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Increased HIV Viral Suppression Among US Adults Receiving Medical Care, 2009-2013
Heather Bradley; Christine Mattson; Linda Beer; Ping Huang; Roy L. Shouse
CDC, Atlanta, GA, USA
Persons living with HIV who achieve viral suppression have greatly improved health outcomes and decreased risk of transmitting HIV to others. Increasing the number of persons living with HIV who are virally suppressed is key to reaching national HIV prevention goals in the United States.
We used 2009 – 2013 Medical Monitoring Project (MMP) data to estimate the proportion of persons receiving HIV medical care who achieved HIV viral suppression (< 200 copies/mL) at both last test and at all tests in the previous 12 months. MMP is a surveillance system that produces nationally representative information about persons receiving HIV medical care in the United States. Data were collected from 23,125 persons using interviews and medical record abstractions. We assessed temporal trends in viral suppression overall and by gender, age, race/ethnicity, and sexual behavior/orientation.
The proportion of persons whose HIV virus was suppressed at most recent test increased from 72% to 80% from 2009 – 2013 (β=0.02, P for trend < 0.01). This positive trend was statistically significant among men and women; all age groups; non-Hispanic blacks, non-Hispanic whites and Hispanics; and men who have sex with men, men who have sex with women, and women who have sex with men. The largest increases were among 18–29 year olds (56% to 68%; β=0.03, P for trend < 0.01), 30 – 39 year olds (62% to 75%; β=0.03, P for trend < 0.01), and non-Hispanic blacks (64% to 76%; β=0.03, P for trend < 0.01).
The proportion of persons whose HIV virus was suppressed at all tests during the previous 12 months increased from 58% to 68% (β=0.03, P for trend < 0.01) from 2009 – 2013. This positive trend was statistically significant among all sub-groups by gender, age, race-ethnicity, and sexual behavior/orientation. The largest increases were among 18–29 year olds (32% to 51%; β=0.05, P for trend < 0.01), 30–39 year olds (47% to 63%; β=0.04, P for trend < 0.01), and non-Hispanic blacks (49% to 61%; β=0.03, P for trend < 0.01).
Persons receiving HIV medical care are increasingly likely to achieve viral suppression. Young people and non-Hispanic blacks, who had the lowest levels of viral suppression in 2009, showed the most improvement over time. Recent efforts to engage persons living with HIV in medical care and promote early antiretroviral therapy use may have contributed to these increases, bringing us closer to realizing key goals of the National HIV/AIDS Strategy.