The Status of the National HIV Surveillance System, United States, 2013

Cohen, Stacy M.; Gray, Kristen Mahle; Ocfemia, M. Cheryl Bañez; Johnson, Anna Satcher; Hall, H. Irene

doi:10.1177/003335491412900408

Cited by 47 publications

(45 citation statements)

References 9 publications

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“…In many states, CD4 + cell counts and viral load test results are now routinely collected as part of HIV surveillance and sent confidentially to the National HIV Surveillance System. Jurisdictions reporting these laboratory test results comprise approximately 60% of persons living with HIV in the US [20,21]. States and cities are increasingly using these data to reliably estimate the percentage of persons living with HIV in their jurisdictions who are in care with sustained viral suppression [22–25].…”

Section: Discussionmentioning

confidence: 99%

Increased antiretroviral therapy prescription and HIV viral suppression among persons receiving clinical care for HIV infection

Bradley

Mattson

Beer

et al. 2016

Aids

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Objective To assess trends during 2009–2013 in antiretroviral therapy (ART) prescription and viral suppression among adults receiving HIV clinical care in the United States. Design We used data from the Medical Monitoring Project, a surveillance system producing national estimates of characteristics of HIV-infected adults receiving clinical care in the United States. Methods We estimated weighted proportions of persons receiving HIV medical care who were prescribed ART and achieved HIV viral suppression (<200 copies/ml) at both last test and at all tests in the previous 12 months during 2009–2013. We assessed trends overall and by gender, age, race/ethnicity, and sexual behavior/orientation. Results ART prescription and viral suppression increased significantly during 2009–2013, overall and in subgroups. ART prescription increased from 89 to 94% (P for trend <0.01). Viral suppression at last measurement increased from 72 to 80% (P for trend <0.01). The largest increases were among 18–29 year olds (56–68%), 30–39 year olds (62–75%), and non-Hispanic blacks (64–76%). Sustained viral suppression increased from 58 to 68% (P for trend <0.01). The largest increases were among 18–29 year olds (32–51%), 30–39 year olds (47–63%), and non-Hispanic blacks (49–61%). Conclusion Adults receiving HIV medical care are increasingly likely to be prescribed ART and achieve viral suppression. Recent efforts to promote early antiretroviral therapy use may have contributed to these increases, bringing us closer to realizing key goals of the National HIV/AIDS Strategy.

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Section: Discussionmentioning

confidence: 99%

Increased antiretroviral therapy prescription and HIV viral suppression among persons receiving clinical care for HIV infection

Bradley

Mattson

Beer

et al. 2016

Aids

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“…Data from the National HIV Surveillance System reported to the CDC through December 2015 were used to determine trends in the annual number of HIV diagnoses in the United States [15]. Data on HIV diagnoses were also used to estimate the annual number of infections (incidence) with 3 models (Table 1) using (1) additional information on a biomarker that classifies infections as recent (or not) in the stratified extrapolation approach [1,2,16-18]; (2) HIV diagnoses and the severity of disease (whether infection is classified as stage-3 AIDS, within the same calendar year as HIV diagnosis) in the back-calculation approach (Bayesian hierarchical model) to estimate HIV prevalence and the percentage of persons living with undiagnosed HIV [4,19,20]; and (3) the first CD4 count after diagnosis in a newly developed approach to derive incidence, prevalence, and the percentage undiagnosed (CD4 model) [21-23].…”

Section: Methodsmentioning

confidence: 99%

HIV Trends in the United States: Diagnoses and Estimated Incidence

Hall¹,

Song²,

Tang³

et al. 2017

JMIR Public Health Surveill

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BackgroundThe best indicator of the impact of human immunodeficiency virus (HIV) prevention programs is the incidence of infection; however, HIV is a chronic infection and HIV diagnoses may include infections that occurred years before diagnosis. Alternative methods to estimate incidence use diagnoses, stage of disease, and laboratory assays of infection recency. Using a consistent, accurate method would allow for timely interpretation of HIV trends.ObjectiveThe objective of our study was to assess the recent progress toward reducing HIV infections in the United States overall and among selected population segments with available incidence estimation methods.MethodsData on cases of HIV infection reported to national surveillance for 2008-2013 were used to compare trends in HIV diagnoses, unadjusted and adjusted for reporting delay, and model-based incidence for the US population aged ≥13 years. Incidence was estimated using a biomarker for recency of infection (stratified extrapolation approach) and 2 back-calculation models (CD4 and Bayesian hierarchical models). HIV testing trends were determined from behavioral surveys for persons aged ≥18 years. Analyses were stratified by sex, race or ethnicity (black, Hispanic or Latino, and white), and transmission category (men who have sex with men, MSM).ResultsOn average, HIV diagnoses decreased 4.0% per year from 48,309 in 2008 to 39,270 in 2013 (P<.001). Adjusting for reporting delays, diagnoses decreased 3.1% per year (P<.001). The CD4 model estimated an annual decrease in incidence of 4.6% (P<.001) and the Bayesian hierarchical model 2.6% (P<.001); the stratified extrapolation approach estimated a stable incidence. During these years, overall, the percentage of persons who ever had received an HIV test or had had a test within the past year remained stable; among MSM testing increased. For women, all 3 incidence models corroborated the decreasing trend in HIV diagnoses, and HIV diagnoses and 2 incidence models indicated decreases among blacks and whites. The CD4 and Bayesian hierarchical models, but not the stratified extrapolation approach, indicated decreases in incidence among MSM.ConclusionsHIV diagnoses and CD4 and Bayesian hierarchical model estimates indicated decreases in HIV incidence overall, among both sexes and all race or ethnicity groups. Further progress depends on effectively reducing HIV incidence among MSM, among whom the majority of new infections occur.

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“…21 We included one sequence per person. When more than one sequence had been obtained from an individual, the longest sequence was used; 80% of these sequences were obtained within 1 year since diagnosis.…”

Section: Sequence Datamentioning

confidence: 99%