 451
Heterosexual contacte
      Male 1,899 822
      Female 4,473 1,998
Otherf
      Male 29 17
      Female 28 11
Region of residenceg
Northeast 4,187 1,682
Midwest 3,925 1,653
South 15,297 7,543
West 5,852 2,397
U.S. dependent areas 291 145
Total 29,552 13,420

Abbreviation: CDC, Centers for Disease Control and Prevention [footnotes only].
Note. Data are for cases reported to CDC through June 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.
bAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
cHispanic/Latino persons 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 include transgender persons.
eHeterosexual contact with a person known to have, or with a risk factor for, HIV infection.
fIncludes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
gData 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, January 2020 through June 2021—United States and 6 dependent areas (preliminary)
2020 2021
(Janurary–June)
Area of residence No. No.
Alabama 574 137
Alaska 29 8
Arizona 675 284
Arkansas 246 185
California 3,535 1,315
Colorado 309 146
Connecticut 170 82
Delaware 96 33
District of Columbia 200 51
Florida 3,456 2,233
Georgia 1,802 761
Hawaii 50 15
Idaho 32 22
Illinois 905 276
Indiana 438 201
Iowa 99 54
Kansas 138 68
Kentucky 294 163
Louisiana 730 465
Maine 16 15
Maryland 719 302
Massachusetts 429 73
Michigan 523 280
Minnesota 226 135
Mississippi 395 166
Missouri 363 236
Montana 14 6
Nebraska 72 34
Nevada 382 212
New Hampshire 30 14
New Jersey 761 381
New Mexico 78 42
New York 1,945 736
North Carolina 1,082 621
North Dakota 30 4
Ohio 887 254
Oklahoma 233 98
Oregon 183 90
Pennsylvania 775 374
Rhode Island 53 6
South Carolina 686 332
South Dakota 34 10
Tennessee 644 349
Texas 3,390 1,219
Utah 129 64
Vermont 8 1
Virginia 625 385
Washington 422 191
West Virginia 125 43
Wisconsin 210 101
Wyoming 14 2
Subtotal 29,261 13,275
U.S. dependent areas
American Samoa 0 0
Guam 0 1
Northern Mariana Islands 0 0
Puerto Rico 289 143
Republic of Palau 0 0
U.S. Virgin Islands 2 1
Subtotal 291 145
Total 29,552 13,420

Abbreviation: CDC, 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 June 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.

Table 1d. Diagnoses of HIV infection among persons aged ≥13 years, by area of residence, January 2020 through June 2021—Ending the HIV Epidemic Phase I jurisdictions (preliminary)
2020 2021
(Janurary–June)
Area of residence No. No.
Arizona
Maricopa County 482 204
California
Alameda County 152 72
Los Angeles County 1,237 429
Orange County 262 116
Riverside County 234 91
Sacramento County 64 27
San Bernardino County 243 74
San Diego County 280 92
San Francisco County 151 78
District of Columbia 200 51
Florida
Broward County 478 308
Duval County 231 144
Hillsborough County 249 163
Miami-Dade County 814 572
Orange County 379 231
Palm Beach County 218 132
Pinellas County 155 83
Georgia
Cobb County 122 43
DeKalb County 240 114
Fulton County 492 223
Gwinnett County 123 41
Illinois
Cook County 687 198
Indiana
Marion County 169 91
Louisiana
East Baton Rouge Parish 124 80
Orleans Parish 106 70
Maryland
Baltimore City 175 56
Montgomery County 84 42
Prince George’s County 216 95
Massachusetts
Suffolk County 130 28
Michigan
Wayne County 228 115
Nevada
Clark County 332 190
New Jersey
Essex County 189 100
Hudson County 117 53
New York
Bronx County 330 148
Kings County 443 147
New York County 296 103
Queens County 315 99
North Carolina
Mecklenburg County 209 134
Ohio
Cuyahoga County 190 80
Franklin County 203 63
Hamilton County 130 6
Pennsylvania
Philadelphia County 330 107
Puerto Rico
San Juan Municipio 71 33
Tennessee
Shelby County 228 122
Texas
Bexar County 278 98
Dallas County 641 241
Harris County 895 385
Tarrant County 283 52
Travis County 166 71
Washington
King County 200 88

Abbreviation: CDC, 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 June 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.

