Are we ending the HIV epidemic among persons who inject drugs?: key findings from 19 US cities.

OBJECTIVES

National HIV Behavioral Surveillance (NHBS) conducts surveillance among key populations, including persons who inject drugs (PWID). NHBS data can be used to monitor progress toward national goals, including Ending the HIV Epidemic (EHE). EHE strategies include HIV testing (Diagnose), rapid linkage to HIV treatment (Treat), and increasing access to preexposure prophylaxis (PrEP), and syringe services programs (SSPs) (Prevent). This analysis aimed to concisely compare NHBS key findings among PWID to EHE goals.

DESIGN/METHODS: Cross-sectional NHBS data were collected from PWID in 2018 ( n  = 9786) and 2022 ( n  = 6574) in 19 US cities. We compared key findings from 2022 NHBS to specified EHE goals for Diagnose (HIV testing) and Treat (linkage to care, current antiretroviral therapy (ART) use) or 2018 NHBS key findings for Prevent (PrEP and SSP use).

RESULTS

In 2022, 45% of PWID were tested for HIV; 45% of PWID with HIV were linked to care within 1 month of diagnosis, and 79% were currently taking ART; 1% of PWID without HIV used PrEP; and approximately half of all PWID received syringes from an SSP. PrEP and SSP use among PWID have not changed since 2018.

CONCLUSION

National HIV strategies are not yet adequately reaching PWID. To end the US HIV epidemic, multilevel solutions are needed to tailor interventions for PWID and dismantle barriers to testing, treatment, and prevention. Structural solutions to improve access to basic needs and SSPs may have downstream benefits across the EHE strategies.