For the third year in a row, the number of Iowans testing positive for HIV has decreased. This translates to a 30% drop from 2016 and marks the first three-year sustained decline since 1998, when the state began tracking HIV data.

In more good news, the populations most affected by HIV in the state all saw reductions. Of note, this includes African Americans, who saw a 33% decline and men who have sex with men, who saw a 43% decline.

The numbers arrive from the Iowa Department of Public Health (IDPH), which released its annual report on HIV data; the June report covers 2019 figures. Overall, 98 people were diagnosed with HIV in the state in 2019, a 16% drop from the previous year. The highest number of annual cases recorded since 1998 was 137 in 2016.

In total, 2,839 people diagnosed with HIV were living in Iowa as of December 31, 2019, residing in 95 of the state’s 99 counties.

“This report and the three-year trend demonstrate the value of early testing, access to good health care and strong support to help people living with HIV make the most of that health care,” said Randy Mayer, chief of the Bureau of HIV, STD and Hepatitis at IDPH, in a press release about the report. “Clearly, our most impactful services include comprehensive health care that includes testing, client-centered case management, transportation assistance and housing.”

Undoubtedly, part of the decline can be attributed to the number of people with HIV who are virally suppressed. People who maintain an undetectable viral load cannot transmit HIV sexually, even when they don’t use condoms. This fact is known as Undetectable Equals Untransmittable, or U=U. In Iowa, of the 2,839 people diagnosed with HIV, 2,304 (81%) were virally suppressed. “This is significantly higher than many parts of the country,” the IDPH report notes. “The most recent estimate from CDC [the Centers for Disease Control and Prevention] is that 65% of people in the U.S. who are diagnosed with HIV were virally suppressed in 2018. Among Iowans who are retained in care, viral suppression is 95%.”

According to the state report, all 98 people newly diagnosed with HIV were offered services to connect them to care and to contact their sexual partners so they could get tested. The partner notification services found four other people who tested HIV positive.

In reporting on the HIV data trends in the state, the Gazette offered one potential reason for the steep increase of HIV cases in 2016: The Affordable Care Act (ACA or Obamacare) launched two years earlier and likely increased the number of people in the state who had access to HIV testing and care.