America’s HIV Epidemic Analysis Dashboard (AHEAD) is an online data visualization tool that tracks progress toward achieving the goals of the Ending the HIV Epidemic (EHE) initiative using six indicators. One of the key indicators, viral suppression, is the percentage of people living with diagnosed HIV infection in a given year who have an amount of HIV that is less than 200 copies per milliliter of blood, including those whose viral load is undetectable.
The EHE initiative’s goal is to increase the percentage of people with HIV in America who are virally suppressed to 95% by 2030. By tracking our progress toward achieving this goal, people with HIV, public health officials, HIV advocacy groups, and other stakeholders are better able to scale up their HIV services and tailor interventions.
Viral Suppression: An Essential Step in Ending the HIV Epidemic
Current U.S. HIV treatment guidelines recommend all people with HIV begin treatment with HIV medication as soon as possible after receiving a diagnosis both for the individual’s health and to prevent sexual transmission of HIV. Over the last decade, a substantial body of research has shown that people with HIV who take medication daily as prescribed and get and keep an undetectable viral load can live long, healthy lives and have effectively no risk of sexually transmitting the virus to an HIV-negative partner. (This is commonly known as U=U or “undetectable = untransmittable.”)
While many people with HIV who are on treatment are virally suppressed, some are not or do not maintain viral suppression over time. According to CDC, in 2018, only 65% of people with diagnosed HIV in 41 states and the District of Columbia were virally suppressed and among some priority populations, the rates are even lower. For example, by race/ethnicity, only 59.9% of Black/African Americans with diagnosed HIV had achieved viral suppression. This is due to a number of factors.
Increasing the percentage of individuals who are virally suppressed will have a large impact on reducing new HIV infections. A CDC analysis found that the vast majority (80%) of new HIV transmissions in the U.S. in 2016 were linked to people whose HIV was either undiagnosed or currently untreated. Twenty percent of the new transmissions were linked to the 11% of people with HIV who were diagnosed and in care but not virally suppressed. These findings highlight the need to increase the proportion of people who are diagnosed, help those who are diagnosed get into care rapidly, and help people with HIV start HIV treatment and stay adherent so that they can achieve and maintain a suppressed viral load.
The AHEAD dashboard displays national viral suppression data overall, as well as for the 57 jurisdictions prioritized in the initiative’s first phase and the states in which EHE counties are located. Use the dashboard and its data to raise questions about the work necessary to scale up evidence-based and evidence-informed programs to enhance rapid linkage to care and support activities and services designed to help people with HIV maintain a suppressed viral load.