Search And Selection Of Studies
A total of 1024 articles were eventually retrieved from the above databases. After the elimination of duplicates, 708 articles were retained. These articles went through two stages of screening. In the first stage, by reading the titles and abstracts and excluding articles failed to meet the inclusion criteria, 192 articles were included in the second stage, of which the full text was required to be read the full text. After excluding the articles in which, for example, the participants were all HIV-infected or negative, or the cases were without reported outcome indicators at last, a total of 35 articles were included in this meta-analysis .
Key Points: Hiv Incidence
- HIV incidence declined 8% from 2015 to 2019. In 2019, the estimated number of HIV infections in the U.S. was 34,800 and the rate was 12.6 .
- , the annual number of HIV infections in 2019, compared with 2015, decreased among persons aged 1324 and persons aged 45-54, but remained stable among all other age groups. In 2019, the rate was highest for persons aged 25-34 , followed by the rate for persons aged 35-44 .
- , the annual number of HIV infections in 2019, compared with 2015, decreased among persons of multiple races, but remained stable for persons of all other races/ethnicities. In 2019, the highest rate was for Blacks/African American persons , followed by Hispanic/Latino persons and persons of multiple races .
- , the annual number of new HIV infections in 2019, as compared to 2015, decreased among males, but remained stable among females. In 2019, the rate for males was 5 times the rate for females .
- , the annual number of HIV infections in 2019, compared with 2015, decreased among males with transmission attributed to male-to-male sexual contact, but remained stable among all other transmission categories. In 2019, the largest percentages of HIV infections were attributed to male-to-male sexual contact
For more details on recent HIV incidence statistics, see Estimated HIV Incidence and Prevalence in the United States, 2015-2019.
Hiv Infections By State
In the United States, where you live plays a large part in how likely you are to get HIV. While it is clear that dense urban populations with high prevalence rates contribute to the risk, there are other unique factors that account for a growing disparity between U.S. states.
A prime example is the rate of infection in states that have either adopted or refused Medicaid expansion, intended to expand healthcare to economically disadvantaged people.
According to the CDC, the 13 states that refused Medicaid expansion account for 42% of all new infections. Florida, Texas, Georgia, and North Carolina represent the lion’s share of these infections.
Poverty remains a driving force for HIV infections, particularly in the South where the rates of poverty are highest. Moreover, nearly half of all Americans without health insurance live in the South.
With that being said, the Northeast has a higher prevalence rate overall, centered mainly in dense urban populations like New York City, Baltimore, and Washington, D.C.
These dynamics are reflected in the 10 U.S. states with the highest HIV prevalence rates, according to the CDC.
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Youth also accounts for the highest rate of undiagnosed infections. Today, nearly half of all HIV-positive youth between the ages of 13 and 24 are unaware of their status and, as a result, are more likely to infect others. The picture is little improved among adults 25 to 34, where one in three remains undiagnosed.
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Study Selection And Data Extraction
Two independent reviewers selected the articles based on the inclusion criteria, and extracted data on the first author, published year, year of study, study locations, setting, recall window of heterosexual behaviour among MSM, sampling method, survey method, sample size and reported outcome indicators with 95% confidence intervals . Moreover, we discussed any differences before reaching an agreement at last.
The Global Distribution Of Deaths From Hiv/aids
In some countries HIV/AIDS is the cause of more than a quarter of all deaths
Globally, 1.5% of deaths were caused by HIV/AIDS in 2019.
This share is high, but masks the wide variations in the toll of HIV/AIDS across the world. In some countries, this share was much higher.In the interactive map we see the share of deaths which resulted from HIV/AIDS across the world. Across most regions the share was low: across Europe, for example, it accounted for less than 0.1% of deaths.
But across some countries focused primarily in Southern Sub-Saharan Africa the share is very high. More than 1-in-4 of deaths in South Africa were caused by HIV/AIDS in 2019. The share was also very high across Botswana Mozambique Namibia Zambia Kenya and Congo .
Death rates are high across Sub-Saharan Africa
The large health burden of HIV/AIDS across Sub-Saharan Africa is also reflected in death rates. Death rates measure the number of deaths from HIV/AIDS per 100,000 individuals in a country or region.
In the interactive map we see the distribution of death rates across the world. Most countries have a rate of less than 10 deaths per 100,000 often much lower, below 5 per 100,000. Across Europe the death rate is less than one per 100,000.
Across Sub-Saharan Africa the rates are much higher. Most countries in the South of the region had rates greater than 100 per 100,000. In South Africa and Mozambique, it was over 200 per 100,000.
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Sti Trends In 2020 Chicago
- Gay and bisexual men continue to account for the majority of primary and secondary syphilis cases.
- Since 2016, the highest proportion of reported STIs has been among non-Hispanic Blacks, with:
- 50.6% of reported chlamydia cases,
- 60.7% of reported gonorrhea cases, and
- 49.9% of reported P& S syphilis cases in 2020.
