Telehealth Visits And Testing Alternatives Have Not Moved The States Numbers
In February, the Mississippi State Department of Health began offering free telehealth services across the state so residents could access PrEP, a breakthrough drug that reduces the risk of contracting HIV by 99 percent and has significantly helped slow the spread of the virus. This was good news for the state, whose capital city has the highest rate of infection in women and the fourth-highest rate overall in the United States, disproportionately affecting Black residents. Thomas Dobbs, Mississippis chief health officer, estimated that hundreds, if not thousands, statewide stood to benefit.
Since it began, though, the online program has been used by four people.
According to the 2019 National HIV Surveillance Data System report, released by the Centers for Disease Control and Prevention on Thursday, new HIV diagnoses are on the decline, dropping 8 percent from 2015 to 2019. In young gay and bisexual men, new diagnoses dropped 33 percent, probably because of an increase in the use of PrEP nearly 23 percent of eligible people were taking the once-daily drug in 2019, compared with about 3 percent in 2015.
Health officials and advocates say a complex mix of cultural, logistical and economic factors is preventing Mississippians from accessing PrEP and preventing doctors from prescribing it. Dobbs puts it bluntly: People dont want to talk about sex in the South.
The Global Distribution Of Deaths From Hiv/aids
In some countries HIV/AIDS is the cause of more than a quarter of all deaths
Globally, 1.5% of deaths were caused by HIV/AIDS in 2019.
This share is high, but masks the wide variations in the toll of HIV/AIDS across the world. In some countries, this share was much higher.In the interactive map we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.
But across some countries focused primarily in Southern Sub-Saharan Africa the share is very high. More than 1-in-4 of deaths in South Africa were caused by HIV/AIDS in 2019. The share was also very high across Botswana Mozambique Namibia Zambia Kenya and Congo .
Death rates are high across Sub-Saharan Africa
The large health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.
In the interactive map we see the distribution of death rates across the world. Most countries have a rate of less than 10 deaths per 100,000 often much lower, below 5 per 100,000. Across Europe the death rate is less than one per 100,000.
Across Sub-Saharan Africa the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. In South Africa and Mozambique, it was over 200 per 100,000.
List Of Countries By Hiv/aids Adult Prevalence Rate
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The human immunodeficiency virus , which causes AIDS, varies in prevalence from nation to nation. Listed here are the prevalence rates among adults in various countries, based on data from various sources, largely the CIA World Factbook.
As of 2018, 38 million people are estimated infected with HIV globally.
The HIV pandemic is most severe in Southern Africa. Over 10% of all people infected with HIV/AIDS reside within the region. Adult HIV prevalence exceeds 15% in Eswatini, Botswana, and Lesotho, while an additional six countries report adult HIV prevalence of at least 10%. Outside Africa, the highest prevalence rate is found in the Bahamas .
In absolute numbers, South Africa , followed by Mozambique , India and Nigeria had the highest HIV/AIDS number of cases by the end of 2022. While South Africa’s large population of HIV-positive people is attributable to its high disease prevalence , Nigeria’s is lower at 1.3%, with India’s prevalence rate at 0.2%. However, countries such as Nigeria with high HIV rates above 1% are classified as having Generalized HIV Epidemics by UNAIDS, while India’s prevalence is well below this threshold, with a prevalence lower than the US’s and about the same as Spain.
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Hiv/aids In The United States
The AIDS epidemic, caused by HIV , found its way to the United States between the 1970s and 1980s, but was first noticed after doctors discovered clusters of Kaposi’s sarcoma and pneumocystis pneumonia in homosexual men in Los Angeles, New York City, and San Francisco in 1981.Treatment of HIV/AIDS is primarily via the use of multiple antiretroviral drugs, and education programs to help people avoid infection.
Initially, infected foreign nationals were turned back at the United States border to help prevent additional infections. The number of United States deaths from AIDS has declined sharply since the early years of the disease’s presentation domestically. In the United States in 2016, 1.1 million people aged over 13 lived with an HIV infection, of whom 14% were unaware of their infection.Gay and bisexual men, African Americans, and Latino Americans remain disproportionately affected by HIV/AIDS in the United States.
Key Points: Hiv Diagnoses
Gay, bisexual and other men who have sex with men b are the population most affected by HIV in the U.S.:
- In 2019, MSM accounted for 69% of new HIV diagnoses in the United States.c
- From 2015 through 2019 in the United States and 6 dependent areas, Black/African American MSM accounted for more than 36% and White MSM accounted for more than 30% of HIV diagnoses among MSM annually.
- In 2019, Black/African American MSM accounted for 26% of new HIV diagnoses and 37.9% of diagnoses among all MSM.
- In 2019, Hispanic/Latinod MSM made up 22% of new HIV diagnoses and 32.5% of diagnosis among all MSM.
The number of HIV diagnoses decreased among MSM overall, but trends varied by race/ethnicity. From 2015 through 2019:
- Among MSM aged 1324 years, HIV diagnoses decreased or were stable among all racial/ethnic groups.
