New HIV infections down, but many aren’t getting drugs

Young people drove a decrease in new HIV diagnoses in 2021, but stark disparities remain, federal data shows.

That year, the nation saw a 12% drop in new HIV infections compared with 2017. Young people ages 13 to 24 had the biggest decline – with roughly 34% fewer cases, according to estimates in the Centers for Disease Control and Prevention’s report, released Tuesday.

Gay and bisexual males accounted for about 80% of new infections among the age group, which suggests testing, treatment and outreach strategies have contributed to progress, the CDC says.

But that outreach isn’t reaching everyone equally.

For young gay and bisexual males, new infections dropped 27% in the Black community and 36% in the Hispanic and Latino community. But their white counterparts saw a far larger decrease of 45%, CDC data shows.

Similar disparities exist in those prescribed PrEP, or pre- exposure prophylaxis, a highly effective drug to lessen the chance of contracting HIV from sex or drug use by injection. Although Black and Hispanic or Latino people make up most of those who could benefit from the drug, CDC data shows, few are getting it: Fewer than a quarter of both groups are getting the prescription, and systemic inequities and structural barriers continue to fuel the disparities.

What are the key findings?

In 2021, the U. S. had about 32,100 total new HIV infections, about 12% less than the 36,500 total cases in 2017.

That year, teens and young adults ages 13 to 24 had about 6,100 new cases, down from about 9,300. Among gay and bisexual males of that age group:

● More were aware of their HIV status: about 56% in 2021 compared with 42% in 2017.

● New cases in Black males decreased from 3,700 to about 2,700.

● New cases in Hispanic and Latino males decreased from 2,200 to 1,400.

● New cases in white males decreased 1,100 to 610.

● White people made up the majority of new cases among those who inject drugs.

More than half – 52% – of total new HIV infections were in the South.

What about women?

One in 10 women are unaware they have HIV, and PrEP use among women is low. Women made up about 18% of total cases in 2021.

Social and systemic inequities such as poverty and structural racism contribute to disparities in women of color. Black women continue to make up the largest portion of new cases among women, with 2,900 cases in 2021 compared with fewer than 1,000 among Hispanic, Latino and white women who contracted it through heterosexual contact.

A larger proportion of Asian females saw a late- stage diagnosis, followed by Black, Hispanic or Latino, and multiracial females, though the CDC says the numbers for Asian and Indigenous people are small in the report and should be interpreted with caution.

Who is getting PrEP?

Deep disparities remain among those who are getting PrEP prescriptions, and overall viral suppression was lower among Black and Hispanic or Latino people than among white people.

The report found that 78% of eligible white patients were prescribed PrEP, compared with just 11% of Black or African American people and 20% of Hispanic or Latino people.

Overall, in 2021, about 30% of more than 1 million who could have benefited from PrEP were prescribed the drug, up from just 13% in 2017.