Despite advances in HIV prevention, including the recent approval of the first injectable preexposure prophylaxis (PrEP) to be given every 2 months, the CDC reports that the HIV epidemic continues and was more severe among Black and Hispanic/Latino gay and bisexual men in the United States between 2010 and 2019.
“Data suggest that unequal reach of HIV prevention and treatment and higher levels of stigma fuel these troubling trends,” according to the CDC.
Although the number of new HIV infections declined among White gay and bisexual men between 2010 and 2019 (from 7500 to 5100), the number remained relatively stable among Black (from 9000 to 8900) and Hispanic/Latino (from 6800 to 7900) gay and bisexual men.
Continuing HIV Inequities in Testing and Treatment
The percentage of gay and bisexual men with HIV who had been diagnosed in 2019 was lower among Black and Hispanic/Latino individuals (83% and 80%) compared with White individuals (90%). Rates of viral suppression were also lower among these minority populations (62% of Black and 67% of Hispanic/Latino gay and bisexual men) compared with White individuals (74%) in the same year.
Rates of PrEP use among HIV-negative men who have sex with men was markedly lower among Black and Hispanic/Latino individuals in 2017 compared with their White counterparts (Figure).
These findings are based on data before the Ending the HIV Epidemic in the US initiative (EHE), which was launched in 2019 by the US Department of Health and Human Services. To achieve the EHE goal of reducing the number of HIV infections by 90% by 2030, at least 95% of infections must be diagnosed and 95% of persons with diagnosed HIV infection must achieve viral suppression.
“With EHE and effective prevention and treatment tools at our disposal, the nation has a decades-in-the-making opportunity to end the epidemic and erase glaring disparities in HIV prevention and care,” the CDC noted.
New Injectable PrEP May Reduce Barriers
In December 2021, the US Food and Drug Administration (FDA) approved Apretude (cabotegravir extended-release injectable suspension) for use in at-risk adults and adolescents weighing at least 35 kg to reduce the risk of sexually acquired HIV infection. The agent is given first as 2 initiation injections administered 1 month apart, and then every 2 months thereafter.
This first non-pill PrEP option was applauded by the FDA. “This injection, given every 2 months, will be critical to addressing the HIV epidemic in the US, including helping high-risk individuals and certain groups where adherence to daily medication has been a major challenge or not a realistic option,” said Debra Birnkrant, MD, director of the Division of Antivirals in the FDA’s Center for Drug Evaluation and Research.
The product is expected to be available in early 2022.
Pitasi MA, Beer L, Cha S, et al. Vital signs: HIV infection, diagnosis, treatment, and prevention among gay, bisexual, and other men who have sex with men — United States, 2010–2019. MMWR Morb Mortal Wkly Rep. 2021;70(48):1669-1675. doi:10.15585/mmwr.mm7048e1