America’s HIV Epidemic Analysis Dashboard (AHEAD) is a unique data visualization tool to empower local stakeholders to track progress towards the goals of the Ending the HIV Epidemic: A Plan for America (EHE) initiative. This post serves as the beginning of a new blog series providing detailed information on each of the six EHE indicators tracked in AHEAD, beginning with pre-exposure prophylaxis (PrEP) coverage.
Investing in proven prevention tools is key to ending the HIV epidemic in America. PrEP is when people at risk for HIV take daily medicine as prescribed to prevent HIV. The Centers for Disease Control and Prevention (CDC) has estimated that approximately 1.2 million people in the U.S. could benefit from PrEP but fewer than one in four are prescribed PrEP.
One of the six goals of the Ending the HIV Epidemic: A Plan for America (EHE) initiative is to increase PrEP coverage, or the estimated percentage of individuals with indications for PrEP to be prescribed PrEP. When taken as prescribed, PrEP is highly effective in preventing HIV. EHE partner agencies are working to support jurisdictional efforts to increase PrEP access and use. The recent release of AHEAD provides the ability to track progress on PrEP coverage goals at local and national levels.
PrEP coverage, reported as a percentage, uses 4 data sources. IQVIA, a pharmacy database used as the data source for the numerator, which is the number of persons prescribed PrEP. Three data sources are used for the denominator to estimate the number of persons with indications for PrEP - American Community Survey (ACS), National Health and Nutrition Examination Survey (NHANES), and the National HIV Surveillance System (NHSS). Additionally, in one instance, Puerto Rico ACS is used in combination with NHANES and NHSS to estimate a PrEP coverage denominator for Puerto Rico.
Viewing the national PrEP data on AHEAD for 2017 shows disparities in who is prescribed PrEP. Approximately 14.4% of males and 4.4% of females with indications for PrEP are estimated to be prescribed PrEP. This is in contrast to the 2025 and 2030 goals of 50% of all people with indications for PrEP to be prescribed PrEP. Disparities also exist among age group and race and ethnicity. Young people aged 16-24 are the least likely to be on PrEP relative to their indication for PrEP (7.5%). Black/African American people are also the population with the highest number of indications for PrEP (479,443) and the lowest rate of PrEP prescription (19,068 or 4.0%). EHE plans and implementation activities should consider these disparities and design programs to close the gaps.
The AHEAD dashboard will be regularly updated to display additional data as they become available from CDC. HHS strives to provide the most accurate and updated picture of how jurisdictions are progressing towards reaching their goals. In that spirit, the PrEP data will be updated both quarterly and annually.
Throughout the rollout of AHEAD, we will post additional information on each of the six EHE indicators on the HIV.gov blog. Sign up for blog updates from HIV.gov to learn more.