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  Conference on Retroviruses
and Opportunistic Infections
February 12-16, 2022
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Lifetime HIV Risk 1 in 120 in US,
Highest in Black and Hispanic Males
  2022 CROI, February 12-16 and 22-24, 2022
Mark Mascolini
People in the United States run a 1 in 120 lifetime risk of HIV infection, according to an analysis by the Centers for Disease Control and Prevention (CDC) based on 2017-2019 data [1]. Subgroup risk of HIV proved highest in black males at 1 in 27, followed by Hispanic males at 1 in 50 then black females at 1 in 75.
CDC epidemiologists noted that lifetime risk of disease-a concept easily grasped by the public-can be used to compare disease burden across population subgroups. Clinicians, outreach workers, and policy makers might all find lifetime risk of HIV infection a useful educational and analytic tool, the CDC suggested.
Focusing on 2017-2019 numbers, the CDC team tapped data from the National HIV Surveillance System, the National Center for Health Statistics, and the US Census. They defined lifetime risk as the cumulative probability of getting diagnosed with HIV from birth. They calculated the probability of HIV diagnosis at a given age by analyzing numbers of HIV diagnoses and non-HIV deaths, assuming 2017-2019 diagnosis rates continue.
Overall lifetime risk of HIV infection in the United States stands at 1 in 120. The rate is highest in Washington, DC (1 in 39), followed by Georgia (1 in 59), Florida (1 in 63), Louisiana (1 in 69), and Maryland (1 in 85). Starting in North Carolina and sweeping across the southernmost states to Texas, all states have a lifetime HIV risk below 1 in 115. Wyoming claims the best lifetime risk, at 1 in 655, followed by Idaho at 1 in 624, Montana at 1 in 536, Alaska at 1 in 417, and Utah at 1 in 361. East of the Mississippi, only three states have a lifetime HIV risk above 1 in 500: Vermont at 1 in 515, New Hampshire at 1 in 533, and Maine at 1 in 584.
By age and race or ethnicity, these US groups have the highest lifetime risk of HIV:
- Black males: 1 in 27
- Hispanic males: 1 in 50
- Black females: 1 in 75
- Native Hawaiian/Other Pacific Islander males: 1 in 89
- American Indian/Alaskan Native males: 1 in 116
Groups with the lowest lifetime risk are:
- Asian females: 1 in 1298
- White females: 1 in 874
- Native Hawaiian/Other Pacific Islander females: 1 in 611
- American Indian/Alaskan Native females: 1 in 435
- Hispanic females: 1 in 287
Among males, the lowest lifetime risks are 1 in 187 for Asians and 1 in 171 for whites. Overall, US males have a 1 in 76 lifetime risk of HIV infection, while US females have a 1 in 309 lifetime risk. From the age of 15, females always have a lower lifetime risk than males.
Next the CDC number crunchers turned to 10-year age-conditional risk of HIV, which is the probability that a person of a specific age will get diagnosed with HIV within 10 years. For males versus females, age-conditional 10-year risks were 1 in 195 versus 1 in 1316 for 20-year-olds, 1 in 280 versus 1 in 1152 for 30-year-olds, 1 in 478 versus 1 in 1390 for 40-year-olds, and 1 in 685 versus 1 in 1870 for 50-year-olds. The only age-related dip in 10-year risk came at age 30 for women, 1 in 1152 versus 1 in 1316 for 20-year-old women. The researchers suggested that groups with the highest 10-year age-conditional risk of HIV may be groups that need more HIV testing.
The good news is that lifetime risk of HIV infection fell in this 2017-2019 analysis from higher risks in a 2010-2014 analysis.
1. Singh S, Hu X, Hess K, et al. Estimating the lifetime risk of a diagnosis of HIV infection in the United States. 2022 CROI, February 12-16 and 22-24, 2022. Abstract 43.