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Ending the HIV Epidemic
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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.
Learn more about the 6 EHE indicators by viewing data either by demographic or geographic location.
Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month after HIV diagnosis. Of note, this indicator is only available for areas that have complete data. Areas with complete data have at least 95% of laboratory results reported to their surveillance programs and have transmitted their data to CDC’s National HIV Surveillance System (NHSS). NHSS includes data for persons aged ≥13 years. Linkage to care data by area are based on residence at time of diagnosis of HIV infection.
For the baseline year 2017, linkage to HIV medical care was available for 41 states and the District of Columbia: Alabama, Alaska, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
There are 41 areas with complete lab reporting for 2018; however, the composition of the states changed. In 2018, linkage was available for Nevada but not available for Connecticut.
For 2019, the number of areas with complete laboratory data increased to 45. Linkage to HIV medical care data is available for 44 states and the District of Columbia including: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
For 2020, the number of areas with complete laboratory data increased to 46. Linkage to HIV medical care data is available for 44 states and the District of Columbia including: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
For 2021, 2022, and 2023, the number of areas with complete laboratory data increased to 48. Linkage to HIV medical care data is available for 47 states and the District of Columbia including: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
Linkage to care data are not provided for jurisdictions that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Area without laws: Idaho. Areas with incomplete reporting: New Jersey, and Puerto Rico. Areas with a lapse in reporting in 2022: Mississippi and West Virginia.
Totals for linkage to care include other risk factors, such as persons whose infection was attributed to hemophilia, blood transfusion, or perinatal exposure or whose risk factor was not reported or not identified. These data are not displayed in tables because the numbers are too small to be meaningful.
Data presented by quarter: Linkage to care for a quarter is calculated for the cumulative number of persons who received an HIV diagnosis through the specified quarter of the calendar year. A 3-month reporting lag is required for calculating linkage to care due to known delays in reporting of laboratory data (e.g., linkage to care through December 2023 is calculated using data reported to CDC’s National HIV Surveillance System through March 2024). Data presented by quarter are preliminary.
Data reported to the NHSS are considered preliminary until a 12-month reporting delay has been reached.
Data for the years 2023 and 2024 are considered preliminary and based on data reported to CDC’s National HIV Surveillance System as of March 2024. Diagnoses data are preliminary through March 2024. Linkage to HIV Medical Care data are preliminary through December 2023 and PrEP Coverage data are preliminary through June 2023.