- HIV diagnoses increased among American Indian/Alaska Native and Native Hawaiian/other Pacific Islander MSM, ages 24 and older.
Transgender people accounted for approximately 2% of new HIV diagnoses in 2019.
- From 2015 through 2019 in the United States and 6 dependent areas, the number of diagnoses of HIV infection for transgender adults and adolescents increased.
- In 2019, among transgender adults and adolescents, the largest percentage of diagnoses of HIV infections was for transgender male-to-female people.
Blacks/African Americans and Hispanics/Latinx continue to be severely and disproportionately affected by HIV:
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Public Health Officials Launch Programs To Address Racial Disparity Infant Hiv And Late Diagnosis In Wake Of Grim Report On Hiv
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Washington, D.C. has the highest HIV/AIDS rate in the nation at 128.4 cases per 100,000 people. The average rate for the rest of the United States is about 14 cases per 100,000 people.
The rates for newly-reported AIDS cases in Washington, D.C. are higher than Baltimore, Chicago, Detroit, New York and Philadelphia.
Statistical data compiled by the Washington, D.C.s Department of Healths HIV/AIDS Administration were released in a report on Nov. 26 concurrent with the launch of several new city initiatives aimed at decreasing HIV/AIDS prevalence.
Findings included trends of racial disparity in HIV/AIDS, a growing trend in women affected by HIV/AIDS and a greater population of infants born with HIV than in most U.S. regions.
At the end of 2006, the number of people with HIV/AIDS in Washington, D.C. increased 43% since 2001. The report is the first to include statistical HIV/AIDS data for Washington, D.C. and provides updates to statistics that were last reported five years ago.
The report gives us critical statistics on HIV and AIDS in our city and we must take advantage of this information with a sense of urgency that the epidemic deserves, Adrian M. Fenty, mayor of Washington, D.C., said in a press release.
CDC officials applauded the report as an important tool to enhance targeted programs to fight the citys epidemic.
Blacks, women most affected
What About Hiv Around The World
HIV disease continues to be a serious health issue for parts of the world. Worldwide, there were about 2.1 million new cases of HIV in 2015. About 36.7 million people are living with HIV around the world, and as of June 2016, 17 million people living with HIV were receiving medicines to treat HIV, called antiretroviral therapy . An estimated 1.1 million people died from AIDS-related illnesses in 2015. Sub-Saharan Africa, which bears the heaviest burden of HIV/AIDS worldwide, accounts for 65% of all new HIV infections. Other regions significantly affected by HIV/AIDS include Asia and the Pacific, Latin America and the Caribbean, and Eastern Europe and Central Asia.
CDC’s Global AIDS websiteexplains what CDC is doing in the global fight against HIV.
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Cities With The Highest Std Rates In The United States
With COVID-19 dominating the news for the past few years, statistics about the high STD disease rates in the United States have flown under the radar. The U.S. Centers for Disease Control and Prevention recently released new data in its STD Surveillance report showing an alarming increase in STD outbreaks.
While COVID-19 is still on our minds, we should not overlook the countless other viruses affecting average Americans. As government statisticsshow, STDs impact well above 110 million United States residents. A majority of these infections occur in cities with the highest STD rates in the country, where viruses can spread quickly.
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Effective Treatment And Counseling Top Of Page
As has been discussed in numerous past issues of The PRN Notebook, an HIV-infected patients viral loadespecially when the patient is unaware of his HIV serostatusis a significant determinant of infectiousness. Antiretroviral therapy has been documented to reduce viral load, which includes among its many benefits decreased transmission risk. The problem is that individuals who dont know their HIV status are not aware that they are infectious and are not receiving treatment to reduce their viral loads, Dr. Frieden said. We also need to continually reiterate key HIV prevention messages to our HIV-positive patients: that abstinence is 100% effective, and that limiting the number of sex partners, always using condoms, and never using dirty needles prevent HIV transmission.
Figure 3. Reported Primary and Secondary Syphilis Case Rates in New York City, 20002003
A fundamental goal of New York City Department of Health and Mental Hygiene HIV/AIDS programming is to curb the epidemic. However, there are significant challenges ahead, including the well-documented resurgence of risky sexual behavior. As is shown here, syphilis cases in New York City have increased more than four-fold over the past three years. The number of syphilis cases doubled between 2000 and 2001, increased another 46% in 2002, and another 22% in 2003. The increase is almost entirely among men, especially MSM.
Source:New York City Department of Health and Mental Hygiene
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Hiv/aids In Nyc: Can It Be Stopped And Reversed Top Of Page
While data have demonstrated that the HIV/AIDS epidemic in New York City has slowed, HIV is still endemic in the city: last year, 4,200 people were newly diagnosed with HIV. In turn, a central question remains: can this epidemic be stopped and reversed? Dr. Frieden explained that the most critical step in controlling an epidemic is stopping its transmission. The key is provided by a fundamental epidemiologic parameter called the basic reproductive number, or Ro, which measures the potential for the spread of an infectious disease. Formally, Ro is defined as the expected number of secondary infectious cases generated by an average infectious case in a susceptible population. Ro not only tells epidemiologists the potential for an epidemic to continue spreading in the absence of interventions, it also allows them to predict the ability of control measures to reduce transmission.
