CROI 2016: Major Disparities Persist in Lifetime Risk of HIV Diagnosis in the U.S.

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The lifetime risk of being diagnosed with HIV infection in the U.S. has decreased overall during the past decade, falling to 1 in 99, according to a study from the Centers for Disease Control and Prevention (CDC) presented at the Conference on Retroviruses and Opportunistic Infections (CROI 2016)this week in Boston. The risk varies widely among population subgroups, however, and half of black gay and bisexual men are likely to become infected if current trends persist.

Kristen Hess and colleagues used HIV diagnosis and death rates from the National HIV Surveillance System, National Center for Health Statistics, and population census data to estimate the lifetime risk of being diagnosed with HIV, looking at sub-groups based on sex, age, and race/ethnicity, as well as by state. These are the first-ever comprehensive national estimates of the lifetime risk of HIV diagnosis for several key populations at risk, according to the CDC.

The number of HIV diagnoses and deaths between 2009 and 2013 were used to calculate the probability of an HIV diagnosis at a given age. The lifetime risk estimate is the cumulative probability of being diagnosed with HIV from birth to death, assuming diagnosis rates remain constant. The new estimates were compared to findings from an analysis done in 2004-2005.

Results

"Lifetime risk may be a useful tool to more effectively communicate the risk of HIV to the general public" and "can help to highlight the severe disparities," the researchers concluded.

"As alarming as these lifetime risk estimates are, they are not a foregone conclusion. They are a call to action," Jonathan Mermin, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention said in a CDC press release. "The prevention and care strategies we have at our disposal today provide a promising outlook for future reductions of HIV infections and disparities in the US, but hundreds of thousands of people will be diagnosed in their lifetime if we don't scale up efforts now."

"These estimates are a sobering reminder that gay and bisexual men face an unacceptably high risk for HIV -- and of the urgent need for action," added Eugene McCray, director of CDC's Division of HIV/AIDS Prevention. "If we work to ensure that every American has access to the prevention tools we know work, we can avoid the outcomes projected in this study."

2/23/16

Reference

K Hess, X Hu, A Lansky, et al. Hess K et al. Estimating the Lifetime Risk of a Diagnosis of HIV Infection in the United States. Conference on Retroviruses and Opportunistic Infections. Boston, February 22-25, 2016. Abstract 52.

Other Sources

CDC. Lifetime Risk of HIV Diagnosis in the United States. Fact sheet. February 2016.

CDC. Half of black gay men and a quarter of Latino gay men projected to be diagnosed within their lifetime. Press release. February 23, 2016.