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THE EVOLVING HIV EPIDEMIC IN THE UNITED STATES
Carlos del Rio1
1Emory University, Atlanta, GA, USA
CDC estimates that approximately 1.2 million people in the United States are living with HIV. Southern states is the home to 38% of the US population yet is where 45% of people living with HIV reside and where 50% of new infections are occurring. Nationally it is estimated that 85% of people living with HIV know their serostatus but in 10 out of 17 Southern states, this percentage is lower. Similarly, the percent who know their status is lower for persons younger than 34 years-old. Despite evolving the new HIV epidemic in the US is very much like the old HIV epidemic with the great majority of new infections happening among gay and bisexual men, however black men who have sex with men (MSM) and Hispanic/Latino MSM account for the largest number of new HIV diagnosis. There are also important racial disparities in HIV with Black/African Americans comprising 12% of the population yet accounting for 44% of new HIV diagnoses. The number of new HIV infections declined 18% between 2008 and 2014 but this decline has been uneven across geographic regions and populations. HIV care continuum outcomes, particularly retention and viral suppression, are key in decreasing HIV transmission. Thus, it is not surprising that the impact of treatment on transmission has not been as significant in the South and among Black/African Americans where continuous retention and viral suppression has been less than optimal. The US is far from reaching the UNAIDS 909090 goals; approximately 85% of people living with HIV diagnosed, 36% are receiving ART and 30% are virally suppressed. It is thus a public health priority to develop and implement interventions to improve retention and viral suppression to decrease regional and racial disparities in HIV and to achieve the goals of the National HIV/AIDS Strategy for 2020.