● Hispanic/Latinx person represented 18% of the population, but accounted for 30% of new HIV diagnoses. New diagnoses of HIV in 2019 were highest among persons 25 to 29 years of age. 7 The greatest overall illness burden across all diseases occurs in people at the lowest socioeconomic status. 9 These healthdisparities are exaggerated in people with HIV. Poverty, discrimination, health inequity, and other social conditions facilitateHIV transmission by influencing local HIV prevalence and individual risk behaviors. High prevalence rates of smoking, obesity,empty calorie/low nutrient diets, substance abuse, and other poor health behaviors, which are also over-represented amongthe poor and disenfranchised, lead to multiple comorbidities. Many of these factors promote HIV infection and impede accessto health care. 9 Most HIV diagnoses are now highly concentrated in certain geographic locations. 7 The Ending the HIV Epidemic: A Plan for America initiative is focusing on the 48 counties in the US, Washington, DC, and San Juan, Puerto Rico that accounted for 50% of new diagnoses in 2016-2017, in addition to 7 states with a high rural burden (Figure 2). 4
In 2019, there were 15,815 deaths among adults and adolescents diagnosed with HIV. 7 Over time, HIV has increasingly become more prevalent among marginalized and stigmatized communities such as men whohave sex with men (MSM), transgender persons, people who inject drugs, adolescents, and prisoners. 1 MSM are the populations most affected by HIV in the US. Between 2015 and 2019, MSM accounted for approximately 69% of new HIV diagnoses. Groups that accounted for the highest prevalence of new HIV diagnoses in 2019 were: 7 ● Black/African American MSM: 26% ● Black/African American heterosexual persons: 23% (men: 7%; women: 16%) ● Hispanic/Latino MSM: 22% ● People who inject drugs: 7% (men: 4%; women: 3%) ● Transgender people: 2% When examined by race/ethnicity, Black/African American and Hispanic/Latinx persons continue to be disproportionately impacted by HIV. 7 In 2019: ● Blacks/African Americans represented 13% of the US population, but accounted for 44% of new HIV diagnoses.
Figure 2: The Ending the HIV Epidemic: A Plan for America Initiative Identified Areas Where Transmission Occurs Most Frequently 4
MODES OF TRANSMISSION
HIV is transmitted by direct contact with body fluids from a person with HIV who has a detectable viral load. Transmission occurs through contact with infected body fluids such as blood, semen, rectal
fluids, vaginal fluid, or breast milk. For transmission to occur, the virus must get into the bloodstream of an HIV-negative person through a mucous membrane, open cut or sore, or by direct injection. 10
Book Code: CT24CME
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