Table 2a. Linkage to HIV medical care within 1 month of HIV diagnosis among persons aged ≥ 13 years, by selected characteristics, January 2020–March 2021—44 states and the District of Columbia (preliminary)
2020 2021 (January–March)
Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test
No. No. % No. % No. No. % No. %
Gender
Male 21,803 18,000 82.6 3,803 17.4 5,858 4,912 83.9 946 16.1
Female 4,851 3,990 82.3 861 17.7 1,254 1,042 83.1 212 16.9
Transgender male-to-femalea 552 451 81.7 101 18.3 119 106 89.1 13 10.9
Transgender female-to-malea 36 32 88.9 4 11.1 9 9 100 0 0.0
Additional gender identityb 11 10 90.9 1 9.1 7 7 100 0 0.0
Age at diagnosis (yr)
13–24 5,494 4,413 80.3 1,081 19.7 1,447 1,171 80.9 276 19.1
25–34 10,147 8,341 82.2 1,806 17.8 2,652 2,207 83.2 445 16.8
35–44 5,291 4,367 82.5 924 17.5 1,496 1,275 85.2 221 14.8
45–54 3,509 2,980 84.9 529 15.1 900 769 85.4 131 14.6
≥55 2,812 2,382 84.7 430 15.3 752 654 87.0 98 13.0
Race/ethnicity
American Indian/Alaska Native 179 145 81.0 34 19.0 40 32 80.0 8 20.0
Asian 576 503 87.3 73 12.7 150 134 89.3 16 10.7
Black/African American 11,769 9,419 80.0 2,350 20.0 3,170 2,594 81.8 576 18.2
Hispanic/Latinoc 7,140 6,061 84.9 1,079 15.1 1,881 1,624 86.3 257 13.7
Native Hawaiian/other Pacific Islander 60 53 88.3 7 11.7 19 16 84.2 3 15.8
White 6,930 5,798 83.7 1,132 16.3 1,884 1,586 84.2 298 15.8
Multiracial 599 504 84.1 95 15.9 103 90 87.4 13 12.6
Transmission categoryd
Male-to-male sexual contact 18,739 15,544 83.0 3,194 17.0 5,052 4,267 84.5 784 15.5
Injection drug use
      Male 992 781 78.7 211 21.3 244 185 75.6 60 24.4
      Female 750 591 78.9 158 21.1 182 148 81.4 34 18.6
Male-to-male sexual contact and injection drug use 929 745 80.2 184 19.8 240 189 78.8 51 21.2
Heterosexual contacte
      Male 1,680 1,368 81.4 312 18.6 437 375 85.7 62 14.3
      Female 4,111 3,408 82.9 704 17.1 1,075 897 83.5 178 16.5
Totalf 27,253 22,483 82.5 4,770 17.5 7,247 6,076 83.8 1,171 16.2

