The pace of transmission of the virus may have plateaued in the United States in recent years, but the HIV-related death rate fell by half between 2010 and 2017, according to a new Centers for Disease Control and Prevention (CDC) study.

Publishing their findings in the Morbidity and Mortality Weekly Report, CDC researchers analyzed National HIV Surveillance System data for people 13 years old and older to determine the annual age-adjusted death rate per 1,000 people with diagnosed HIV between 2010 and 2018. When deaths in this dataset had an established underlying cause, the researchers determined whether the deaths were HIV-related.

Between 2010 and 2018, the annual death rate declined by 36.6% overall—from 19.4 to 12.3 deaths per 1,000 people with diagnosed HIV. Between 2010 and 2017 (2018 was excluded on this particular point due to reporting delays), the HIV-related death rate declined by 48.4% (from 9.1 to 4.7 deaths per 1,000 HIV-diagnosed people). During that same period, the rate of non–HIV-related deaths decreased by just 8.6% (from 9.3 to 8.5 deaths per 1,000 HIV-diagnosed people).

Reductions in HIV-related death rates were seen across the board, whether the researchers broke down the data by age, sex, or race.

In 2017, the rates of HIV-related death per 1,000 HIV-diagnosed people were highest among people of multiple races (7.0 deaths) and African-Americans (5.6 deaths), followed by whites (3.9 deaths) and Latinos (3.9 deaths). By region, the HIV-related death rate was highest in the South (6.0 deaths) and lowest in the Northeast (3.2 deaths).

The gap in the HIV-related death rate between Blacks and whites narrowed by two thirds between 2010 and 2017. In 2010, the death rate for Latinos was higher than for whites; but by 2017, the disparity had vanished.

According to the CDC, much of the reduction in the HIV-related death rate seen in recent years is likely the result of aggressive nationwide efforts to drive up diagnosis rates among people living with the virus and to help keep diagnosed individuals on antiretroviral (ARV) treatment.

“The decline in HIV-related deaths proves that investments in HIV testing, care and treatment are paying off, but we should also protect people from getting HIV in the first place,” Jonathan Mermin, MD, MPH, the director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a press release.

Between 2010 and 2018, the estimated proportion of people with the virus who knew their HIV status increased from 82% to 86%. During that period, the estimated proportion of the HIV population with a fully suppressed viral load increased from 46% to nearly 65%.

Even so, the U.S. viral suppression rate remains lower than rates in the vast majority of other wealthy nations. Kaiser Family Foundation reported that in 2018, the United Kingdom and Switzerland each boasted a viral suppression rate of 84% in their HIV populations.

Increasing viral suppression is of vital importance in the effort to slow the spread of HIV because people who are on ARVs and maintain an undetectable viral load cannot transmit the virus through sex. 

To read the report, click here

To read the CDC press release, click here