Vital Signs: Status of Human Immunodeficiency Virus Testing, Viral Suppression, and HIV Preexposure Prophylaxis — United States, 2013–2018

Since 2013, progress in reducing the number of new human immunodeficiency virus (HIV) infections has stalled at approximately 38,000 new infections occurring each year. Infections are preventable. Persons who are aware that they have HIV infection and maintain a suppressed viral load (<200 copies of HIV RNA per mL) have effectively no risk of sexually transmitting the virus to HIV-negative partners. Nevertheless, 38% of new HIV infections are transmitted from persons with HIV infection who are unaware of their infection. Further, 43% of new HIV infections are transmitted from persons who have received a diagnosis but are not receiving HIV medical care, and 20% of new HIV infections are transmitted from persons receiving medical care for HIV, but who are not virally suppressed. Preexposure prophylaxis (PrEP), a daily oral pill that includes two HIV antiretroviral medications (tenofovir and emtricitabine), has been found to be highly effective in preventing acquisition of HIV infection. PrEP coverage has increased in recent years; however, coverage among persons at risk for exposure remains low. In February 2019, a new national initiative, Ending the HIV Epidemic: A Plan for America, was proposed. The plan calls for intensified efforts to diagnose, treat, and prevent HIV infections in the United States, with an overall goal of reducing new infections by at least 90% by 2030. Use of PrEP is a major component of the prevention strategy and is indicated for men and women with sexual or injection drug use behaviors that increase their risk for acquiring HIV. To focus national and local prevention efforts on eliminating HIV, CDC analyzed surveillance, pharmacy, and other data to determine the status of these strategies (diagnose, treat, and prevent HIV infections) at the national and state levels.