The Three Stages Of Hiv:
HIV progresses through three distinct stages, which range in severity from inconvenient but manageable to terminal.
Since 2017 Public Health England Has Published Data On Trans People Accessing Hiv Care And Those Newly Diagnosed With Hiv
- The majority of trans people accessing HIV care are trans women. In 2019, 111 trans women, 31 trans men and 7 gender diverse people were accessing HIV care in England.
- Trans people aged 35-49 are the largest group in terms of age.
- The majority of trans people accessing HIV care are white , with 47 trans people of other or mixed ethnicity making up the second largest group.
- Nearly all of the trans people accessing HIV care in 2019 acquired HIV through sex between men.
The Health System And Hiv Transmission
Four decades into the HIV epidemic, one lesson learned is that encouraging people living with HIV or at risk of HIV infection to engage with the healthcare system and to take advantage of care and treatment resources available to them has led to significant improvements in health outcomes. With the range of antiretroviral treatments and prevention tools now available, and the knowledge that undetectable does not mean untransmissible, epidemic control should be possible. Yet overall, less than 60 percent of people living with HIV have undetectable viral loads and pre-exposure prophylaxis is only accessible to 23 percent of the population.
All too often, the health system makes it difficult for people living with HIV to achieve viral suppression and persist with their treatmentclinics may be located too far away for people who cannot afford transportation or childcare, clinic schedules may not accommodate the needs of homeless people, and many HIV-positive people cannot afford access to care, even if they have physical access to HIV/AIDS services. And there is significant mistrust and discrimination in the health system among some key populations: transgender individuals, for instance, often find that LGBTQ-friendly services often only are friendly toward white, cisgendered, gay males.
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Hiv Statistics By State 2022
Human immunodeficiency virus, or HIV, is a virus that weakens a persons immune system by attacking cells that fight off infection, specifically a persons CD4 cells. HIV is spread through body fluids such as blood. If HIV goes untreated and advances, it can lead to acquired immunodeficiency syndrome or AIDS. Unlike most other viruses, when a person contracts HIV, they have it for life because the human body cannot fight off the virus entirely. HIV, however, can be controlled and its progression can be slowed significantly. There are three stages of HIV: acute HIV infection, clinical latency , and AIDS.
Impact Across The Country
- Although HIV has been reported in all 50 states, the District of Columbia, and U.S. dependencies, the impact of the epidemic is not uniformly distributed.
- Ten states accounted for about two-thirds of HIV diagnoses among adults and adolescents in 2019 .31 Regionally, the South accounted for more than half of HIV diagnoses in 2019.32
- Rates of HIV diagnoses per 100,000 provide a different measure of the epidemicâs impact, since they reflect the concentration of diagnoses after accounting for differences in population size across states. The District of Columbia has the highest rate in the nation, compared to states, nearly 3 times the national rate and Georgia was the state with highest rate , twice that of the national rate.33,34 Nine of the top 10 states by rate are in the South.35
- New HIV diagnoses are concentrated primarily in large U.S. metropolitan areas , with Miami, Orlando, and Atlanta topping the list of the areas most heavily burdened.36
|Table 1: Top Ten States/Areas by Number and Rate of New HIV Diagnoses , 2019|
|CDC. HIV Surveillance Report, Diagnoses of HIV Infection in the United States and Dependent Areas, 2019 vol. 32. May 2021.|
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The Global Hiv/aids Epidemic
HIV, the virus that causes AIDS, is one of the worlds most serious public health challenges. But there is a global commitment to stopping new HIV infections and ensuring that everyone with HIV has access to HIV treatment.
According to UNAIDS:
Number of People with HIVThere were approximately 38.4 million people across the globe with HIV in 2020. Of these, 36.7 million were adults and 1.7 million were children . In addition, 54% were women and girls.
New HIV InfectionsAn estimated 1.5 million individuals worldwide acquired HIV in 2021, marking a 32% decline in new HIV infections since 2010. New HIV infections, or HIV incidence, refers to the estimated number of people who newly acquired HIV during a given period such as a year, which is different from the number of people diagnosed with HIV during a year. Of these 1.5 million new HIV infections:
- 1.3 million were among adults
- 160,000 were among children
HIV TestingApproximately 85% of people with HIV globally knew their HIV status in 2021. The remaining 15% did not know they had HIV and still needed access to HIV testing services. HIV testing is an essential gateway to HIV prevention, treatment, care, and support services.
- 85% knew their HIV status
- 75% were accessing ART
- 68% were virally suppressed
Perinatal TransmissionIn 2021, 81% of pregnant people with HIV had access to ART to prevent transmitting HIV to their babies during pregnancy and childbirth and to protect their own health.