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, 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 June 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 January 2020 through March 2021 and reported to NHSS through June 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.
bAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
cHispanic/Latino persons 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 include transgender persons.
eHeterosexual contact with a person known to have, or with a risk factor for, HIV infection.
fIncludes 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 of HIV diagnosis among persons aged ≥ 13 years, by area of residence, January 2020–March 2021—44 states and the District of Columbia (preliminary)
2020 2021 (January–March)
Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test
Area of residence No. No. % No. % No. No. % No. %
Alabama 574 461 80.3 113 19.7 99 73 73.7 26 26.3
Alaska 29 28 96.6 1 3.4 4 4 100 0 0.0
Arizona 675 568 84.1 107 15.9 202 169 83.7 33 16.3
Arkansas 246 201 81.7 45 18.3 89 71 79.8 18 20.2
California 3,535 2,962 83.8 573 16.2 838 712 85.0 126 15.0
Colorado 309 270 87.4 39 12.6 88 80 90.9 8 9.1
Connecticut 170 143 84.1 27 15.9 57 51 89.5 6 10.5
Delaware 96 77 80.2 19 19.8 21 18 85.7 3 14.3
District of Columbia 200 175 87.5 25 12.5 38 35 92.1 3 7.9
Florida 3,456 2,906 84.1 550 15.9 1,177 1,009 85.7 168 14.3
Georgia 1,802 1,513 84.0 289 16.0 468 418 89.3 50 10.7
Hawaii 50 43 86.0 7 14.0 10 6 60.0 4 40.0
Illinois 905 766 84.6 139 15.4 215 188 87.4 27 12.6
Indiana 438 323 73.7 115 26.3 120 101 84.2 19 15.8
Iowa 99 89 89.9 10 10.1 29 26 89.7 3 10.3
Louisiana 730 556 76.2 174 23.8 233 190 81.5 43 18.5
Maine 16 15 93.8 1 6.3 8 8 100 0 0.0
Maryland 719 632 87.9 87 12.1 200 180 90.0 20 10.0
Massachusetts 429 373 86.9 56 13.1 50 48 96.0 2 4.0
Michigan 523 442 84.5 81 15.5 140 120 85.7 20 14.3
Minnesota 226 199 88.1 27 11.9 68 60 88.2 8 11.8
Mississippi 395 286 72.4 109 27.6 92 66 71.7 26 28.3
Missouri 363 289 79.6 74 20.4 137 108 78.8 29 21.2
Montana 14 12 85.7 2 14.3 4 4 100 0 0.0
Nebraska 72 64 88.9 8 11.1 17 15 88.2 2 11.8
Nevada 382 323 84.6 59 15.4 111 97 87.4 14 12.6
New Hampshire 30 24 80.0 6 20.0 6 6 100 0 0.0
New Mexico 78 65 83.3 13 16.7 21 20 95.2 1 4.8
New York 1,945 1,676 86.2 269 13.8 488 423 86.7 65 13.3
North Carolina 1,082 888 82.1 194 17.9 336 280 83.3 56 16.7
North Dakota 30 25 83.3 5 16.7 4 4 100 0 0.0
Ohio 887 764 86.1 123 13.9 171 149 87.1 22 12.9
Oklahoma 233 180 77.3 53 22.7 48 34 70.8 14 29.2
Oregon 183 152 83.1 31 16.9 48 39 81.3 9 18.8
Rhode Island 53 48 90.6 5 9.4 4 2 50.0 2 50.0
South Carolina 686 606 88.3 80 11.7 206 192 93.2 14 6.8
South Dakota 34 30 88.2 4 11.8 8 8 100 0 0.0
Tennessee 644 476 73.9 168 26.1 180 109 60.6 71 39.4
Texas 3,390 2,550 75.2 840 24.8 785 581 74.0 204 26.0
Utah 129 109 84.5 20 15.5 26 24 92.3 2 7.7
Virginia 625 509 81.4 116 18.6 212 180 84.9 32 15.1
Washington 422 375 88.9 47 11.1 109 98 89.9 11 10.1
West Virginia 125 92 73.6 33 26.4 19 16 84.2 3 15.8
Wisconsin 210 185 88.1 25 11.9 60 53 88.3 7 11.7
Wyoming 14 13 92.9 1 7.1 1 1 100 0 0.0
Total 27,253 22,483 82.5 4,770 17.5 7,247 6,076 83.8 1,171 16.2

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, 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 June 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 January 2020 through March 2021 and reported to NHSS through June 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.

