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HIV Diagnoses and the HIV Care Continuum Among Women and Girls Aged ≥13 Years–39 States and the District of Columbia, 2015–2016

Hoover, Karen W. MD, MPHa; Hu, Xiaohong MSa; Porter, Sarah E. MPHa; Buchacz, Kate PhDa; Bond, Martha D. MAb; Siddiqi, Azfar-E-Alam PhDa; Haynes, Suzanne G. PhDb

JAIDS Journal of Acquired Immune Deficiency Syndromes: July 1, 2019 - Volume 81 - Issue 3 - p 251–256
doi: 10.1097/QAI.0000000000002023
Epidemiology
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Background: In 2017, 19% of new HIV diagnoses in the United States were in women. HIV acquisition can be prevented with pre-exposure prophylaxis, and HIV transmission with viral suppression. HIV viral suppression is achieved by linking women to care and supporting adherence to antiretroviral medications. The national HIV prevention goal for viral suppression is 80%.

Setting: United States.

Methods: We analyzed data reported by 40 US jurisdictions to the Centers for Disease Control and Prevention's National HIV Surveillance System to determine the number and rate of HIV diagnoses per 100,000 women in 2016. We also determined the percentages of women with diagnosed HIV who were linked to care within 1 and 3 months, received HIV care, were retained in HIV care, and were virally suppressed in 2015. Findings were stratified by demographic characteristics and HIV transmission category.

Results: In 2016, 6407 women were diagnosed with HIV. Black women had a rate of 783.7 per 100,000, Hispanic/Latino women 182.7, and white women 43.6. In 2015, 190,735 women were living with diagnosed HIV. Viral suppression increased with age, ranging from 46.5% among women aged 13–24 years to 62.3% among women aged ≥45 years. Black women had the lowest rate of viral suppression (55.5%). No age group of women achieved 80% viral suppression.

Conclusions: Pre-exposure prophylaxis implementation for women at high risk for HIV infection can help to decrease new infections. Women living with HIV would benefit from interventions that support linkage to HIV care and antiretroviral medication adherence to increase viral suppression.

aDivision of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA; and

bOffice on Women's Health, US Department of Health and Human Services, Washington, DC.

Correspondence to: Karen W. Hoover, MD, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, MPH, 1600 Clifton Road, NE MS E45, Atlanta, GA 30329 (e-mail: khoover@cdc.gov).

The authors have no conflicts of interest to disclose.

Received September 17, 2018

Accepted February 13, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.