Highly variable trends in rates of newly diagnosed HIV cases in U.S. hotspots, 2008-2017
The U.S. Ending the HIV Epidemic (EHE) initiative was announced in early 2019 and rapidly became a focal point for domestic HIV prevention and treatment programs. Using publicly available data from CDC, we examined historical trends in the average annual percent change (AAPC) in HIV diagnosis rates...
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| description | The U.S. Ending the HIV Epidemic (EHE) initiative was announced in early 2019 and rapidly became a focal point for domestic HIV prevention and treatment programs. Using publicly available data from CDC, we examined historical trends in the average annual percent change (AAPC) in HIV diagnosis rates for the 57 EHE high incidence "hotspots" using Joinpoint analysis. We then assessed the ecologic association of various hotspot characteristics with changes in these rates over time using a multivariable regression model. From 2008-2017, the overall rate of newly diagnosed HIV cases in the U.S. declined from 19 to 14 per 100,000 persons, with the AAPC declining significantly in the U.S. overall (-3.1%; 95% CI: -3.7, -2.4) and in the 57 hotspots (-3.3%; 95% CI: -4.6, -2.8). There were large (AAPC 0.0) noted in seven hotspots. In the multivariable regression analysis, higher initial HIV diagnosis rate and location in the Northeast region were significantly associated with declining AAPC rates whereas no significant differences were found by hotspot gender, age, or race/ethnicity distribution. This analysis demonstrates that the rate of decline in HIV diagnosis rates in hotspots across the U.S. has been highly variable. Further exploration is warranted to assess the correlation between programmatic factors such as HIV testing and antiretroviral therapy and pre-exposure prophylaxis coverage with HIV trends across the hotspots. |
| doi_str_mv | 10.1371/journal.pone.0250179 |
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Using publicly available data from CDC, we examined historical trends in the average annual percent change (AAPC) in HIV diagnosis rates for the 57 EHE high incidence "hotspots" using Joinpoint analysis. We then assessed the ecologic association of various hotspot characteristics with changes in these rates over time using a multivariable regression model. From 2008-2017, the overall rate of newly diagnosed HIV cases in the U.S. declined from 19 to 14 per 100,000 persons, with the AAPC declining significantly in the U.S. overall (-3.1%; 95% CI: -3.7, -2.4) and in the 57 hotspots (-3.3%; 95% CI: -4.6, -2.8). There were large (AAPC <-5.0), moderate (-5.0 to -2.5) and small (-2.5 to 0.0) rates of decline in 14, 19 and 17 hotspots respectively, with increasing trends (AAPC >0.0) noted in seven hotspots. In the multivariable regression analysis, higher initial HIV diagnosis rate and location in the Northeast region were significantly associated with declining AAPC rates whereas no significant differences were found by hotspot gender, age, or race/ethnicity distribution. This analysis demonstrates that the rate of decline in HIV diagnosis rates in hotspots across the U.S. has been highly variable. 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In the multivariable regression analysis, higher initial HIV diagnosis rate and location in the Northeast region were significantly associated with declining AAPC rates whereas no significant differences were found by hotspot gender, age, or race/ethnicity distribution. This analysis demonstrates that the rate of decline in HIV diagnosis rates in hotspots across the U.S. has been highly variable. 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Using publicly available data from CDC, we examined historical trends in the average annual percent change (AAPC) in HIV diagnosis rates for the 57 EHE high incidence "hotspots" using Joinpoint analysis. We then assessed the ecologic association of various hotspot characteristics with changes in these rates over time using a multivariable regression model. From 2008-2017, the overall rate of newly diagnosed HIV cases in the U.S. declined from 19 to 14 per 100,000 persons, with the AAPC declining significantly in the U.S. overall (-3.1%; 95% CI: -3.7, -2.4) and in the 57 hotspots (-3.3%; 95% CI: -4.6, -2.8). There were large (AAPC <-5.0), moderate (-5.0 to -2.5) and small (-2.5 to 0.0) rates of decline in 14, 19 and 17 hotspots respectively, with increasing trends (AAPC >0.0) noted in seven hotspots. In the multivariable regression analysis, higher initial HIV diagnosis rate and location in the Northeast region were significantly associated with declining AAPC rates whereas no significant differences were found by hotspot gender, age, or race/ethnicity distribution. This analysis demonstrates that the rate of decline in HIV diagnosis rates in hotspots across the U.S. has been highly variable. Further exploration is warranted to assess the correlation between programmatic factors such as HIV testing and antiretroviral therapy and pre-exposure prophylaxis coverage with HIV trends across the hotspots.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33872328</pmid><doi>10.1371/journal.pone.0250179</doi><tpages>e0250179</tpages><orcidid>https://orcid.org/0000-0001-7830-8003</orcidid><orcidid>https://orcid.org/0000-0003-1674-0217</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acquired immune deficiency syndrome Adolescent Adult Aged AIDS Biology and Life Sciences Correlation Disease control Disease prevention Distribution Epidemics Epidemiology Ethnicity Female HIV HIV infection HIV Infections - diagnosis HIV Infections - transmission HIV Testing - statistics & numerical data HIV Testing - trends HIV-1 - pathogenicity Human immunodeficiency virus Humans Incidence Male Mathematical models Medical diagnosis Medicine and health sciences Middle Aged Minority & ethnic groups Model testing People and places Physical Sciences Pre-Exposure Prophylaxis Prevention Public health Regression analysis Regression models Research and Analysis Methods Trends United States Variables Websites |
| title | Highly variable trends in rates of newly diagnosed HIV cases in U.S. hotspots, 2008-2017 |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-22T17%3A40%3A18IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Highly%20variable%20trends%20in%20rates%20of%20newly%20diagnosed%20HIV%20cases%20in%20U.S.%20hotspots,%202008-2017&rft.jtitle=PloS%20one&rft.au=Segarra,%20Lorena&rft.date=2021-04-19&rft.volume=16&rft.issue=4&rft.spage=e0250179&rft.pages=e0250179-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0250179&rft_dat=%3Cgale_plos_%3EA658982377%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2515040966&rft_id=info:pmid/33872328&rft_galeid=A658982377&rft_doaj_id=oai_doaj_org_article_5cc54291635343d9b50b5c4edfa64739&rfr_iscdi=true |