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Brief Report: HIV Prevalence and the Prevalence of Unsuppressed HIV in New York City, 2010–2014

Xia, Qiang MD, MPH; Sun, Xuming MS; Wiewel, Ellen W. DrPH, MHS; Torian, Lucia V. PhD

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 June 2017 - Volume 75 - Issue 2 - p 143–147
doi: 10.1097/QAI.0000000000001311
Epidemiology

Background: The widespread use of antiretroviral treatment made HIV prevalence no longer a good measure of population-level transmission risk. The objective of this analysis was to use the prevalence of unsuppressed HIV to describe population-level HIV transmission risk.

Methods: Using New York City (NYC) HIV surveillance data, we reported HIV prevalence and the prevalence of unsuppressed HIV, defined as the number of persons living with HIV with an unsuppressed viral load divided by population size.

Results: The estimated number of persons living with HIV in NYC increased from 79,100 [95% confidence interval (CI): 78,200 to 80,000] in 2010 to 81,700 (95% CI: 80,500 to 82,900) in 2014. HIV prevalence (≥18 years old) remained unchanged at 1.22% (95% CI: 1.21% to 1.24%) in 2010 and 1.22% (95% CI: 1.20% to 1.24%) in 2014. The prevalence of unsuppressed HIV (≥18 years old) steadily decreased from 0.49% (95% CI: 0.48% to 0.51%) in 2010 to 0.34% (95% CI: 0.32% to 0.36%) in 2014. Men had both higher HIV prevalence (1.86% vs. 0.65% in 2014) and higher prevalence of unsuppressed HIV (0.51% vs. 0.18% in 2014) than women. In 2014, the black–white ratio of prevalence of unsuppressed HIV was 5.8 among men and 26.3 among women, and the Hispanic–white ratio was 2.7 among men and 10.0 among women.

Conclusions: The prevalence of unsuppressed HIV has been steadily decreasing in NYC. As antiretroviral treatment continues to expand, programs should consider using the prevalence of unsuppressed HIV to measure population-level transmission risk.

New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, New York, NY.

Correspondence to: Qiang Xia, MD, MPH, New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, 42-09 28th Street, Queens, NY 11101 (e-mail: qxia@health.nyc.gov).

Supported in part by a Cooperative Agreement with the Centers for Disease Control and Prevention, PS08-80202, #UC62/CCU223595.

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.jaids.com).

Received October 17, 2016

Accepted January 29, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.