Table 2c. Linkage to HIV medical care within 1 month of HIV diagnosis among persons aged ≥ 13 years, by area of residence, January 2020–March 2021—Ending the HIV Epidemic Phase I jurisdictions (preliminary)
2020 2021 (January–March)
Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test
Area of residence No. No. % No. % No. No. % No. %
Arizona
Maricopa County 482 411 85.3 71 14.7 140 117 83.6 23 16.4
California
Alameda County 152 129 84.9 23 15.1 37 32 86.5 5 13.5
Los Angeles County 1,237 1,031 83.3 206 16.7 285 248 87.0 37 13.0
Orange County 262 235 89.7 27 10.3 62 53 85.5 9 14.5
Riverside County 234 191 81.6 43 18.4 63 47 74.6 16 25.4
Sacramento County 64 54 84.4 10 15.6 23 21 91.3 2 8.7
San Bernardino County 243 174 71.6 69 28.4 53 40 75.5 13 24.5
San Diego County 280 243 86.8 37 13.2 68 57 83.8 11 16.2
San Francisco County 151 143 94.7 8 5.3 43 42 97.7 1 2.3
District of Columbia 200 175 87.5 25 12.5 38 35 92.1 3 7.9
Florida
Broward County 478 418 87.4 60 12.6 172 146 84.9 26 15.1
Duval County 231 186 80.5 45 19.5 81 66 81.5 15 18.5
Hillsborough County 249 211 84.7 38 15.3 71 63 88.7 8 11.3
Miami-Dade County 814 682 83.8 132 16.2 288 253 87.8 35 12.2
Orange County 379 324 85.5 55 14.5 127 109 85.8 18 14.2
Palm Beach County 218 174 79.8 44 20.2 73 58 79.5 15 20.5
Pinellas County 155 131 84.5 24 15.5 52 42 80.8 10 19.2
Georgia
Cobb County 122 106 86.9 16 13.1 24 21 87.5 3 12.5
DeKalb County 240 204 85.0 36 15.0 78 72 92.3 6 7.7
Fulton County 492 423 86.0 69 14.0 126 112 88.9 14 11.1
Gwinnett County 123 97 78.9 26 21.1 27 25 92.6 2 7.4
Illinois
Cook County 687 585 85.2 102 14.8 153 136 88.9 17 11.1
Indiana
Marion County 169 128 75.7 41 24.3 59 49 83.1 10 16.9
Louisiana
East Baton Rouge Parish 124 101 81.5 23 18.5 32 28 87.5 4 12.5
Orleans Parish 106 85 80.2 21 19.8 40 37 92.5 3 7.5
Maryland
Baltimore City 175 152 86.9 23 13.1 43 37 86.0 6 14.0
Montgomery County 84 75 89.3 9 10.7 27 27 100 0 0.0
Prince George’s County 216 194 89.8 22 10.2 59 51 86.4 8 13.6
Massachusetts
Suffolk County 130 116 89.2 14 10.8 19 19 100 0 0.0
Michigan
Wayne County 228 188 82.5 40 17.5 68 59 86.8 9 13.2
Nevada
Clark County 332 281 84.6 51 15.4 100 87 87.0 13 13.0
New York
Bronx County 330 285 86.4 45 13.6 92 82 89.1 10 10.9
Kings County 443 376 84.9 67 15.1 106 88 83.0 18 17.0
New York County 296 254 85.8 42 14.2 73 63 86.3 10 13.7
Queens County 315 279 88.6 36 11.4 63 58 92.1 5 7.9
North Carolina
Mecklenburg County 209 173 82.8 36 17.2 78 70 89.7 8 10.3
Ohio
Cuyahoga County 190 170 89.5 20 10.5 51 48 94.1 3 5.9
Franklin County 203 179 88.2 24 11.8 39 33 84.6 6 15.4
Hamilton County 130 115 88.5 15 11.5 6 6 100 0 0.0
Pennsylvania
Philadelphia County 330 285 86.4 45 13.6 67 54 80.6 13 19.4
Tennessee
Shelby County 228 153 67.1 75 32.9 58 27 46.6 31 53.4
Texas
Bexar County 278 187 67.3 91 32.7 66 45 68.2 21 31.8
Dallas County 641 482 75.2 159 24.8 157 118 75.2 39 24.8
Harris County 895 675 75.4 220 24.6 224 168 75.0 56 25.0
Tarrant County 283 206 72.8 77 27.2 41 26 63.4 15 36.6
Travis County 166 123 74.1 43 25.9 41 21 51.2 20 48.8
Washington
King County 200 181 90.5 19 9.5 43 41 95.3 2 4.7

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, 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 June 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 January 2020 through March 2021 and reported to NHSS through June 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.

Table 3a. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage during January 2019 through March 2021, among persons aged ≥16 years, by selected characteristics—United States (preliminary)
2019 2020 2020 (January-March)
Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec
No. No. % No. No. % No. No. %
Sex at birth
Male 252,373 989,200 25.5 277,207 989,200 28.0 182,316 989,200 18.4
Female 21,008 227,010 9.3 23,696 227,010 10.4 11,472 227,010 5.1
Age (yr)
16–24 36,873 246,290 15.0 38,454 246,290 15.6 17,894 246,290 7.3
25–34 112,071 434,680 25.8 119,246 434,680 27.4 74,221 434,680 17.1
35–44 63,344 238,470 26.6 72,146 238,470 30.3 51,250 238,470 21.5
45–54 36,951 173,420 21.3 40,694 173,420 23.5 27,985 173,420 16.1
≥55 24,201 123,350 19.6 30,394 123,350 24.6 22,606 123,350 18.3
Race/ethnicityd
Black/African American 36,890 468,540 7.9 42,372 468,540 9.0 26,205 468,540 5.6
Hispanic/Latinoe 42,985 312,820 13.7 48,838 312,820 15.6 31,090 312,820 9.9
Other 11,550 131,180 8.8 12,326 131,180 9.4 7,677 131,180 5.9
White 182,101 300,650 60.6 197,497 300,650 65.7 129,048 300,650 42.9
Total 273,526 1,216,210 22.5 301,033 1,216,210 24.8 194,020 1,216,210 16.0

Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].
Note: Data for years 2020 and 2021 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.

aEstimated using data from IQVIA pharmacy database reported through March 2021 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.
bEstimated 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, 2020 and January – March 2021 PrEP coverage data.
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.
dRace/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.
eHispanic/Latino persons can be of any race.

Table 3b. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage during January 2019 through March 2021, among persons aged ≥16 years, by area of residence—United States and Puerto Rico (preliminary)
2019 2020 2020 (January-March)
Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec
No. No. % No. No. % No. No. %
Alabama 1,837 11,020 16.7 1,927 11,020 17.5 1,430 11,020 13.0
Alaska 232 1,780 13.0 246 1,780 13.8 153 1,780 8.6
Arizona 4,544 25,780 17.6 5,047 25,780 19.6 3,512 25,780 13.6
Arkansas 740 5,130 14.4 876 5,130 17.1 636 5,130 12.4
California 41,508 165,030 25.2 42,399 165,030 25.7 26,444 165,030 16.0
Colorado 4,332 25,120 17.2 4,745 25,120 18.9 3,060 25,120 12.2
Connecticut 2,660 9,560 27.8 2,478 9,560 25.9 1,574 9,560 16.5
Delaware 471 4,400 10.7 463 4,400 10.5 327 4,400 7.4
District of Columbia 5,805 12,950 44.8 5,953 12,950 46.0 3,998 12,950 30.9
