Cross-posted from Centers for Disease Control and Prevention

Dear Colleague,

As our country continues to battle the COVID-19 pandemic, we understand that our partners in HIV prevention are facing unprecedented challenges and demands. The Centers for Disease Control and Prevention (CDC) remains committed to working to protect the communities it serves and to providing timely and important data that can be used to help guide decision-making and advance progress toward ending the HIV epidemic in the United States.

Today, CDC has published two new reports: Diagnoses of HIV Infection in the United States and Dependent Areas, 2018 (Updated) and Estimated HIV Incidence and Prevalence in the United States 2014–2018 (PDF, 3 MB), as well as an AtlasPlus update that includes data from these reports. The reports and AtlasPlus update provide HIV diagnoses, diagnosed prevalence, and death data, along with estimated HIV incidence, prevalence, and knowledge of status through the year 2018. HIV prevention partners can use these reports, along with the data published in AtlasPlus, to help focus prevention efforts, allocate resources, monitor trends, and determine gaps and successes in HIV prevention.

Changes in Reporting
CDC is committed to publishing data in a timely manner and will now be publishing these reports together, earlier in the calendar year, to better equip stakeholders with the tools they need to identify and address gaps in HIV prevention and facilitate resource allocation. The reports will also feature the same time frames (e.g., this year’s report features the years 2014–2018) for all outcomes, to improve data interpretation and utility.

Other important changes include:

• For the first time, CDC is publishing national-level data by gender, which include data for transgender persons and persons of additional gender identity.
• For the first time, CDC has produced and is releasing estimates of HIV incidence and prevalence for Puerto Rico and at the county level for Ending the HIV Epidemic (EHE) jurisdictions.

Estimated HIV Incidence and Prevalence: Report Findings
Annual HIV infections in the United States have been reduced by more than two-thirds since the height of the epidemic in the mid-1980s, but CDC data indicate that recent progress has stalled. The estimated number of new HIV infections has leveled off in recent years (36,400 in 2018) and this stabilization at far too high a level reinforces the need for increased action to end America’s HIV epidemic. The latest estimates indicate that effective prevention and treatment are not adequately reaching people who could benefit most, and certain groups such as men who have sex with men (MSM), transgender persons, African Americans, and Hispanics/Latinos continue to be disproportionately affected. Additionally, the highest rates of new HIV infection continue to occur in the South. Finally, this report reveals that at year-end 2018, an estimated 1.2 M persons aged 13 years and older were living with HIV infection, including about 14% of persons whose infection had not been diagnosed. The number of undiagnosed infections were highest among blacks/African Americans, followed by Hispanics/Latinos, and whites.

HIV Diagnoses: Report Findings
CDC’s HIV surveillance report provides information that can deepen our understanding of the burden of disease in the U.S. In 2018, there were 37,968 HIV diagnoses in the United States and 6 dependent areas—an overall 7% decrease compared to 2014. Specifically, the number of HIV diagnoses decreased among males and females; blacks/African Americans; whites; people of multiple races; persons aged 13-24, 35-44, and 45-54 years; and among MSM overall. HIV diagnoses increased among transgender males and females; Native Hawaiians/other Pacific Islanders; persons aged 25-34 years; and people who inject drugs (PWID), with notable increases occurring among white PWID, likely due to concentrated HIV outbreaks among this group. Diagnoses remained stable among Asians, Hispanics/Latinos, American Indian/Alaska Natives, and persons aged 55 and over. Variations in trends among groups are expected and may be due to differences in testing behaviors, targeted HIV testing initiatives, or changes in the numbers of new HIV infections (incidence) in some subgroups.

The declines seen in these reports suggest that national HIV prevention efforts are paying off in some populations, while overall stability and increases among other groups and geographic areas signal an urgent need to expand and improve HIV prevention and treatment in those groups who could most benefit. Intensified efforts are particularly needed in the South and among disproportionately affected populations like gay and bisexual men, transgender persons, African Americans, and Hispanics/Latinos. CDC is committed to continuing its work with national, state, and local partners through the Ending the HIV Epidemic initiative. Together, we can make progress, close gaps, and turn around troublesome trends.

Thank you for your continued support for HIV prevention efforts in the United States.

Sincerely,

/Eugene McCray/
Eugene McCray, MD
Director
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention

/Jonathan Mermin/
Jonathan H. Mermin, MD, MPH
Rear Admiral and Assistant Surgeon General, USPHS
Director
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention