The Centers for Disease Control and Prevention (CDC) has projected that, if current trends persist, half of black men who have sex with men and a quarter of Latino MSM will become HIV positive during their lifetimes. CDC researchers analyzed HIV diagnosis and death rates between 2009 and 2013 to conduct the first-ever projection of the lifetime risk of contracting HIV among certain populations. (All estimates assume that current diagnosis trends will endure.) The findings were presented at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI) in Boston.
“As alarming as these lifetime risk estimates are, they are not a foregone conclusion. They are a call to action,” Jonathan Mermin, MD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, said in a press release. “The prevention and care strategies we have at our disposal today provide a promising outlook for future reductions of HIV infections and disparities in the U.S., but hundreds of thousands of people will be diagnosed in their lifetime if we don’t scale up efforts now.”
On average, Americans have a chance of 1 in 99 of contracting HIV during their lifetimes. One in six MSM are projected to contract HIV, including 1 in 2 black, 1 in 4 Latino and 1 in 11 white MSM. The lifetime risk of HIV among African Americans overall is 1 in 20 in men and 1 in 48 for women. The corresponding figures for whites are 1 in 132 for men and 1 in 880 for women. Among injection drug users, the lifetime risk is 1 in 23 for women and 1 in 36 for men.
Heterosexual women have only a 1 in 241 lifetime risk of contracting the virus, as do 1 in 473 heterosexual men.
In the hard-hit South, where residents are at higher risk of HIV compared with those in other U.S. regions, 1 in 13 people in Washington, DC, are projected to contract HIV during their lifetimes, as are 1 in 49 in Maryland, 1 in 51 in Georgia, 1 in 54 in Florida, and 1 in 56 in Louisiana. By comparison, the lifetime risk is 1 in 69 in New York, 1 in 101 in Illinois, 1 in 196 in New Mexico and 1 in 670 in North Dakota.
“These estimates are a sobering reminder that gay and bisexual men face an unacceptably high risk for HIV—and of the urgent need for action,” Eugene McCray, MD, director of the CDC’s Division of HIV/AIDS Prevention, said in the press release. “If we work to ensure that every American has access to the prevention tools we know work, we can avoid the outcomes projected in this study.”
A recent CDC report on U.S. HIV diagnosis trends, covering 2005 to 2014, actually showed some hopeful signs about the direction of the epidemic among black MSM. While the rate of new diagnoses increased among this population over the past decade, this rate has leveled off in recent years, including among young black MSM. The diagnosis rate continues to increase among Latino MSM, however. White MSM, meanwhile, have seen a dropping HIV diagnosis rate during the past decade. CDC researchers feel that these diagnosis rates are a reflection of actual HIV transmission trends, because HIV testing rates among these populations have apparently remained stable or have increased.
“The lifetime risk findings provide a peek into what could happen if we lose momentum in our prevention efforts,” Mermin told POZ. “We have the tools we need to end this epidemic, but the challenge now is to make sure that everyone is benefitting.”
Previous research has showed discouraging signs about the hope of using PrEP to help reduce HIV incidence among black MSM, especially among young black MSM, whose overall adherence to PrEP was essentially nil at the end of one recent study. New research presented at CROI, however, demonstrated the success of an intervention in getting black MSM interested in PrEP and ultimately adhering to the daily Truvada regimen.
To read the report, click here.
To read a POZ feature article on the state of the U.S. HIV epidemic, click here.
To see a CDC fact sheet on the report, click here.