HIV Transmission Rates in the United States, 2006-2008

National HIV incidence for a given year x [I(x)] equals prevalence [P(x)] times the transmission rate [T(x)]. Or, simply rearranging the terms, T(x) = [I(x)/P(x)]*100 (where T(x) is the number of HIV transmissions per 100 persons living with HIV in a given year). The transmission rate is an underutilized measure of the speed at which the epidemic is spreading. Here, we utilize recently updated information about HIV incidence and prevalence in the U.S. to estimate the national HIV transmission rate for 2006 through 2008, and present a novel method to express the level of uncertainty in these estimates. Transmission rate estimates for 2006 through 2008 are as follows (respectively): 4.39 (4.01 to 4.73); 4.90 (4.49 to 5.28); and 4.06 (3.70 to 4.38). Although there are methodological challenges inherent in making these estimates, they do give some indications that the U.S. HIV transmission rate is at a historically low level.

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HIV Transmission Rates and Factors Associated with Recent HIV Infection: Results from the Ndhiwa HIV Impact Assessment, South Nyanza, Kenya, 2012

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx162.037 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S15-S15

Author(s):

Elfriede Agyemang ◽

Clement Zeh ◽

Irene Mukui ◽

David Maman ◽

Andrea Kim

Keyword(s):

Hiv Infection ◽

Impact Assessment ◽

Hiv Transmission ◽

Transmission Rate ◽

Hiv Incidence ◽

Recent Infection ◽

Targeted Interventions ◽

Transmission Rates ◽

Factors Associated ◽

Persons Living With Hiv

Abstract Background Identifying populations with high HIV transmission rates is important for prevention and treatment strategies. Persons with recently acquired HIV infection are drivers of HIV transmission due to high levels of HIV viral load (VL). We assessed annual HIV transmission rates and factors associated with recent infection to inform targeted interventions in a hyperendemic region in Kenya. Methods The Ndhiwa HIV impact assessment was a population-based survey among persons aged 15–59 years living in South Nyanza, Kenya in 2012. Respondents were tested for HIV using rapid tests per national guidelines and provided blood for centralized testing. Specimens from HIV+ persons were tested for VL and recent infection. Recent infection was defined as normalized optical density value <1.5 on the Limiting Antigen Enzyme Immunoassay, VL >1,000 copies/mL, and no report of HIV treatment. The annual HIV transmission rate per 100 persons living with HIV (PLHIV) was calculated as HIV incidence divided by HIV prevalence, multiplied by 100. Annualized HIV incidence was estimated, assuming a mean duration of recent infection of 141 days (confidence interval [CI] 123–160). Multivariate analysis identified independent factors associated with recent infection. Estimates were adjusted for survey design. Results Of 6,076 persons tested, 1,457 were HIV+, and 28 were recently infected. HIV incidence and prevalence were 1.7% (CI 1.5–2.0) and 24.1% (CI 22.6–25.5), respectively. Per 100 PLHIV, the annual HIV transmission rate was 7.0 and varied by sex (4.6 male vs. 8.3 female), age (5.2 aged 30+ vs. 10.4 aged <30), and residence (1.4 Kobama vs. 12.0 Riana vs. 12.1 Pala divisions). After controlling for age, sex, and residence, recently infected persons were significantly more likely to reside in Pala division (AOR 8.3, CI 1.1–62.9) than HIV-uninfected persons. Conclusion Approximately 7 in 100 PLHIV transmitted to HIV-uninfected persons in South Nyanza in 2012, similar to national rates observed in the 2012 Kenya AIDS Indicator Survey. HIV transmission rates were higher in females than males, younger than older, and Riana and Pala than other divisions. Residence in Pala was a risk factor for recent infection. These findings could guide prioritization of interventions to interrupt HIV transmission in this hyperendemic setting. Disclosures All authors: No reported disclosures.

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Implementation of a Rapid Entry Program Decreases Time to Viral Suppression Among Vulnerable Persons Living With HIV in the Southern United States

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy104 ◽

2018 ◽

Vol 5 (6) ◽

Cited By ~ 26

Author(s):

Jonathan Colasanti ◽

Jeri Sumitani ◽

C Christina Mehta ◽

Yiran Zhang ◽

Minh Ly Nguyen ◽

...