Geography of HIV in Chicago
In 2020, the top three community areas with the highest new HIV infection diagnosis rates were:
- Washington Park , and
The top three community areas with the highest number of new HIV infection diagnoses were:
In 2020, the top three community areas with the highest HIV prevalence rates were:
Boxed Warning: Risk Of Drug Resistance With Use Of Descovy For Prep In Undiagnosed Early Hiv1 Infection And Post
- DESCOVY FOR PrEP must be prescribed only to individuals confirmed to be HIV negative immediately prior to initiation and at least every 3 months during use. Drug-resistant HIV-1 variants have been identified with use of emtricitabine/tenofovir disoproxil fumarate for HIV-1 PrEP following undetected acute HIV-1 infection. Do not initiate if signs or symptoms of acute HIV-1 infection are present unless HIV-negative status is confirmed
- Severe acute exacerbations of hepatitis B have been reported in individuals infected with hepatitis B virus who discontinued products containing FTC and/or TDF and may occur with discontinuation of DESCOVY®. Closely monitor hepatic function with both clinical and laboratory follow-up for at least several months in individuals with HBV who discontinue DESCOVY. If appropriate, anti-hepatitis B therapy may be warranted
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How Common Is Hiv Among Heterosexuals
31 August 20163 minute read
CLAIM: 41% of those living with HIV in Northern Ireland are heterosexual.
The claim is accurate. Furthermore, Northern Ireland has observed the fastest growth in diagnoses over the past 10 years, when compared to the average both in Ireland and in the United Kingdom.
Speaking of a new drug that would help prevent HIV, Northern Ireland Assembly Health chair Paula Bradley of the DUP stated: 41% of those living with HIV in Northern Ireland are heterosexual. This is based on statistics published in the annual HIV Surveillance Report, which show that of those receiving care, acquired their infection through heterosexual contact. It also states that out of the 809 people currently receiving treatment, 90% contracted the disease through sexual contact.
Rates around the British Isles
Across the United Kingdom, there are approximately 45,000 men living with HIV who were infected through sex with other men . This is out of 103,700people in total, and compared with 54,100 people who contracted the disease through heterosexual sex. This means that in the UK as a whole, 52% of people living with HIV are heterosexual.
Data from Ireland does not reveal how many people are living with HIV. However, it shows a very similar proportion of new HIV infections through male to male contact. In 2014, 48.5% of new diagnoses were a result of homosexual activity, while 33.2% were from heterosexual activity. This is a drop from 50% in 2004.
Tuberculosis Among People Living With Hiv
Tuberculosis is the leading HIV-associated opportunistic infection in low- and middle- income countries, and it is a leading cause of death globally among people living with HIV. Death due to tuberculosis still remains high among people living with HIV, however the number of deaths is decreasing. Most of the global mortality due to TB among those with HIV is from cases in Sub-Saharan Africa.
In the charts here we see the number of tuberculosis patients who tested positive for HIV the number receiving antiretroviral therapy and the number of TB-related deaths among those living with HIV.
People who use ART are living longer
ART not only saves lives but also gives a chance for people living with HIV/AIDS to live long lives. Without ART very few infected people survive beyond ten years.3
Today, a person living in a high-income country who started ART in their twenties can expect to live for another 46 years that is well into their 60s.4
ART prevents new HIV infections
There is considerable evidence to show that people who use ART are less likely to transmit HIV to another person.7 ART reduces the number of viral particles present in an HIV-positive individual and therefore, the likelihood of passing the virus to another person decreases.
We need to increase ART coverage
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Data Sources For Calculating The Proportion Of Heterosexuals In The Us
The three national population-based surveys included were the National Survey of Family Growth , the National Health and Nutrition Examination Survey , and the General Social Survey . These surveys and general question wording are described in Table 1 website addresses are provided for further information about the sampling methods, human subjects review, specific question wording, response rates, and weighting.
Hiv Trends In 2020 Chicago
- 627 new HIV diagnoses in 2020 in Chicago, a decrease of 5% from 2019 and a decrease of 32% from 2015
- NH-Blacks also represented 57% of AIDS diagnoses, and 48% of late HIV diagnoses
People Living with HIV and Viral Suppression
- 19,340 individuals who had been diagnosed with HIV through 2019 were living with HIV in 2020 in Chicago, corresponding to a rate of 717.9 per 100,000 population.
- People 40 years and older accounted for 67 percent of Chicagoans living with HIV in 2020
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Key Points: Hiv Diagnoses
Gay, bisexual and other men who have sex with men b are the population most affected by HIV in the U.S.:
- In 2019, MSM accounted for 69% of new HIV diagnoses in the United States.c
- From 2015 through 2019 in the United States and 6 dependent areas, Black/African American MSM accounted for more than 36% and White MSM accounted for more than 30% of HIV diagnoses among MSM annually.
- In 2019, Black/African American MSM accounted for 26% of new HIV diagnoses and 37.9% of diagnoses among all MSM.
- In 2019, Hispanic/Latinod MSM made up 22% of new HIV diagnoses and 32.5% of diagnosis among all MSM.
