HIV antibody testing has been included in the National Health and Nutrition Examination Survey, for ages 18–49 since 1999 and for ages 18–59 years since 2009 enabling estimation of trends in HIV prevalence as part of national surveillance in the U.S. household population. Self-reported HIV testing and antiretroviral use was also included in the survey since 1999.
A continuous household-based probability sample of the U.S. population.
From 1999 to 2018, 29,020 participants age 18–49 years were tested for HIV antibody and 34,092 participants age 18–59 years were asked about self-report of any previous HIV testing.
HIV prevalence was 0.41% among those aged 18–59 in 2009–2018 with a nonsignificant trend over time among those aged 18–49 years from 1999–2002 to 2015–2018. However, significant declines in prevalence were seen among those aged 18–39 years (0.37%–0.11%), women (0.22%–0.06%) and non-Hispanic black persons (2.14%–0.80%). Participants aged 18–39 years self-reported a decline in HIV testing, whereas those aged 40–49 and 50–59 years, non-Hispanic black persons and women reported an increase in getting a HIV test. Prevalence of infection and self-reported history of HIV testing varied by demographic and risk groups. HIV testing among HIV-positive persons was 83.9%. Antiretroviral therapy among those HIV-positive was under 50%.
Although total HIV prevalence and previous self-reported HIV testing remained stable for the last 20 years, there were significant declines in age and demographic subgroups. Prevalence for both outcomes varied by demographic and risk variables.