RESUMO
Gay, bisexual, and other men who have sex with men (MSM) represent approximately 2% of the United States population, yet are the risk group most affected by human immunodeficiency virus (HIV). In 2010, among persons newly infected with HIV, 63% were MSM; among persons living with HIV, 52% were MSM. The three goals of the National HIV/AIDS Strategy are to reduce new HIV infections, to increase access to care and improve health outcomes for persons living with HIV, and to reduce HIV-related health disparities. In July 2013, the HIV Care Continuum Initiative was established by executive order to mobilize and accelerate federal efforts to increase HIV testing, services, and treatment along the continuum. To meet the 2015 targets of the National HIV/AIDS Strategy, 85% of MSM diagnosed with HIV should be linked to care, 80% should be retained in care, and the proportion with an undetectable viral load (VL) should be increased by 20%. To assess progress toward meeting these targets, CDC assessed the level at each step of the continuum of care for MSM by age and race/ethnicity. CDC analyzed data from the National HIV Surveillance System (NHSS) and the Medical Monitoring Project (MMP) for MSM with diagnosed HIV infection. The results indicated that 77.5% were linked to care, 50.9% were retained in care, 49.5% were prescribed antiretroviral therapy (ART), and 42.0% had achieved viral suppression. Younger MSM and black/African American MSM had lower levels of care compared with older MSM and those of all other races/ethnicities. Interventions aimed at MSM are needed that increase linkage to care, retention in care, and ART use, particularly among MSM aged <25 years and black/African American MSM.
Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Homossexualidade Masculina/psicologia , Adolescente , Adulto , Distribuição por Idade , Continuidade da Assistência ao Paciente , Etnicidade/psicologia , Etnicidade/estatística & dados numéricos , Infecções por HIV/etnologia , Disparidades em Assistência à Saúde/etnologia , Homossexualidade Masculina/etnologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Raciais/psicologia , Grupos Raciais/estatística & dados numéricos , Estados Unidos , Adulto JovemRESUMO
BACKGROUND: In 2017, 19% of new HIV diagnoses in the United States were in women. HIV acquisition can be prevented with pre-exposure prophylaxis, and HIV transmission with viral suppression. HIV viral suppression is achieved by linking women to care and supporting adherence to antiretroviral medications. The national HIV prevention goal for viral suppression is 80%. SETTING: United States. METHODS: We analyzed data reported by 40 US jurisdictions to the Centers for Disease Control and Prevention's National HIV Surveillance System to determine the number and rate of HIV diagnoses per 100,000 women in 2016. We also determined the percentages of women with diagnosed HIV who were linked to care within 1 and 3 months, received HIV care, were retained in HIV care, and were virally suppressed in 2015. Findings were stratified by demographic characteristics and HIV transmission category. RESULTS: In 2016, 6407 women were diagnosed with HIV. Black women had a rate of 783.7 per 100,000, Hispanic/Latino women 182.7, and white women 43.6. In 2015, 190,735 women were living with diagnosed HIV. Viral suppression increased with age, ranging from 46.5% among women aged 13-24 years to 62.3% among women aged ≥45 years. Black women had the lowest rate of viral suppression (55.5%). No age group of women achieved 80% viral suppression. CONCLUSIONS: Pre-exposure prophylaxis implementation for women at high risk for HIV infection can help to decrease new infections. Women living with HIV would benefit from interventions that support linkage to HIV care and antiretroviral medication adherence to increase viral suppression.