HIV-Related Death Rate in U.S. Fell by Half From 2010 to 2017

Increasing survival of people with HIV shows progress in efforts against the virus

In a sign of hope, the rate of HIV-related deaths among people 13 years and older in the United States fell by nearly half from 2010 to 2017, according to a new Centers for Disease Control and Prevention study.

Reductions were seen across the board – among men and women, all ages, and all racial and ethnic groups. Still, with over 5,500 HIV-related deaths in 2017, the number remains too high, particularly among African Americans and people of multiple races – underscoring the importance of additional efforts to reduce the burden of HIV disease and to end the HIV epidemic in the United States.

The study, published in CDC’s Morbidity and Mortality Weekly Report, shows that from 2010 to 2017, the age-adjusted HIV-related death rate (the number of HIV-related deaths per 1,000 people with HIV) fell from 9.1 to 4.7, a decline of 48%. In 2017, 16,358 people with HIV died, and 5,534 of those deaths were from HIV-related causes.

Importantly, racial and ethnic differences in HIV-related death rates also declined during the time period examined in the study. Although African Americans had a substantially higher HIV-related death rate than most other groups in 2017, the absolute gap between African Americans and whites fell by two-thirds between 2010 and 2017. In addition, the HIV-related death rate for Hispanics/Latinos was 7.9 in 2010 and by 2017 the rate decreased to 3.9 – the same as whites.

“The decline in HIV-related deaths proves that investments in HIV testing, care, and treatment are paying off, but we should also protect people from getting HIV in the first place,” said Jonathan Mermin, M.D., M.P.H., Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Through the Ending the HIV Epidemic initiative, we are working to accelerate progress and ultimately make this epidemic a thing of the past.”

Much of the reduction in HIV-related death rates was likely the result of diagnosing people with HIV earlier in infection and helping them to get – and stay on – lifesaving treatment. From 2010 to 2018, the share of Americans with HIV who knew their status increased from 82% to an all-time high of 86%. In that same period, the percentage of people with diagnosed HIV who had a suppressed viral load (a measure of the amount of HIV in a person’s blood) increased from 46% to nearly 65%. This change is critical because those who maintain an undetectable viral load live longer, healthier lives and have effectively no risk of sexually transmitting HIV.

Possible drivers in the reduction of HIV-related deaths include investments and action by community organizations, CDC, the Health Resources and Services Administration’s Ryan White HIV/AIDS Program, the National Institutes of Health, people with HIV, and many other partners. Also, providers’ increased adherence to federal HIV treatment guidelines recommending antiretroviral medication for all people with HIV, instead of restricting it to people with poor immune health may have helped decrease HIV-related deaths.

CDC funds health departments and local organizations to implement HIV prevention programs, test and diagnose people with HIV, link them to care, and help ensure they stay in care. Efforts are designed to reach those most affected by HIV, including African Americans and Hispanics/Latinos at risk for or living with HIV. CDC also sponsors national awareness campaigns designed to encourage people to seek out HIV testing and treatment and to help end HIV-related stigma.

Action needed to further reduce HIV deaths, prevent new transmissions, and end disparities

Despite the progress highlighted in today’s study, there is an urgent need to get more Americans with HIV diagnosed early and into sustained HIV care and treatment. Thousands of Americans still die from HIV each year and there are more than 36,000 new HIV transmissions annually. HIV remains a leading cause of death for people aged 25 to 44 years.

Additionally, differences in HIV-related death rates still exist by race/ethnicity, age, gender, U.S. region and other categories. Variations among these groups in timely diagnosis and treatment, along with ongoing treatment likely contributed to the rate differences. Accelerated efforts are needed to continue to reduce and ultimately eliminate ethnic, racial, and other disparities in new HIV transmissions, early diagnosis, viral suppression, and mortality. Although HIV-related death rates declined for all groups, this study shows that rates were highest among people of multiple races and African Americans compared to whites. In 2017, the HIV-related death rates were 7.0 among people of multiple races, 5.6 among African Americans, and 3.9 among whites.

Ending the HIV Epidemic initiative is key to accelerating progress

Through a federal initiative launched in early 2019, Ending the HIV Epidemic: A Plan for America, CDC and other federal agencies are providing a targeted infusion of new resources, technology, and expertise to expand and implement proven HIV prevention and treatment strategies where they are needed most. In July 2020, CDC awarded $109 million to state and local health departments to advance implementation of the initiative in the 57 areas currently hardest hit by the epidemic. Individual jurisdictions will tailor strategies for their local populations at greatest risk and address the social determinants of health that contribute to ongoing disparities. Through sustained and expanded efforts, the multi-year initiative aims to reduce new HIV transmissions in the U.S. by at least 90% by the year 2030.

While the COVID-19 pandemic has created major new challenges, CDC and its partners remain committed to accelerating efforts to end the HIV epidemic. CDC has worked to provide grantees the guidance and flexibility required to address urgent needs and effectively adapt key HIV prevention services so that they can continue during the COVID-19 pandemic. Many CDC-funded programs, including health departments and community-based organizations, have adopted innovative strategies to deliver HIV services in spite of social distancing requirements – for example, by expanding the use of telemedicine to ensure people continue to receive HIV care and pre-exposure prophylaxis and the use of HIV self-test kits to help people get tested early and often.

“Creative community-led solutions are a critical part of the Ending the HIV Epidemic initiative,” stressed Mermin. “Innovation and resolve will be vital to overcome barriers to testing, treatment, and care — both during the COVID-19 pandemic and beyond.”

For more information from CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, visit www.cdc.gov/nchhstp/newsroom.

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