There are six EHE indicators: HIV incidence, knowledge of HIV status, diagnoses, linkage to HIV medical care, HIV viral suppression, and PrEP coverage.
Each indicator was chosen with specific public health goals in mind and in line with the four key strategies of the initiative: diagnose, prevent, treat and respond. Incidence measures our overarching goal of reducing new infections by 90% by 2030. Diagnoses, and Knowledge of Status are all key to identifying which individuals need to be linked to care, and represent important steps on the HIV Care Continuum. Data have shown that upon diagnosis, immediate linkage to care and treatment results in improved HIV outcomes, so it is important to track how these indicators change over time. Viral Suppression and PrEP use will have the greatest impact on reducing new transmissions if they are scaled up.
Knowledge (or awareness) of HIV-positive status means a person has been tested and received a diagnosis of HIV infection. Knowledge of HIV status is estimated as the percentage of persons with HIV who have received a diagnosis and is calculated by dividing the estimated number of persons living with diagnosed infections by the estimated total HIV prevalence (diagnosed and undiagnosed cases) for each year. Estimates derived by using HIV surveillance data and CD4 data for persons aged ≥13 years at diagnosis.
Relative standard errors (RSEs) were calculated for estimates of incidence, prevalence, and percentages of persons living with diagnosed HIV infection and were used to determine the reliability of estimates. Estimates with a RSE of < 30% meet the standard of reliability and is displayed. Estimates with a RSE of 30%–50% meet a lower standard of reliability and is displayed but should be interpreted with caution. Estimates with a RSE of > 50% are statistically unreliable and not displayed.
Estimates with a relative standard error (RSE) of ≥30% do not meet the standard of reliability and are represented in the following way:
Estimates with an RSE of 30% - 50% are marked with an asterisk (*), indicating that they should be used with caution.
Estimates with an RSE>50 percent are not shown, and are replaced with the phrase “Data N/A due to high relative standard error.”
To reflect model uncertainty, all estimates were rounded to the nearest 100 for estimates of more than 1,000 and to the nearest 10 for estimates of less than 1,000.
About Knowledge of Status Data
Estimates should be interpreted with caution for jurisdictions that do not have laws requiring complete reporting of laboratory data or has incomplete reporting. Area without laws: Idaho. Areas with incomplete reporting: New Jersey, Pennsylvania (excluding Philadelphia), Puerto Rico.
Estimates should be interpreted with caution due to incomplete ascertainment of deaths that occurred during the year 2021. Areas with incomplete ascertainment of deaths: Mississippi and West Virginia.
Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative: National HIV Surveillance System data reported through December 2022; and preexposure prophylaxis (PrEP) data reported through September 2022. HIV Surveillance Data Tables, 2022; 4(1). https://www.cdc.gov/hiv/library/reports/surveillance-data-tables/. Published May 2023. Accessed July 12, 2023.
Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2017–2021. HIV Surveillance Supplemental Report, 2023; 28(3). http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html. Published May 2023. Accessed July 12, 2023.
Ending the HIV Epidemic (EHE) seeks to reduce the number of new HIV infections in the United States by 75 percent by 2025, and then by at least 90 percent by 2030, for an estimated 250,000 total HIV infections averted. AHEAD is paid for by EHE.
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