FAQs

The purpose of AHEAD is to help stakeholders evaluate the nation's progress toward reaching the goals of the EHE initiative and to use the data to inform local EHE and HIV related community planning efforts.

AHEAD displays both data and goals for 57 priority areas*:

• 50 priority counties/areas
• 7 priority states
• 43 remaining states for which data is also available

The Dashboard tracks national and jurisdictional progress for the six EHE indicators leading to the overarching goal of the initiative: reducing new HIV transmissions 75% by 2025 and 90% by 2030.

_{*To achieve maximum impact, the Ending the HIV Epidemic initiative focuses its Phase I efforts in 48 counties, Washington, DC, and San Juan, Puerto Rico, where >50% of new HIV diagnoses occurred in 2016 and 2017, and an additional seven states with a substantial number of HIV diagnoses in rural areas, bringing the total number of Phase I jurisdictions to 57.}

The Dashboard features data on the six EHE indicators for each of the 57 prioritized jurisdictions, all states, and for the nation as a whole. The Dashboard displays data for: HIV incidence, Knowledge of HIV status, HIV diagnoses, Linkage to HIV medical care, Viral suppression, and PrEP coverage.

AHEAD strives to provide the most updated data possible to aid in implementing timely public health strategies. Although data for most of the indicators will be updated on an annual basis, linkage to HIV medical care, diagnoses, and PrEP coverage data will be updated quarterly as data become available. AHEAD will send updates through the HIV.gov listserv whenever new data are added to the Dashboard.

On AHEAD, stakeholders can:

• View goals for the 57 priority areas;
• Review cumulative quarterly data;
• Filter by specific EHE HIV indicator data;
• Filter by demographic variables at the national, state, and local levels;
• Compare data across peer, county-level priority areas through an automated comparison feature;
• Contextualize the data: HIV diagnoses data are presented alongside HIV linkage to care data to foster a deeper understanding of the relationship between indicators; and
• Download data in multiple ways: all AHEAD data, partial data, and as a graphic.

Funding for the Dashboard is provided by OASH’s Minority HIV/AIDS Fund (MHAF) and development of this project is being managed by the Office of Infectious Disease and HIV/AIDS Policy (OIDP).

At this time, there are no plans to add any additional indicators.

These indicators were chosen because progress on these indicators will have the greatest impact on ending the HIV epidemic in the U.S. by 2030: incidence, diagnoses, knowledge of status, linkage to HIV medical care, viral suppression, and PrEP coverage.

These six indicators were chosen with specific public health goals in mind in addition to aligning with the four key strategies of the initiative: diagnose, prevent, treat and respond. Incidence measures our overarching goal of reducing new transmissions by 90% by 2030. Diagnoses, and knowledge of status are both key to identifying which individuals need to be linked to HIV medical care and represent important steps on the HIV Care Continuum. Data have shown that, upon diagnosis, immediate linkage to HIV medical care and treatment results in improved HIV outcomes, so it is important to track how these indicators change over time. If scaled, viral suppression, and PrEP use are the two EHE indicators that will have the greatest impact on reducing new transmissions.

The six indicators were selected by a federal working group comprised of CDC, HRSA, NIH and others. Progress in these six indicators would have the most impact towards reaching the EHE goals. As part of this selection process, other indicators, such as those that are part of the HIV Care Continuum were not chosen

Only the 50 priority counties/areas and 7 priority states/territories are funded as part of the EHE initiative and have established EHE goals.

The overarching goal refers to the main goal of the Ending the HIV Epidemic initiative: to end the HIV epidemic in the U.S. by reducing the number of HIV infections 75% by 2025 and 90% by 2030. That is why the overarching goal is tied to the incidence indicator. The midterm goal refers to the indicator that will give us the best idea of overall progress which is knowledge of HIV status. The knowledge of HIV status indicator is tied to the midterm goal because an increase in knowledge of status gives us a good indication that we are making progress.

For incidence, the stated EHE 2030 goal is a 90% reduction from baseline year (2017) and the stated 2025 goal is a 75% reduction; these also apply to the diagnosis indicator. The stated 2030 and 2025 goals for other EHE indicators are as follows:

• Knowledge of status: 95%
• Linkage to care: 95%
• Viral suppression: 95%
• PrEP coverage: 50%

Ending the HIV Epidemic initiative focuses its efforts in 48 counties, Washington, DC, and San Juan, Puerto Rico, where >50% of HIV diagnoses occurred in 2016 and 2017, and an additional seven states with a substantial number of HIV diagnoses in rural areas, bringing the total number of Phase I jurisdictions to 57.

