9 in 10 new U.S. HIV infections come from people not receiving HIV care

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New CDC analysis reinforces importance of HIV testing and treatment for health and prevention

via Press Release from the CDC

More than 90 percent of new HIV infections in the United States could be averted by diagnosing people living with HIV and ensuring they receive prompt, ongoing care and treatment. This finding was published today in JAMA Internal Medicine by researchers at the Centers for Disease Control and Prevention.

The analysis showed that 30 percent of new HIV infections were transmitted from people who did not know that they were infected with the virus, highlighting the importance of getting tested. People who had been diagnosed were less likely to transmit their infection, in part because people who know they have HIV are more likely to take steps to protect their partners from infection.

“Positive or negative, an HIV test opens the door to prevention. For someone who is positive, it can be the gateway to care and the signal to take steps to protect partners from infection. For someone who tests negative, it can be a direct link to important prevention services to help them stay HIV-free,” said Eugene McCray, MD, director of CDC’s Division of HIV/AIDS Prevention.

People who were successfully keeping the virus under control through treatment were 94 percent less likely than those who did not know they were infected to transmit their virus. However, previous national estimates have indicated that just 30 percent of people with HIV have reached this critical step in care.

The study authors stress that effective HIV care offers multiple mechanisms to prevent transmission. For example, in addition to antiretroviral therapy, HIV care should include risk reduction counseling on how to protect their partners, screening and treatment for other sexually transmitted infections, and treatment for mental health and substance use disorders.

This is the latest in a growing body of evidence that prevention of new infections depends on reaching people who are HIV-positive with testing, care, and treatment. CDC has responded by more extensively focusing its prevention strategy on people living with HIV, while continuing to ensure HIV-negative people have tools and information about all available prevention options, including daily pre-exposure prophylaxis.

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