The average time between HIV infection and diagnosis decreased 17% in the United States from 3 years and 7 months in 2011 to 3 years in 2015, according to data released today by the CDC.
However, delays in HIV diagnosis continue to be substantial in certain populations, and about a quarter of all people living with HIV go undiagnosed for 7 years or longer, according to Andre F. Dailey, MSPH, of the CDC’s Division of HIV/AIDS Prevention and the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, and colleagues.
“Many Americans are not getting tested for HIV as CDC recommends, and too many people have HIV infections that go undiagnosed for far too long,” CDC Director Brenda Fitzgerald, MD, said during a telebriefing. “We are still missing opportunities to test many people who are most at risk for HIV. While we should celebrate our progress, we must still make HIV prevention a priority.”
Approximately 40% of new HIV infections in the U.S. are transmitted by people who are unaware of their HIV infection, Eugene McCray, MD, director of the CDC’s Division of HIV/AIDS Prevention said during the briefing. The CDC recommends HIV testing for everyone aged 13 to 64 years at least once in their lifetime and for high-risk individuals at least once a year. Men who have sex with men (MSM) may benefit from more frequent testing every 3 to 6 months.
Recent MMWR data compiled by Dailey and colleagues showed that 14.5% of all people living with HIV were undiagnosed in 2015. Half of these undiagnosed infections were in the South.
There was a median delay of 3 years between HIV infection and diagnosis; however, durations ranged from:
- 2.2 years among whites to 4.2 years among Asians;
- 2.5 years among heterosexual women to 4.9 years among heterosexual men; and
- 2.4 years among people aged 13 to 24 years to 4.5 years among those aged 55 years or older.
Data from the CDC’s National HIV Behavioral Surveillance system showed an increase in HIV testing from 63% in 2008 to 71% in 2014 among MSM; from 50% in 2009 to 58% in 2015 among people who inject drugs (PWID); and from 34% in 2010 to 41% in 2016 among high-risk heterosexual men and women.
“Although HIV testing is up among these risk groups, our report also found that we still need to test more people and test more often,” said Jonathan H. Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.
Almost one in three MSM, more than two in five PWID, and more than one in two heterosexuals at an increased risk for HIV were not tested in the past 12 months. Seven in 10 of these high-risk individuals saw a health care provider during that time, signaling a missed opportunity for HIV testing, Mermin said.
During the telebriefing, McCray urged health care providers to include HIV testing as part of routine medical care.
“Ideally, HIV is diagnosed within months of infection, rather than years later,” he said. “Further increasing regular HIV testing and closing testing, diagnoses and treatment gaps is essential to stopping HIV in our communities.”
By Stephanie Viguers