The number of HIV diagnoses decreased among MSM overall, but trends varied by race/ethnicity. From 2015 through 2019:
- Among MSM aged 1324 years, HIV diagnoses decreased or were stable among all racial/ethnic groups.
- HIV diagnoses increased among American Indian/Alaska Native and Native Hawaiian/other Pacific Islander MSM, ages 24 and older.
Transgender people accounted for approximately 2% of new HIV diagnoses in 2019.
- From 2015 through 2019 in the United States and 6 dependent areas, the number of diagnoses of HIV infection for transgender adults and adolescents increased.
- In 2019, among transgender adults and adolescents, the largest percentage of diagnoses of HIV infections was for transgender male-to-female people.
Blacks/African Americans and Hispanics/Latinx continue to be severely and disproportionately affected by HIV:
The Uks Gay/straight Prep Divide
In addition to not enough HIV testing among heterosexuals, too few are being told about or going on PrEP, especially women. And as with HIV testing, thats because PrEP is currently only offered out of SHS centerswhich are far more commonly visited by gay and bi menand not via primary care providers, where most women go. Thats according to Sophie Strachan, CEO of Sophia Forum, which advocates in the UK for HIV prevention and treatment among women.
Strachan says that PrEP in the UK for women needs to be reframed as an upbeat lifestyle choice, as it has for gay and bi men. When working groups started talking about how to promote the PrEP IMPACT trials a few years ago, she says, women werent even being considered in the PrEP discussion. And when they were, they were framed as these helpless victims of domestic abuse and violence.
Granted, there is a link between domestic violence and HIV, she says, but still, for men, PrEP was framed as liberating and empowering. Were about two years behind promotion of PrEP for women.
Key to this, she says, is that primary care providers need to be trained to get over their discomfort and biases related to talking about HIV with women patients and to routinize offering PrEP. Its not about telling women that they have to take it, she says, but that its an option. The countrys new HIV Action Plan, she notes, is prioritizing this in the years ahead.
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Proportion Of The Population And Number Estimated To Be Heterosexual In The Us
Table 2 shows the estimated population proportion of lifetime heterosexuals overall and for males and females for each population-based survey and the combined estimates from the meta-analysis. The overall combined estimate was 86.7% . As noted, Q statistics and I2 indicated heterogeneity of results across the surveys . The combined estimate for males was 84.1% and for females was 89.4% .
Hiv Infection Among Heterosexuals At Increased Risk United States 2010
In 2009, an estimated 27% of human immunodeficiency virus infections in the United States were attributed to heterosexual contact . During 20062007, as part of the data collection for the National HIV Behavioral Surveillance System , CDC surveyed heterosexuals who lived in urban areas with a high prevalence of acquired immunodeficiency syndrome and found an overall HIV prevalence of 2.0% and a prevalence of 2.3% among persons with annual household incomes at or below the poverty level and 2.8% among persons with less than a high school education . This report summarizes HIV testing results from the second cycle of NHBS, conducted in 2010, which focused on heterosexual persons with low socioeconomic status living in areas with high AIDS case rates. The results indicated that HIV prevalence was 2.3% overall and 1.1% among participants who did not report a previous positive HIV test result. Overall, 25.8% of participants had never been tested for HIV until the NHBS survey. Given the high HIV prevalence in this sample, additional research should be conducted to identify culturally appropriate interventions that overcome barriers to HIV testing and increase linkage to care for heterosexuals with low SES in urban areas with high prevalence of AIDS.
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Indication & Limitation Of Use
DESCOVY® for HIV-1 pre-exposure prophylaxis is indicated in at-risk adults and adolescents to reduce the risk of sexually acquired HIV-1 infection, excluding individuals at risk from receptive vaginal sex. HIV-1negative status must be confirmed immediately prior to initiation.
Limitation of Use: DESCOVY FOR PrEP® is not indicated in individuals at risk of HIV-1 from receptive vaginal sex because effectiveness in this population has not been evaluated.
For Calculating Hiv Disease Rates And Rate Ratios
We calculated HIV rates by dividing the estimated number of HIV cases attributed to heterosexual contact by the estimated number of heterosexuals . Corresponding to measures included in annual HIV surveillance reports , we calculated two types of HIV rates: 1) diagnosis rates and 2) the rates of heterosexuals living with diagnosed HIV infection. For the numerators, we used HIV case surveillance data from all 50 states and the District of Columbia reported to CDC as of June 2014 for adults and adolescents diagnosed with HIV infection in 2013 and for those living with diagnosed HIV infection as of December 2012.
For the denominators, we used the estimated number of heterosexuals. Denominators were calculated by multiplying census data by the population proportion of heterosexuals derived from the meta-analysis. We used 2013 and 2012 census data, respectively, to determine the number of heterosexuals for the HIV diagnosis rates and rates of living with diagnosed HIV infection.
We calculated rate ratios to compare rates by sex, race/ethnicity, and age. Males, whites, and the youngest age group served as the reference groups, respectively.
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