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About the Six EHE Indicators

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.

What is Viral Suppression?

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 resulted 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. Viral suppression data by area are based on most recent known address at the end of the specified year.

For the baseline year 2017, viral suppression 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, viral suppression was available for Nevada but not available for Connecticut.

For 2019, the number of areas with complete laboratory data increased to 45. Viral suppression data are 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. Viral suppression data are 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, 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.

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 below conditions were met:

  • HIV infection was diagnosed by the end of the 2016 calendar year,
  • For the calendar year 2017, persons' last known place of residence falls in any of the 42 jurisdictions with complete reporting,
  • Persons were 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, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho. Areas with incomplete reporting: New Jersey, Pennsylvania (excluding Philadelphia), and Puerto Rico.

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