Florida 21,693 125,330 17.3 34,604 125,330 27.6 20,483 125,330 16.3
Georgia 8,576 39,030 22.0 9,746 39,030 25.0 6,903 39,030 17.7
Hawaii 815 4,360 18.7 904 4,360 20.7 606 4,360 13.9
Idaho 471 4,790 9.8 656 4,790 13.7 435 4,790 9.1
Illinois 16,587 55,860 29.7 15,951 55,860 28.6 10,609 55,860 19.0
Indiana 2,960 22,170 13.4 3,200 22,170 14.4 2,260 22,170 10.2
Iowa 1,418 4,760 29.8 1,513 4,760 31.8 961 4,760 20.2
Kansas 903 5,060 17.8 949 5,060 18.8 645 5,060 12.7
Kentucky 1,609 12,990 12.4 1,668 12,990 12.8 1,108 12,990 8.5
Louisiana 3,926 15,920 24.7 3,610 15,920 22.7 2,408 15,920 15.1
Maine 636 3,950 16.1 658 3,950 16.7 462 3,950 11.7
Maryland 4,940 27,300 18.1 4,809 27,300 17.6 3,154 27,300 11.6
Massachusetts 9,283 24,900 37.3 9,391 24,900 37.7 5,304 24,900 21.3
Michigan 4,362 29,570 14.8 4,697 29,570 15.9 3,157 29,570 10.7
Minnesota 4,181 21,720 19.2 4,197 21,720 19.3 2,797 21,720 12.9
Mississippi 935 4,530 20.6 1,095 4,530 24.2 820 4,530 18.1
Missouri 3,481 18,370 18.9 3,594 18,370 19.6 2,322 18,370 12.6
Montana 267 2,290 11.7 297 2,290 13.0 182 2,290 7.9
Nebraska 615 2,180 28.2 728 2,180 33.4 521 2,180 23.9
Nevada 2,157 11,390 18.9 2,495 11,390 21.9 1,554 11,390 13.6
New Hampshire 616 3,020 20.4 646 3,020 21.4 424 3,020 14.0
New Jersey 5,666 25,280 22.4 5,936 25,280 23.5 3,874 25,280 15.3
New Mexico 1,074 6,800 15.8 1,241 6,800 18.3 832 6,800 12.2
New York 34,993 72,640 48.2 34,080 72,640 46.9 21,250 72,640 29.3
North Carolina 5,371 32,490 16.5 6,166 32,490 19.0 4,309 32,490 13.3
North Dakota 194 1,520 12.8 218 1,520 14.3 133 1,520 8.8
Ohio 6,113 40,320 15.2 6,846 40,320 17.0 4,666 40,320 11.6
Oklahoma 1,143 11,030 10.4 1,525 11,030 13.8 1,071 11,030 9.7
Oregon 3,358 19,750 17.0 3,813 19,750 19.3 2,297 19,750 11.6
Pennsylvania 10,113 36,490 27.7 10,627 36,490 29.1 7,304 36,490 20.0
Puerto Rico 330 9,700 3.4 368 9,700 3.8 271 9,700 2.8
Rhode Island 1,078 3,880 27.8 1,148 3,880 29.6 811 3,880 20.9
South Carolina 1,724 10,390 16.6 2,124 10,390 20.4 1,493 10,390 14.4
South Dakota 147 910 16.2 146 910 16.0 105 910 11.5
Tennessee 3,888 22,460 17.3 5,171 22,460 23.0 3,800 22,460 16.9
Texas 22,966 123,790 18.6 27,527 123,790 22.2 19,355 123,790 15.6
Utah 2,021 6,840 29.5 2,380 6,840 34.8 1,769 6,840 25.9
Vermont 337 1,060 31.8 320 1,060 30.2 202 1,060 19.1
Virginia 4,422 31,430 14.1 5,164 31,430 16.4 3,275 31,430 10.4
Washington 9,802 40,050 24.5 10,005 40,050 25.0 6,153 40,050 15.4
West Virginia 570 5,250 10.9 526 5,250 10.0 381 5,250 7.3
Wisconsin 2,461 12,980 19.0 2,521 12,980 19.4 1,488 12,980 11.5
Wyoming 93 890 10.4 97 890 10.9 60 890 6.7

Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].
Note: Data year 2020 and 2021 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

aEstimated using data from IQVIA pharmacy database reported through March 2021 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.
bEstimated 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, 2020 and January – March 2021 PrEP coverage data. 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 during January 2019 through March 2021, among persons aged ≥16 years, by area of residence—Ending the HIV Epidemic Phase I jurisdictions (preliminary)
2019 2020 2020 (January-March)
Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec
No. No. % No. No. % No. No. %
Arizona
Maricopa County 3,522 22,720 15.5 3,889 22,720 17.1 2,761 22,720 12.2
California
Alameda County 2,167 8,930 24.3 2,039 8,930 22.8 1,103 8,930 12.4
Los Angeles County 13,660 67,450 20.3 14,799 67,450 21.9 9,771 67,450 14.5
Orange County 2,033 10,510 19.3 2,224 10,510 21.2 1,486 10,510 14.1
Riverside County 1,761 11,080 15.9 1,913 11,080 17.3 1,344 11,080 12.1
Sacramento County 949 5,920 16.0 968 5,920 16.4 544 5,920 9.2
San Bernardino County 752 11,890 6.3 820 11,890 6.9 540 11,890 4.5
San Diego County 3,701 14,500 25.5 3,767 14,500 26.0 2,378 14,500 16.4
San Francisco County 8,809 10,840 81.3 8,099 10,840 74.7 4,589 10,840 42.3
District of Columbia 5,805 12,950 44.8 5,953 12,950 46.0 3,998 12,950 30.9
Florida
Broward County 3,742 20,470 18.3 6,688 20,470 32.7 4,206 20,470 20.5
Duval County 503 8,970 5.6 745 8,970 8.3 485 8,970 5.4
Hillsborough County 1,379 12,910 10.7 1,519 12,910 11.8 978 12,910 7.6
Miami-Dade County 6,521 21,760 30.0 10,303 21,760 47.3 5,912 21,760 27.2
Orange County 2,764 15,310 18.1 3,876 15,310 25.3 2,552 15,310 16.7
Palm Beach County 876 9,170 9.6 3,023 9,170 33.0 1,243 9,170 13.6
Pinellas County 1,106 9,530 11.6 1,207 9,530 12.7 850 9,530 8.9
Georgia
Cobb County 557 3,070 18.1 644 3,070 21.0 440 3,070 14.3
DeKalb County 1,549 6,290 24.6 1,707 6,290 27.1 1,233 6,290 19.6
Fulton County 3,265 13,120 24.9 3,558 13,120 27.1 2,594 13,120 19.8
Gwinnett County 680 3,240 21.0 791 3,240 24.4 549 3,240 16.9
Illinois
Cook County 13,550 39,060 34.7 12,864 39,060 32.9 8,595 39,060 22.0
Indiana
Marion County 1,121 9,150 12.3 1,198 9,150 13.1 898 9,150 9.8
Louisiana
East Baton Rouge Parish 490 1,810 27.1 525 1,810 29.0 345 1,810 19.1
Orleans Parish 1,509 4,590 32.9 1,343 4,590 29.3 903 4,590 19.7
Maryland
Baltimore City 898 6,330 14.2 857 6,330 13.5 554 6,330 8.8
Montgomery County 909 5,770 15.8 918 5,770 15.9 583 5,770 10.1
Prince George’s County 800 4,040 19.8 814 4,040 20.1 572 4,040 14.2
Massachusetts
Suffolk County 2,755 6,520 42.3 2,806 6,520 43.0 1,484 6,520 22.8
Michigan
Wayne County 1,206 9,270 13.0 1,238 9,270 13.4 821 9,270 8.9
Nevada
Clark County 1,848 11,670 15.8 2,099 11,670 18.0 1,294 11,670 11.1
New Jersey
Essex County 679 4,090 16.6 709 4,090 17.3 454 4,090 11.1
Hudson County 1,035 4,650 22.3 1,042 4,650 22.4 676 4,650 14.5
New York
Bronx County 2,221 5,570 39.9 2,051 5,570 36.8 1,178 5,570 21.1
Kings County 7,453 15,650 47.6 7,379 15,650 47.2 4,615 15,650 29.5
New York County 13,906 15,540 89.5 13,620 15,540 87.6 8,932 15,540 57.5
Queens County 3,865 9,230 41.9 3,826 9,230 41.5 2,344 9,230 25.4
North Carolina
Mecklenburg County 1,338 8,450 15.8 1,567 8,450 18.5 1,165 8,450 13.8
Ohio
Cuyahoga County 949 7,520 12.6 959 7,520 12.8 664 7,520 8.8
Franklin County 2,039 11,620 17.5 2,309 11,620 19.9 1,653 11,620 14.2
Hamilton County 553 7,720 7.2 626 7,720 8.1 393 7,720 5.1
Pennsylvania
Philadelphia County 3,637 9,840 37.0 3,484 9,840 35.4 2,206 9,840 22.4
Puerto Rico
San Juan Municipio –d 2,190 n/a –d 2,190 n/a –d 2,190 n/a
Tennessee
Shelby County 641 6,450 9.9 818 6,450 12.7 518 6,450 8.0
Texas
Bexar County 1,483 11,920 12.4 1,765 11,920 14.8 1,273 11,920 10.7
Dallas County 4,037 28,670 14.1 5,142 28,670 17.9 3,752 28,670 13.1
Harris County 4,884 40,670 12.0 5,960 40,670 14.7 4,168 40,670 10.2
Tarrant County 1,455 11,340 12.8 1,647 11,340 14.5 1,184 11,340 10.4
Travis County 4,545 11,590 39.2 5,070 11,590 43.7 3,466 11,590 29.9
Washington
King County 6,856 17,890 38.3 6,955 17,890 38.9 4,272 17,890 23.9

Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].
Note: Data for years 2020 and 2021 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

aEstimated using data from IQVIA pharmacy database reported through March 2021 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.
bEstimated 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, 2020 and January – March 2021 PrEP coverage data.
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.