About the EHE Indicators: Viral Suppression

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.

Explore HIV indicator data on the AHEAD dashboard.

What Is Viral Suppression?

If taken as prescribed, HIV medicine reduces the amount of HIV in the body (viral load) to a very low level. This is called viral suppression and is defined as having less than 200 copies of HIV per milliliter of blood. Viral suppression is the goal of HIV treatment; it keeps the immune system working, prevents illness, and prevents transmission of the virus to others.

What Is the EHE Viral Suppression Indicator?

The EHE viral suppression indicator tracks the proportion of all people with diagnosed HIV whose viral load is suppressed in a given year.

Specifically, it is the percentage of people with diagnosed HIV who have fewer than 200 copies of HIV per milliliter of blood at the most recent test in a calendar year.

The EHE goal is to increase the percentage of people with diagnosed HIV who are virally suppressed to 95% from a 2017 baseline of 63.1%. Increasing viral suppression reduces HIV transmission, because people with HIV who are virally suppressed cannot transmit HIV to their sexual partners.

Uses of Viral Suppression Data

Viral suppression data can provide insights into trends in viral suppression over time and by population group, monitor the effectiveness of interventions to link people to and retain people in HIV treatment, reveal disparities, or highlight gaps in care or service availability.

How Is the Viral Suppression Indicator Calculated?

Viral suppression is calculated by dividing the number of people with a viral load result of <200 copies/mL (numerator) by the total number of people in the surveillance population who had at least one viral load test in the last year and who resided in a jurisdiction with complete data available (denominator).

A viral load (VL) test result of <200 copies/mL indicates HIV viral suppression. The cutoff value of <200 copies/mL was based on the following definition of viral failure: viral load of ≥200 copies/mL. If multiple viral load tests were performed during the same month and could thus qualify as “most recent,” the viral load with VL result of <200 copies/mL was selected. If the numerical result was missing or the result was a logarithmic value, the interpretation of the result (e.g., below limit) was used to determine viral suppression. Viral failure may indicate lack of adherence to ART. Of note, this indicator is only available for areas that have complete data, which is defined as areas that 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.

For the baseline year 2017, viral suppression data were available for the following 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 were 41 areas with complete lab reporting for 2018; however, the composition of the states changed. In 2018, viral suppression data were available for Nevada but not Connecticut.

For 2019, the number of areas with complete laboratory data increased to 45. Viral suppression data were available for the following 44 states and the District of Columbia: 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. Viral suppression data were available for the following 45 states and the District of Columbia: 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, the number of areas with complete laboratory data increased to 48. Linkage to HIV medical care data were available for the following 47 states and the District of Columbia: 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.

For 2022, the number of areas with complete laboratory data increased to 49. Linkage to HIV medical care data were available for the following 48 states and the District of Columbia: 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, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

For 2023, national analyses include data from all 50 states and the District of Columbia. While data for Idaho were included in national and regional analyses, they are not presented in jurisdiction-level tables due to the state's lack of mandatory reporting of all CD4 and viral load test results. Conversely, data for Puerto Rico were not included in national and regional analyses but are available in jurisdiction-level tables.

About Viral Suppression

HIV viral suppression for a given year was measured for persons aged ≥13 years and living with HIV infection that had been diagnosed by the beginning of the previous year and were alive at the end of the given year. Viral suppression data by jurisdiction are based on most recent known address at the end of the specified year. As an example, viral suppression for 2017 was measured if all of the following conditions were met:

1. HIV infection was diagnosed by the end of the 2016 calendar year.
2. For the calendar year 2017, individual's last known place of residence falls in any of the 42 jurisdictions with complete reporting.
3. Individual was alive at the end of the 2017 calendar year.

Viral suppression data are not provided for jurisdictions that do not have laws requiring reporting of all CD4 and viral loads. Areas without laws: Idaho. Areas with a lapse in reporting in 2023: Tennessee.

Data Sources

1. National HIV Prevention and Care Objectives: 2025 Update

   See Full Citation

Centers for Disease Control and Prevention. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 Territories and Freely Associated States, 2023. https://www.cdc.gov/hiv-data/nhss/national-hiv-prevention-and-care-objectives-2025.html. Published April 29, 2025. Accessed June 4, 2025.

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2. HIV Surveillance Data Tables (early release), 2020; 1(1)

   See Full Citation

Centers for Disease Control and Prevention. Core indicators for Monitoring the Ending the HIV Epidemic Initiative (Data reported through December 2019). HIV Surveillance Data Tables (early release), 2020; 1(1). https://stacks.cdc.gov/view/cdc/149334. Published March 2020. Accessed March 2, 2026.

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