Overall, HIV prevalence and testing rates in the U.S. have remained stable over the past 20 years, but certain subgroups saw significant changes, researchers reported in Journal of Acquired Immune Deficiency Syndromes.
They analyzed data from the National Health & Nutrition Examination Surveys, which were administered to a sample of US households in five four-year cycles from 1999 to 2018 and included an HIV test. A total of 29,020 participants 18 to 49 years old were tested for HIV, and 34,092 people 18 to 59 years old reported whether they had been previously tested for the virus.
During the 2009-2018 survey cycle, 91 participants tested positive for HIV, a prevalence rate of 0.41%. Of those individuals, 46% indicated in a subsequent survey that they had recently taken an antiretroviral medication, and 84% reported having been previously tested for HIV. (The study authors noted that recommendations updated in 2006 by the Centers for Disease Control and Prevention set a testing rate target of 90% for people living with HIV by 2020; 84% falls just shy of that goal.)
HIV testing rates and seroconversions both declined among younger adults (18 to 39 years old), while testing increased among older participants (40 to 59 years old). Testing rates rose among women and Black participants, while seroconversion rates declined; no other notable changes in demographic trends were seen in the study. Overall disparities continued to persist by sex (with men far more likely to test positive than women, but also less likely to report being tested) and race (with people classified as “non-Hispanic Black” people having much higher rates of HIV testing and diagnosis than people classified as “non-Hispanic white,” “Hispanic,” and “non-Black”).
There are several limitations to the data: the sampling method excluded people experiencing homelessness and other marginalized groups, few participants reported injection drug use, few Latinx people were included, and few people tested positive for HIV.