Why has the HIV epidemic been sustained in New York City and the rest of the United States? For starters, there are issues related to early diagnosis. If everyone infected with HIV learned of their diagnosis soon after infection, we could get these individuals into treatment and get them to take steps to protect themselves and their partners, Dr. Frieden said. This alone would cause a sharp decline in the number of new HIV infections in New York.
Cities Show Movement In Our Rankings
Numerous cities worsened significantly in our rankings, including:
- Washington, DC rose 12 spots from 17 5
- Knoxville, TN rose 17 spots from 26 9
- New Orleans, LA rose 13 spots from 24 11
- Jacksonville, FL rose 15 spots from 38 23
- Albany, NY rose 15 spots from 68 53
It wasnt all bad news some cities bucked the national trend with improved STD rates. For instance, Milwaukee, WI and Indianapolis, IN both moved out of the Top 10, though they remain among the Top 25 cities.
Other cities rankings also improved dramatically, such as:
- Shreveport, LA improved 12 spots from 9 21
- Denver, CO improved 13 spots from 19 32
- Richmond, VA improved 12 spots from 32 44
- Portland, OR improved 15 spots from 73 88
- Omaha, NE improved 13 spots from 79 92
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States With The Highest Rates Of Hiv
These numbers are based on the CDCs HIV Surveillance Report.
California has the highest number of people living with HIV of 128,153, a rate of 389.7 people with HIV per 100,000 residents. Of those living with HIV in California, the largest group is White with 48,155 people and the second-largest is Hispanic/Latino with 48,029.
New York has the second-highest number of people living with HIV of 126,495, a rate of 760.2 per 100,000. This rate is more than double that of Californias. The largest group living with HIV in New York is Black/African American with 47,164 people living with the virus.
Florida has 110,034 people living with HIV, the third-highest number in the United States. Floridas HIV rate is 612.3 per 100,000. The group with the highest number of people living with HIV is Black/African American with 49,943.
Texas has the fourth-highest number of people living with HIV in the United States of 88,099, translating to a rate of 382.9 per 100,000 people. The largest group living with the virus is Black/African American with 31,915 people, followed by Hispanic/Latino with 29,758.
Georgia has 52,528 people living with HIV, a rate of 608.8 per 100,000. This is the fifth-highest in the country. A majority of those infected with the virus are Black/African American, totaling 35,974.
Here are the 10 states with the highest rates of HIV:
The Need For Coordinated Care Top Of Page
For New York City to respond fully and effectively to the HIV/AIDS epidemicensuring the health of those infected and putting various prevention strategies into practicecoordinated care is going to be essential. We provide a lot of housing for people living with HIV, he explained. We also provide a lot of medical care. We also provide a lot of social services. The problem is, these arent being coordinated. We need to do a much better job. We need to make sure that all other services are tied to either housing or medical care. That housing is tied to medical care and that medical care is accountable for suppressing viral load, reducing hospitalizations, increasing life expectancy, using a harm reduction approach to get people into drug and alcohol treatment, and providing prevention messages aimed at reducing risky behavior. The connection between housing and medical care is important. We cant get people into treatment and provide necessary support services or counseling, if theyre not stably housed.
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Can The Hiv/aids Epidemic In New York City Be Stopped
Thomas R. Frieden, MD, MPHCommissioner, New York City Department of Health and Mental HygieneSummary by Tim HornEdited by Susan Blank, MD, MPH and Lucia V. Torian, PhD
Reprinted from The PRN Notebook® | March 2005 | Dr. James F. Braun, Editor-in-Chief, Tim Horn, Executive Editor | Published in New York City by the Physicians Research Network, Inc.® | John Graham Brown, Executive Director | All rights reserved. ©March 2005
As of December 31, 2003, a total of 88,479 New Yorkers have been diagnosed, reported, and are known to be living with HIV or AIDS. Dr. Frieden explained that 57,316 have already received an AIDS diagnosis and that 31,163 are infected with HIV but have not met the immunologic or clinical case definition for AIDS. Of central concern to us, Dr. Frieden said, is that we probably have another 20,000 New York City residents who are HIV-positive but arent aware of their status.
Based on these data, New York City remains the epicenter of the HIV/AIDS epidemic in the United States . New York City has the highest AIDS case rate in the United States while it is home to less than 3% of the U.S. population, the city accounts for 17% of national AIDS deaths. We have more cases than Los Angeles, San Francisco, Miami, and Washington, D.C., combined, Dr. Frieden noted. Our case rate is 60 times the national target for 2010, four times the U.S. average, and higher than any other city in the U.S.