September 6, 2017

An 18 Percent Decline In U.S. HIV Incidence Over Six Years Is Not Enough

Written by David Holtgrave and Robert Bonacci

This article originally appeared on

The National HIV/AIDS Strategy set forth in 2010 called for a 25 percent reduction in HIV incidence by 2015.

On February 14, 2017, the U.S. Centers for Disease Control and Prevention (CDC) unveiled new HIV incidence estimates for the United States from the years 2008 through 2014. Employing a recently developed method for estimating HIV incidence (based on diagnostic and CD4 cell level at time of diagnosis information), CDC provided the first official updates of HIV incidence estimates in several years.
This new methodology and updated estimates are very welcome and will better help address the epidemic in the United States, since timely incidence estimates (previous estimates were for the year 2010) are key to understanding the dynamics of the U.S. epidemic and are an essential component to any national statistical dashboard for up-to-date monitoring of the HIV epidemic.

CDC reported that between 2008 and 2014, HIV incidence declined by 18 percent in the United States. However, several key disparities are apparent. In 2014, Southern states comprised about one-half of new HIV infections, and gay and bisexual men accounted for approximately 70 percent of new HIV infections. Additionally, incidence did not decline for Black gay and bisexual men over this time frame. Further, incidence increased among Latino gay and bisexual men and also increased among gay and bisexual men ages 25 to 34.
While the overall 18 percent decline from 2008 to 2014 is welcome news, we must not celebrate too quickly. In order to understand the magnitude and meaning of an 18 percent decline in any public health metric, we must compare it to previously set national goals. The National HIV/AIDS Strategy (NHAS) set forth by President Obama’s administration in 2010 called for a 25 percent reduction in HIV incidence by 2015. Did we make it?

CDC estimates that HIV incidence in 2010 was 41,600; in 2014 it was 37,600. This decline of approximately 4,000 new HIV infections through 2014 reflects a roughly 9.6 percent drop; less than halfway to the national goal of 25 percent reduction by 2015 (though future updates from CDC for HIV incidence in 2015 will be important to monitor in this regard).

This 9.6 percent drop from 2010 through 2014 is similar to a 9.1 percent estimate we published last year using a somewhat different methodology; in our previous paper, we modeled incidence for 2015 as well and estimated that from 2010 through 2015, HIV incidence in the United States is likely to have dropped roughly 11.1 percent.

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