Keyword(s):

United States ◽

Viral Suppression ◽

Hiv Transmission ◽

Positive Impact ◽

Population Level ◽

The United States ◽

Clinic Visit ◽

Art Initiation ◽

Persons Living With Hiv ◽

Sex With Men

Abstract Background Rapid entry programs (REPs) improve time to antiretroviral therapy (ART) initiation (TAI) and time to viral suppression (TVS). We assessed the feasibility and effectiveness of a REP in a large HIV clinic in Atlanta, Georgia, serving a predominately un- or underinsured population. Methods The Rapid Entry and ART in Clinic for HIV (REACH) program was implemented on May 16, 2016. We performed a retrospective cohort study with the main independent variable being period of enrollment: January 1, 2016, through May 15, 2016 (pre-REACH); May 16, 2016, through July 31, 2016 (post-REACH). Included individuals were HIV-infected and new to the clinic with detectable HIV-1 RNA. Six-month follow-up data were collected for each participant. Survival analyses were conducted for TVS. Logistic and linear regression analyses were used to evaluate secondary outcomes: attendance at first clinic visit, viral suppression, TAI, and time to first attended provider visit. Results There were 117 pre-REACH and 90 post-REACH individuals. Median age (interquartile range [IQR]) was 35 (25–45) years, 80% were male, 91% black, 60% men who have sex with men, 57% uninsured, and 44% active substance users. TVS decreased from 77 (62–96) to 57 (41–70) days (P < .0022). Time to first attended provider visit decreased from 17 to 5 days, and TAI from 21 to 7 days (P < .0001), each remaining significant in adjusted models. Conclusions This is the largest rapid entry cohort described in the United States and suggests that rapid entry is feasible and could have a positive impact on HIV transmission at the population level.

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Socioeconomic, Behavioral, and Clinical Characteristics of Persons Living with HIV Who Experience Homelessness in the United States, 2015–2016

AIDS and Behavior ◽

10.1007/s10461-019-02704-4 ◽

2019 ◽

Vol 24 (6) ◽

pp. 1701-1708 ◽

Cited By ~ 1

Author(s):

Jacob J. Wainwright ◽

◽

Linda Beer ◽

Yunfeng Tie ◽

Jennifer L. Fagan ◽

...

Keyword(s):

United States ◽

Clinical Characteristics ◽

The United States ◽

Persons Living With Hiv ◽

Living With Hiv

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Sociocultural Factors Influencing The Transmission of HIV/AIDS in The United States

10.1093/med/9780199392742.003.0009 ◽

2017 ◽

Author(s):

Robert E Fullilove

Keyword(s):

United States ◽

Criminal Justice ◽

Correctional Facility ◽

The United States ◽

Hiv Care ◽

Sociocultural Factors ◽

Effective Interventions ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Hiv Aids

This chapter discusses the unique impact that social disadvantage in general and the criminal justice systems in the United States in particular have on the conditions that drive the HIV/AIDS epidemic in this country. HIV/AIDS is classified as an important racial/ethnic health disparity because residents of marginalized black and Hispanic communities are overrepresented among persons living with HIV/AIDS in the United States. Members of black and Hispanic communities are also overrepresented in the criminal justice; in terms of the epidemic, approximately one out of seven persons living with HIV/AIDS will pass through a U.S. correctional facility in any given year. A history of incarceration is associated with poor treatment outcomes for HIV illness. Improving the quality of HIV care in correctional facilities and in the communities to which incarcerated persons will return is imperative, as is effective interventions in incarcerated populations and communities. Having AIDS activists, scientists, and healthcare workers join in efforts to reform incarceration policies and practices will improve efforts to prevent and treat HIV/AIDS, particularly in communities that confront high rates of HIV/AIDS and incarceration.

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Persons Living With HIV in the United States

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0000000000001008 ◽

2016 ◽

Vol 72 (5) ◽

pp. 552-557 ◽

Cited By ~ 20

Author(s):

Qiang Xia ◽

Sarah L. Braunstein ◽

Ellen W. Wiewel ◽

Joanna J. Eavey ◽

Colin W. Shepard ◽

...

Keyword(s):

United States ◽

The United States ◽

Persons Living With Hiv ◽

Living With Hiv

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Updated Annual HIV Transmission Rates in the United States, 1977-2006

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e31819001be ◽

2009 ◽

Vol 50 (2) ◽

pp. 236-238 ◽

Cited By ~ 33

Author(s):

David R Holtgrave ◽

H Irene Hall ◽

Philip H Rhodes ◽

Richard J Wolitski

Keyword(s):

United States ◽

Hiv Transmission ◽

The United States ◽

Transmission Rates

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Antiretroviral treatment among commercially insured persons living with HIV in an era of universal treatment in the United States – 2012–2014

AIDS Care ◽

10.1080/09540121.2018.1489099 ◽

2018 ◽

Vol 30 (9) ◽

pp. 1128-1134 ◽

Cited By ~ 3

Author(s):

Kashif Iqbal ◽

Ya-lin A. Huang ◽

Philip Peters ◽

Paul Weidle ◽

Karen Hoover

Keyword(s):

United States ◽

Antiretroviral Treatment ◽

The United States ◽

Persons Living With Hiv ◽

Living With Hiv ◽

Universal Treatment

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Genomic epidemiology identifies emergence and rapid transmission of SARS-CoV-2 B.1.1.7 in the United States

10.1101/2021.02.06.21251159 ◽

2021 ◽

Cited By ~ 3

Author(s):

Nicole L. Washington ◽

Karthik Gangavarapu ◽

Mark Zeller ◽

Alexandre Bolze ◽

Elizabeth T. Cirulli ◽

...

Keyword(s):

United States ◽

Transmission Rate ◽

Growth Dynamics ◽

The United States ◽

Gene Target ◽

Genomic Epidemiology ◽

The United Kingdom ◽

Rapid Transmission ◽

Decisive Action ◽

The U.S

SummaryAs of January of 2021, the highly transmissible B.1.1.7 variant of SARS-CoV-2, which was first identified in the United Kingdom (U.K.), has gained a strong foothold across the world. Because of the sudden and rapid rise of B.1.1.7, we investigated the prevalence and growth dynamics of this variant in the United States (U.S.), tracking it back to its early emergence and onward local transmission. We found that the RT-qPCR testing anomaly of S gene target failure (SGTF), first observed in the U.K., was a reliable proxy for B.1.1.7 detection. We sequenced 212 B.1.1.7 SARS-CoV-2 genomes collected from testing facilities in the U.S. from December 2020 to January 2021. We found that while the fraction of B.1.1.7 among SGTF samples varied by state, detection of the variant increased at a logistic rate similar to those observed elsewhere, with a doubling rate of a little over a week and an increased transmission rate of 35-45%. By performing time-aware Bayesian phylodynamic analyses, we revealed several independent introductions of B.1.1.7 into the U.S. as early as late November 2020, with onward community transmission enabling the variant to spread to at least 30 states as of January 2021. Our study shows that the U.S. is on a similar trajectory as other countries where B.1.1.7 rapidly became the dominant SARS-CoV-2 variant, requiring immediate and decisive action to minimize COVID-19 morbidity and mortality.

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Estimation of COVID-19 transmission rates in California and the U.S. with reporting delays

10.1101/2020.05.14.20101162 ◽

2020 ◽

Author(s):

Lee Worden ◽

Rae Wannier ◽

Micaela Neus ◽

Jennifer C. Kwan ◽

Alex Y. Ge ◽

...

Keyword(s):

United States ◽

Symptom Onset ◽

The United States ◽

Time Varying ◽

Transmission Rates ◽

Reproduction Numbers ◽

Serial Interval ◽

Reporting Delays ◽

Interval Distribution ◽

The U.S

We estimated time-varying reproduction numbers of COVID-19 transmission in counties and regions of California and in states of the United States, using the Wallinga-Teunis method of estimations applied to publicly available data. The serial interval distribution assumed incorporates wide uncertainty in delays from symptom onset to case reporting. This assumption contributes smoothing and a small but meaningful increase in numerical estimates of reproduction numbers due to the likely existence of secondary cases not yet reported. Transmission in many areas of the U.S. may not yet be controlled, including areas in which case counts appear to be stable or slowly declining.

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