HIV Trends in Metropolitan US Cities From 2014 to 2021: Baseline Data for the Ending the HIV Epidemic Initiative.

Gupta, Ribhav; Vermund, Sten H.

Objective. To examine baseline trends for the 2019 Ending the HIV Epidemic in the United States (EHE), which aims to reduce HIV incidence by 90% by 2030 in the 57 counties and states responsible for half of incident infections, and to provide a counterfactual comparator for future evaluation of the initiative's midpoint. Methods. We used 2014‒2021 metropolitan statistical area (MSA) data to compare HIV diagnostic rate trends between MSAs subsuming EHE regions (n = 46) and other MSAs (n = 76). A difference-in-difference analysis illustrated potential early-stage programmatic effects. Results. From 2014 to 2021 across 122 MSAs, 305 413 HIV cases were diagnosed with a mean annual MSA-level diagnostic rate change of ‒6.7% (range = ‒66.1‒466.7%). MSA-level diagnostic rate changed by ‒21.3% (range = ‒50.8%‒14.8%) amongst MSAs including EHE regions and by 2.1% (range = ‒66.1%‒466.7%) in other MSAs. In a difference-in-difference analysis, the HIV diagnostic rate change from 2020 to 2021 was 3.1 cases per 100 000 people-years (P =.03) greater in EHE regions compared to the baseline HIV diagnostic rate change of ‒0.8 cases per 100 000 people-years (P <.01) across all MSAs. Conclusions. Although MSAs including EHE regions experienced greater reductions in HIV diagnoses from 2014 to 2021, high interregional variability requires exploration. These trends provide a baseline for subsequent EHE programmatic evaluations. (Am J Public Health. 2025;115(2):217–220. https://doi.org/10.2105/AJPH.2024.307890)

UNITED States; DIAGNOSIS of HIV infections; HIV infection epidemiology; HIV prevention; RESEARCH funding; HIV infections; DESCRIPTIVE statistics; POPULATION geography; METROPOLITAN areas; GOVERNMENT programs

American Journal of Public Health, 2025, Vol 115, Issue 2, p217

0090-0036

Academic Journal

10.2105/AJPH.2024.307890