The State Of Hiv Care And Treatment Today
Wafaa El-Sadr, Kenneth Mayer, and Sally Hodder wrote a memorable article in the New England Journal of Medicine in 2010 titled AIDS in AmericaForgotten but Not Gone, in which they pointed out that HIV prevalence in key subpopulations in certain U.S. cities like New York and Washington, D.C., was as high as some African countries with generalized epidemics. They highlighted the need to focus on HIV as a major health threat in the United Statesand how it affected disenfranchised communities disproportionately. These stark realities are still true today, as recent data on the U.S. HIV epidemic from the Centers for Disease Control and Prevention show.
Approximately 1.2 million people in the United States are living with an HIV infection, of whom an estimated 13 percent are unaware of their HIV status. As noted above, there were an estimated 34,800 new HIV infections in the United States in 2019, and still some 15,815 deaths that year from HIV/AIDS .
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What Are The Implications For Public Health Practice
HIV treatment and prevention services should be tailored to the most affected communities and their service providers and address social and economic obstacles contributing to HIV-related health disparities. Ending the HIV epidemic requires equitable implementation of prevention tools to diagnose HIV infection early, treat persons with HIV to rapidly achieve viral suppression, and link persons to preventive services.
Risk Factors Contributing To The Black Hiv Rate
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Access to healthcare is very important in preventing and treating HIV/AIDS. It can be affected by health insurance which is available to people through private insurers, Medicare and Medicaid which leaves some people still vulnerable. Historically, African-Americans have faced discrimination when it comes to receiving healthcare.
Homosexuality is viewed negatively in the African-American Community. “In a qualitative study of 745 racially and ethnic diverse undergraduates attending a large Midwestern university, Calzo and Ward determined that parents of African-American participants discussed homosexuality more frequently than the parents of other respondents. In analyses of the values communicated, Calzo and Ward reported that Black parents offered greater indication that homosexuality is perverse and unnatural”.
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How Have Deaths From Hiv/aids Changed Over Time
Global deaths from HIV/AIDS halved within a decade
The world has made significant progress against HIV/AIDS. Global deaths from AIDS have halved over the past decade.
In the visualization we see the global number of deaths from HIV/AIDS in recent decades this is shown by age group. In the early 2000s 2004 to 2005 global deaths reached their peak at almost 2 million per year.
Driven mostly by the development and availability of antiretroviral therapy , global deaths have halved since then. In 2017, just under one million died from the disease.
You can explore this change for any country or region using the change country toggle on the interactive chart.
HIV/AIDS once accounted for more than 1-in-3 deaths in some countries, but rates are now falling
Global progress on HIV/AIDS has been driven by large improvements in countries which were most affected by the HIV epidemic.
Today the share of deaths remains high: more than 1-in-4 deaths in some countries are caused by HIV/AIDS. But in the past this share was even higher.In the visualization we see the change in the share of deaths from HIV/AIDS over time. From the 1990s through to the early 2000s, it was the cause of greater than 1-in-3 deaths in several countries. In Zimbabwe, it accounted for more than half of annual deaths in the late 1990s.
We see that over the past decade this share has fallen as antiretoviral treatment has become more widely available.
Children living with HIV
New HIV infections of children
In 2019 It Was Estimated That There Are 105200 People Living With Hiv In The Uk
- 94% of these people are diagnosed, and therefore know that they have HIV. This means that around 1 in 16 people living with HIV in the UK do not know that they have the virus.
- 98% of people diagnosed with HIV in the UK are on treatment, and 97% of those on treatment are virally suppressed which means they cant pass the virus on. Of all the people living with HIV in the UK, 89% are virally suppressed.
How Does Cdc Know The Number Of People Living With Hiv If Some Of Those People Are Unaware Of Their Status
CDC estimates the number of people living with HIV by using a scientific model. This model helps CDC estimate the number of new HIV infections and how many people are infected but dont know it. HIV prevalence is the number of people living with HIV infection at a given time, such as at the end of a given year. More information on HIV prevalence.
New Hiv Diagnoses And People With Diagnosed Hiv In The Us And Dependent Areas By Area Of Residence 2020*
Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state and local jurisdictions.* Among people aged 13 and older.Source: CDC.Diagnoses of HIV infection in the United States and dependent areas, 2020. HIV Surveillance Report2022 33
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Hiv Infections By State
In the United States, where you live plays a large part in how likely you are to get HIV. While it is clear that dense urban populations with high prevalence rates contribute to the risk, there are other unique factors that account for a growing disparity between U.S. states.
A prime example is the rate of infection in states that have either adopted or refused Medicaid expansion, intended to expand healthcare to economically disadvantaged people.
According to the CDC, the 13 states that refused Medicaid expansion account for 42% of all new infections. Florida, Texas, Georgia, and North Carolina represent the lion’s share of these infections.
Poverty remains a driving force for HIV infections, particularly in the South where the rates of poverty are highest. Moreover, nearly half of all Americans without health insurance live in the South.
