Baxter Arden, Gopalappa Chaitra, Islam Md Hafizul, Viguerie Alex, Lyles Cynthia, Johnson Anna Satcher, Khurana Nidhi, Farnham Paul G
Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, GA.
Currently, Manhattan Associates, Atlanta GA; and.
J Acquir Immune Defic Syndr. 2025 May 1;99(1):47-54. doi: 10.1097/QAI.0000000000003623.
In 2019, there were an estimated 1.2 million persons with HIV (PWH) and 35,100 new infections in the United States. The HIV care continuum has a large influence on transmission dynamics.
We updated Progression and Transmission of HIV 3.0, an agent-based simulation model, to estimate 2019 HIV transmission rates and distribution of transmissions by the HIV care continuum, race/ethnicity, transmission group, and age group.
In 2019, the estimated transmission rate in the United States was 2.94 new infections per 100 person-years ( inf/100p-y) . Transmission rates decreased along the HIV care continuum; the highest transmission rate was associated with persons with acute HIV infection and unaware of their HIV status at 16.35 inf/100p-y , followed by PWH (nonacute) and unaware of their HIV status (9.52), persons aware of their HIV status and not in care (5.96), persons receiving HIV care (on antiretroviral therapy) but not virally suppressed (4.53), and persons virally suppressed (0). The highest transmission rate by transmission group was among men who have sex with men at 3.68 inf/100p-y . Transmission rates decreased as age increased and are similar by race/ethnicity, after accounting for the HIV care continuum.
Our results support a continued emphasis on helping PWH move along the care continuum through early diagnosis, linkage to care, and adherence to ART, resulting in viral suppression to reduce HIV transmissions. Furthermore, efforts should focus on reducing disparities in the provision of HIV prevention and care services, particularly for populations disproportionally affected by HIV.
2019年，美国估计有120万艾滋病毒感染者（PWH），新增感染病例35100例。艾滋病毒治疗连续体对传播动态有很大影响。
我们更新了基于代理的模拟模型“艾滋病毒的进展与传播3.0”，以估计2019年艾滋病毒的传播率，以及按艾滋病毒治疗连续体、种族/族裔、传播组和年龄组划分的传播分布情况。
2019年，美国估计的传播率为每100人年2.94例新感染（感染数/100人年）。传播率沿艾滋病毒治疗连续体下降；最高传播率与急性艾滋病毒感染且未意识到自己感染艾滋病毒状况的人相关，为16.35感染数/100人年，其次是未意识到自己感染艾滋病毒状况的艾滋病毒感染者（非急性）（9.52）、意识到自己感染艾滋病毒状况但未接受治疗的人（5.96）、接受艾滋病毒治疗（接受抗逆转录病毒疗法）但病毒未得到抑制的人（4.53），以及病毒得到抑制的人（0）。按传播组划分，最高传播率出现在男男性行为者中，为3.68感染数/100人年。传播率随年龄增长而下降，在考虑艾滋病毒治疗连续体后，不同种族/族裔的传播率相似。
我们的结果支持继续强调通过早期诊断、与治疗机构建立联系以及坚持接受抗逆转录病毒治疗（ART），帮助艾滋病毒感染者在治疗连续体中取得进展，从而实现病毒抑制以减少艾滋病毒传播。此外，应努力减少艾滋病毒预防和护理服务提供方面的差距，特别是针对受艾滋病毒影响尤为严重的人群。
