Sonia Singh, PhD; Ruiguang Song, PhD; Anna Satcher Johnson, MPH; Eugene McCray, MD; H. Irene Hall, PhD
Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the CDC.
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2082.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.
Reproducible Research Statement:Study protocol: Not applicable. Statistical code: Not applicable. Data set: Data from the NHSS (www.cdc.gov/hiv/pdf/guidelines/cdc-hiv-adult-confidential-case-report-form-2018.pdf).
Requests for Single Reprints: Sonia Singh, PhD, Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, MS E-47, Atlanta, GA 30329; e-mail, firstname.lastname@example.org.
Current Author Addresses: Drs. Singh, Song, McCray, and Hall and Ms. Satcher Johnson: Centers for Disease Control and Prevention, 1600 Clifton Road Northeast, MS E-47, Atlanta, GA 30329.
Author Contributions: Conception and design: S. Singh, R. Song, A. Satcher Johnson, E. McCray, H.I. Hall.
Analysis and interpretation of the data: S. Singh, R. Song, A. Satcher Johnson, H.I. Hall.
Drafting of the article: S. Singh, R. Song.
Critical revision for important intellectual content: S. Singh, R. Song, A. Satcher Johnson, E. McCray, H.I. Hall.
Final approval of the article: S. Singh, R. Song, A. Satcher Johnson, E. McCray, H.I. Hall.
Statistical expertise: R. Song.
Administrative, technical, or logistic support: S. Singh.
Collection and assembly of data: H.I. Hall.
HIV infection is a persistent health concern in the United States, and men who have sex with men (MSM) continue to be the most affected population.
To estimate HIV incidence and prevalence and the percentage of undiagnosed HIV infections overall and among MSM.
National HIV Surveillance System.
Persons aged 13 years or older with diagnosed HIV infection.
Data on HIV diagnoses and the first CD4 test result after diagnosis were used to model HIV incidence and prevalence and the percentage of undiagnosed HIV infections from 2008 to 2015 on the basis of a well-characterized CD4 depletion model.
Modeled HIV incidence decreased 14.8% overall, from 45 200 infections in 2008 to 38 500 in 2015, and among all transmission risk groups except MSM. The incidence of HIV increased 3.1% (95% CI, 1.6% to 4.5%) per year among Hispanic/Latino MSM (6300 infections in 2008, 7900 in 2015), decreased 2.7% (CI, −3.8% to −1.5%) per year among white MSM (8800 infections in 2008, 7100 in 2015), and remained stable among black MSM at about 10 000 infections. The incidence decreased by 3.0% (CI, −4.2% to −1.8%) per year among MSM aged 13 to 24 years and by 4.7% (CI, −6.2% to −3.1%) per year among those aged 35 to 44 years. Among MSM aged 25 to 34 years, HIV incidence increased 5.7% (CI, 4.4% to 7.0%) per year and among MSM aged 55 years and older, HIV increased 4.1% (CI, 0.8% to 7.4%). The percentage of undiagnosed HIV infections was higher among black, Hispanic/Latino, and younger MSM than white and older MSM, respectively.
Assumptions of the CD4 depletion model and variability of CD4 values.
Expansion of HIV screening to reduce undiagnosed infections and increased access to care and treatment to achieve viral suppression are critical to reduce HIV transmission. Access to prevention methods, such as condoms and preexposure prophylaxis, also is needed, particularly among MSM of color and young MSM.
Singh S, Song R, Johnson AS, McCray E, Hall HI. HIV Incidence, Prevalence, and Undiagnosed Infections in U.S. Men Who Have Sex With Men. Ann Intern Med. 2018;168:685–694. doi: 10.7326/M17-2082
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Published: Ann Intern Med. 2018;168(10):685-694.
Published at www.annals.org on 20 March 2018
HIV, Infectious Disease.
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