With that being said, the Northeast has a higher prevalence rate overall, centered mainly in dense urban populations like New York City, Baltimore, and Washington, D.C.
These dynamics are reflected in the 10 U.S. states with the highest HIV prevalence rates, according to the CDC.
|65 and over||900|
Youth also accounts for the highest rate of undiagnosed infections. Today, nearly half of all HIV-positive youth between the ages of 13 and 24 are unaware of their status and, as a result, are more likely to infect others. The picture is little improved among adults 25 to 34, where one in three remains undiagnosed.
Impact On Gay And Bisexual Men
- While estimates show that gay and bisexual men comprise only about 2% of the U.S. population, male-to-male sexual contact accounts for most new HIV infections and most people living with HIV .58
- Annual new infections among gay and bisexual men declined overall between 2015 and 2019 but remained stable among Black and Latino gay and bisexual men.59
- Blacks gay and bisexual men accounted for the largest number of new diagnoses among this group in 2019, followed by Latino gay and bisexual men .60 Additionally, according to a recent study, Black gay and bisexual men were found to be at a much higher risk of being diagnosed with HIV during their lifetimes compared with Latino and white gay and bisexual men.61 Young Black gay and bisexual men are at particular risk â Black gay and bisexual men ages 20-29 accounted for 51% of new diagnoses among that age group and 13% of all diagnoses.62
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The Status Of The Hiv/aids Epidemic In Sub
Senior Fellow, Futures Group International
Despite the fact that sub-Saharan Africa contains only about 11 percent of the Earths population, the region is the worlds epicenter of HIV/AIDS. The numbers are daunting. Adult HIV prevalence is 1.2 percent worldwide , but it is 9.0 percent in sub-Saharan Africa. UNAIDS estimates that at the end of 2001, there were 40 million people living with HIV/AIDS, 28.5 million of them from sub-Saharan African. Five million adults and children became newly infected with HIV in 2001, 3.5 million of them from sub-Saharan Africa. Three million people died from AIDS-related causes in 2001, and 2.2 million of these deaths were among sub-Saharan Africans.2
AIDS is now the leading cause of death in sub-Saharan Africa. Life expectancy at birth has plummeted in many African countries, wiping out the gains made since independence. The combination of high birth rates and high AIDS mortality among adults, including many parents, has meant that more than 90 percent of children who have been orphaned as a consequence of the HIV/AIDS epidemic are in this region.2
According to UNAIDS, all the worst affected countries are contiguous to one another in the lower part of the continent. These include South Africa, Lesotho, Swaziland, Botswana, Namibia, Zambia, and Zimbabwe. Botswana, Lesotho, Swaziland, and Zimbabwe have prevalence rates above 30 percent.4
|Total Adults and Children|
Only 53% Of Children Infected With Hiv Have Access To Treatment
Compared to 67% of adults who had access to treatment. In other words, HIV statistics suggest that about 850,000 infected children are not getting the treatment that could potentially save their lives. In addition to that, over half of the children are from the Democratic Republic of the Congo, Kenya, Mozambique, Nigeria, and South Africa.
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Social Determinants Of Health 2019
Percent of Population with a High School Education, 2019 88.6%
Income Inequality , 2019 0.481
Percent of Population Living in Poverty, 2019 12.3%
Median Household Income, 2019 $65,712
Percent of Population Lacking Health Insurance, 2019 10.4%
Percent of Population Unemployed, 2019 3.7%
Percent of Population Living with Food Insecurity, 2016-2019 10.5%
Percent of Population Living in Unstable Housing, 2019 13.7%
Population Of People With Hiv On Treatment In Us Projected To Keep Increasing Through 2030
Model projects older ages and potential for significant burden on health care systems
The number of people with HIV using antiretroviral therapy to suppress the virus could increase as much as 36 percent by the end of the decade and includes more older people, representing a continued public health burden, according to new projections led by researchers at the Johns Hopkins Bloomberg School of Public Health.
For their analysis, the researchers ran two scenarios using a mathematical model named PEARL informed by data from the Centers for Disease Control and Prevention and the North American AIDS Cohort Collaboration on Research and Design. In a baseline scenario, the researchers project a rise in the ART-using population from about 670,000 in 2020 to nearly 910,000 by the end of 2030 if current trends in new HIV infections persist.
In a more optimistic scenario, the model predicts that the number of people with HIV using ART will rise by 7 percent from 2020 to 2030. This model assumes that the U.S reaches goals set forth in the federal initiative, Ending the HIV Epidemic: A Plan for America, in which new HIV diagnoses decline by 75 percent from 2020 to 2025 and hold steady at that lower rate through 2030.
Under both scenarios, the model projects that nearly one quarter of ART users will be 65 or older by 2030.
The findings were published online this month in the journal AIDS.
The research was supported by the National Institutes of Health
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