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The risk of being diagnosed with HIV declined by about 11% in the latest analysis of disease trends in the U.S., CDC researchers reported.

Compared with 2010-2014 when the overall risk of being diagnosed with HIV was 1 in 106, the risk was reduced to 1 in 120 during 2017-2019, said Sonia Singh, PhD, of the CDC's Division of HIV Prevention in Atlanta, in a presentation at the virtual Conference on Retroviruses and Opportunistic Infections.

Singh and colleagues meshed data from the National HIV Surveillance System, mortality data from the National Center for Health Statistics, and census data to determine the overall risk of being diagnosed with HIV. The analysis stratified risks by sex, age, and racial groups, but did not assess risk for behavioral factors, she noted.

"Lifetime risk may be a useful tool to more effectively communicate the burden of HIV overall and in specific communities," Singh said in her oral presentation, adding that the findings my help highlight areas of the country where prevention efforts can be accelerated.

James Hoxie, MD, emeritus professor of medicine at the University of Pennsylvania Perelman School of Medicine in Philadelphia, told MedPage Today, "This is an important message for the public -- and that is there is considerable ongoing risk of infection in the U.S."

Hoxie, co-moderator of a press conference at which Singh discussed her findings, said, "The disparities in race, risk group, and geographical region have been appreciated, but I had not seen these issues presented as a 'probability of being infected during a lifetime' before. It magnifies the ongoing need to address these risks and the disparities that drive them."

Singh reported that the highest risk of being diagnosed with HIV infection was in Washington, D.C., where 1 in 39 individuals are likely to be diagnosed with HIV during their lifetime. The Southeast has the next highest areas of risk, she told MedPage Today, with the risks greatest in Georgia (1 in 59 people), Florida (1 in 63 people), and Louisiana (1 in 69 people).

States where the risk of a lifetime diagnosis of HIV is lowest are Wyoming (1 in 655 people), Idaho (1 in 624), Maine (1 in 584), Montana (1 in 536), New Hampshire (1 in 533), and Vermont (1 in 515).

Singh explained that the analysis assumes that the rate of infection will continue, adding that the decline seen between the two periods "tells us that prevention efforts work."

Men, she said, are at greater risk of an HIV diagnosis in their lifetime compared with women. Overall, the lifetime risk of an HIV diagnosis for men is 1 in 78, compared with 1 in 306 for women.

In addition, Black men overall have a lifetime risk of 1 in 27; for black women, the risk is 1 in 75. Hispanic men have a lifetime risk of 1 in 50, while Hispanic women have a lifetime risk of 1 in 287. White men have a lifetime risk of 1 in 171 compared with 1 in 874 for white women.

The lowest risk for both men and women overall is for people who identify as Asian: 1 in 187 for men and 1 in 1,298 for women, Singh said.

She noted that the analysis had several limitations, including that the study was based on diagnosis data, not on incidence; and that HIV status is sometimes omitted from the death certificates of people who were HIV-positive.

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