Considerable geographic and sex-based disparities exist when assessing HIV care outcomes in Black communities in the U.S., the Centers for Disease Control and Prevention reported in Morbidity and Mortality Weekly Report.
The study featured data from 41 states and Washington, D.C.; Arizona, Arkansas, Connecticut, Idaho, Kansas, Kentucky, New Jersey, Pennsylvania, and Vermont were not included in the analysis. In 2018, 43% of new HIV diagnoses in those 42 jurisdictions were among Black people; of these, 77% were linked to care within one month of diagnosis and 63% were virally suppressed within six months, substantially lower than Ending the HIV Epidemic targets or UNAIDS’ global 90-90-90 goals.
Of the 14,502 Black people diagnosed per the report, 6% lived in rural settings, 13% in urban areas, and 81% in metropolitan areas. Late-stage diagnoses were more common in rural areas—especially among women of all races, who accounted for 31% of such diagnoses, compared to 19% among metropolitan men.
Other key findings include:
- Independent of location, people 45 years old and older were more likely not to learn their serostatus until advanced disease.
- Men were less likely to be linked to care or virally suppressed than women.
- This was especially true for men who acquired HIV through heterosexual contact; they also had the highest rate of late diagnoses by transmission category.
“For equitable health to be achieved for Black persons in all geographic areas, culturally appropriate and stigma-free sexual health care is needed, particularly among those who live in rural communities,” study authors commented.