The 50 priority counties/areas are:

• Maricopa County, AZ
• Alameda County, CA
• Los Angeles County, CA
• Orange County, CA
• Riverside County, CA
• Sacramento County, CA
• San Bernardino County, CA
• San Diego County, CA
• San Francisco County, CA
• District of Columbia
• Broward County, FL
• Duval County, FL
• Hillsborough County, FL
• Miami-Dade County, FL
• Palm Beach County, FL
• Pinellas County, FL
• Cobb County, GA
• De Kalb County, GA
• Fulton County, GA
• Gwinnett County, GA
• Cook County, IL
• Marion County, IN
• East Baton Rouge Parish, LA
• Orleans Parish, LA
• Baltimore City, MD
• Montgomery County, MD
• Prince George’s County, MD
• Suffolk County, MA
• Wayne County, MI
• Clark County, NV
• Essex County, NJ
• Hudson County, NJ
• Bronx County, NY
• Kings County, NY
• New York County, NY
• Queens County, NY
• Mecklenburg County, NC
• Cuyahoga County, OH
• Franklin County, OH
• Hamilton County, OH
• Philadelphia County, PA
• San Juan Municipio, Puerto Rico
• Shelby County, TN
• Bexar County, TX
• Dallas County, TX
• Harris County, TX
• Tarrant County, TX
• Travis County, TX
• King County, WA

The 7 priority states are:

• Alabama
• Arkansas
• Kentucky
• Mississippi
• Missouri
• Oklahoma
• South Carolina

While Phase I of EHE focuses on the 57 priority areas, reaching the 2030 goal of reducing the number of new HIV infections to 3,000 or less, will require the effort of the entire nation. Data for all 50 states are provided so that all states have an opportunity to see their indicator data to inform their planning processes.

The data source for 5 of the 6 EHE indicators is CDC's National HIV Surveillance System, the primary source for monitoring HIV trends in the United States. CDC funds and assists state and local health departments to collect the information.

The sixth indicator, pre-exposure prophylaxis (PrEP) coverage uses 4 data sources: IQVIA, American Community Survey (ACS), National Health and Nutrition Examination Survey (NHANES), and the National HIV Surveillance System (NHSS).

IQVIA is a pharmacy database that is used as the data source for the numerator, which is the number of persons classified as having been prescribed PrEP. Three data sources, ACS, NHANES, and NHSS are used to estimate the denominator, the number of persons with indicators for PrEP. Additionally, in one instance, Puerto Rico ACS is used in combination with NHANES and NHSS to estimate PrEP coverage denominator for Puerto Rico.

The EHE community plans are available on CDC's website.

At this time there are no plans to add STI/STD data to the Dashboard. STI/STD data can be found in CDC's 2020 STD Surveillance Report.

2020 was the first year of implementation of the EHE initiative. Since 2017 was selected as the baseline for calculation of the goals for each priority area, data for 2018 and 2019 can provide additional context and understanding.

Data for the year 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and HIV case surveillance activities in state/local jurisdictions. Inclusion of 2020 data in trend assessments is discouraged.

The reduction in HIV diagnoses in 2020 is likely due to disruptions in clinical care services, patient hesitancy in accessing clinical services, and shortages in HIV testing reagents/materials during the COVID-19 pandemic.

Estimates of new HIV infections (HIV incidence) and knowledge of HIV status are not available for the year 2020 due to the impact of the COVID-19 pandemic on HIV testing. More time and data are needed to accurately assess COVID-19’s impact on HIV transmission in the United States. 

AHEAD can be cited in the following format, using APA style.

U.S. Health and Human Services. (2019, August 18). America's HIV Epidemic Analysis Dashboard (AHEAD). Retrieved from https://ahead.hiv.gov/

The EHE jurisdictions can view and track their progress towards meeting the goals for each indicator and view their data alongside that of other jurisdictions.

By monitoring progress towards their indicator goals, jurisdictions can identify which indicators they need to direct more resources to in order to reach their 2025 and 2030 goals. Innovative strategies or “success stories” can be shared with other priority areas to assist them in reaching their goals. The Dashboard may also be used to indicate that jurisdictions may need additional technical assistance and support. This information can also be used to inform public health action, including future notice of funding opportunities, studies, and other activities.

Yes, you can download the data in multiple ways: all AHEAD data, partial data, and as a graphic.

Yes. The Dashboard was conceived and developed as a resource on HIV indicator data for a broad range of audiences. The Dashboard can be used by the EHE jurisdictions, federal government, community, and other stakeholders at local, state, and national levels to monitor progress in reaching EHE goals. As a public-facing dashboard, it can be used by anyone interested in understanding the HIV epidemic in the United States and the nation’s efforts to address HIV in the most impacted areas of the country.

Data may not match because CDC de-duplicates cases at the national level, and national data have been statistically adjusted to account for missing transmission category. CDC aims to provide standardized data to make it easier to compare across jurisdictions and view data over time.

HHS will continue to host a series of webinars and listening sessions throughout the evolution of the Dashboard at which stakeholders are encouraged to provide input and express feedback. Stakeholders can also provide feedback via e-mail at: endHIVepidemic@hhs.gov.

Yes, stakeholders can sign up for EHE updates from AHEAD and HIV.gov by clicking here.

By visiting HIV.gov, the federal government's leading source for information about HIV.