Data Methods

 HIV 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 therefore qualify as “most recent,” the highest viral load (most severe) 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 states that have complete data, which is defined as states that have reported at least 95% of laboratory results 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. 

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.

For the baseline year 2017, HIV viral suppression was 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.

Similarly, 2018 HIV viral suppression data was available for 41 states and the District of Columbia. However, the composition of the states changed. In 2018, viral suppression data was available for Nevada but not available for Connecticut. For the year 2019, the number of jurisdictions with HIV viral suppression data increased to include 44 states and the District of Columbia. Completeness of reporting varied among states and local jurisdictions. 

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 and New Jersey. Areas with incomplete reporting: Kentucky, Pennsylvania (excluding Philadelphia), Vermont, and Puerto Rico.

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. 

Data for the year 2021 are preliminary. Due to the impact of the COVID-19 pandemic, data for the year 2020 should be interpreted with caution. COVID-19 disruptions in HIV, diagnosis, care and reporting of deaths during 2020 have also made incidence, prevalence, and knowledge of status estimates derived from a CD4-based model, unreliable. Therefore, the HIV surveillance supplemental report Estimated HIV Incidence and Prevalence in the U.S., which provides data on estimated incidence, prevalence, and knowledge of status in the U.S., was not published by CDC this year.

More information about HIV Viral Suppression data can be found at: HIV Surveillance Report Supplemental Report Volume 27, Number 3. 

The most recent CDC HIV Viral Suppression data can be found at: HIV Surveillance Data Tables 2022, Vol. 3, No. 1.