HIV death rate drops by half, 2010-18

Deaths related to HIV in the United States fell significantly from 2010 through 2018, regardless of sex, age, race or region, the Centers for Disease Control and Prevention reported Thursday.

The death rate declined overall by about half, a welcome sign in the fight against the virus, experts said. But the data also highlighted some troubling trends: Gains among women, Black people and those of multiple races were much smaller. And the rate of death was about twice as high in Southern states as in the Northeast.

And it is possible the pandemic has dampened these improvements. The CDC did not offer numbers on testing for HIV or access to pre- exposure prophylaxis therapy over the past few months, but many facilities have shuttered their HIV clinics or reported decreases in the number of people using their services, the researchers said. Still, experts said the news was a testament to the enormous strides made in efforts to end the HIV epidemic.

“The reduction in death is something that we couldn’t have imagined even as recently as 2010,” roughly a decade after the introduction of powerful antiretroviral drugs, said Dr. Jeanne Marrazzo, director of infectious diseases at the University of Alabama in Birmingham, who was not involved in the work. “The fact that these therapies have become so standard and turned things around for so many people is just incredibly gratifying and astonishing.”

Marrazzo credited the success to investments in HIV care, including through the federal Ryan White HIV/AIDS Program, for such services as nutritional support, social work, psychiatry and other assistance. “This is not just about the drugs. It’s the entire structure that supports people,” she said. “Sometimes that’s lost in the dialogue.”

From 1990 through 2011, deaths among people with AIDS decreased significantly. They dropped even more after 2012, when treatment guidelines began recommending antiretroviral therapy for anyone with HIV.