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Estimated Annual Number of HIV Infections ─ United States, 1981-2019
Abstract:
The first cases of Pneumocystis carinii (jirovecii) pneumonia among young men, which were subsequently linked to HIV infection, were reported in the MMWR on June 5, 1981 (1). At year-end 2019, an estimated 1.2 million persons in the United States were living with HIV infection (2). Using data reported to the National HIV Surveillance System, CDC estimated the annual number of new HIV infections (incidence) among persons aged ≥13 years in the United States during 1981-2019. Estimated annual HIV incidence increased from 20,000 infections in 1981 to a peak of 130,400 infections in 1984 and 1985. Incidence was relatively stable during 1991-2007, with approximately 50,000-58,000 infections annually, and then decreased in recent years to 34,800 infections in 2019. The majority of infections continue to be attributable to male-to-male sexual contact (63% in 1981 and 66% in 2019). Over time, the proportion of HIV infections has increased among Black/African American (Black) persons (from 29% in 1981 to 41% in 2019) and among Hispanic/Latino persons (from 16% in 1981 to 29% in 2019). Despite the lack of a cure or a vaccine, today's HIV prevention tools, including HIV testing, prompt and sustained treatment, preexposure prophylaxis, and comprehensive syringe service programs, provide an opportunity to substantially decrease new HIV infections. Intensifying efforts to implement these strategies equitably could accelerate declines in HIV transmission, morbidity, and mortality and reduce disparities.
Insights
New HIV infections in the US peaked in 1984-1985 but have since declined. While male-to-male sexual contact remains the primary driver, HIV disproportionately affects Black and Hispanic populations, highlighting the need for equitable prevention strategies.
Area of Science:
- Epidemiology
- Public Health
- Infectious Diseases
Background:
- The first reported cases of Pneumocystis pneumonia linked to HIV infection occurred in 1981.
- As of 2019, an estimated 1.2 million individuals in the U.S. were living with HIV.
- HIV remains a significant public health concern globally and domestically.
Purpose of the Study:
- To estimate the annual number of new Human Immunodeficiency Virus (HIV) infections in the United States from 1981 to 2019.
- To analyze trends in HIV incidence by demographic groups and transmission routes.
- To assess the impact of prevention strategies on HIV infection rates.
Main Methods:
- Utilized data from the National HIV Surveillance System.
- Estimated annual HIV incidence for persons aged 13 years and older.
- Analyzed trends in HIV transmission categories and demographic proportions over time.
Main Results:
- HIV incidence peaked at 130,400 infections in 1984-1985, declining to 34,800 by 2019.
- Male-to-male sexual contact remained the predominant transmission category (63% in 1981, 66% in 2019).
- The proportion of HIV infections increased among Black/African American (29% to 41%) and Hispanic/Latino (16% to 29%) persons from 1981 to 2019.
Conclusions:
- Despite advancements in prevention and treatment, HIV disparities persist.
- Equitable implementation of existing HIV prevention tools is crucial for reducing new infections and health inequities.
- Continued efforts in HIV testing, treatment, pre-exposure prophylaxis, and harm reduction programs are essential.
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