Racial and Ethnic Disparities in Sustained Viral Suppression and Transmission Risk Potential Among Persons Receiving HIV Care – United States, 2014, Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report 67:4 (2018)

Racial disparities in HIV treatment and care in the United States continue to be profoundly disturbing. Focusing on data from 2013 and 2014, fewer Black Americans living with HIV are on antiretroviral medication (“ART”) or reach sustained viral suppression (40.8%) than their Latinx (50.1%) and white (56.3%) counterparts (viral suppression is less than 200 HIV RNA copies/ml – the amount of the virus in your blood).

Viral suppression is important for the health of people living with HIV and also for community-level prevention efforts because it means that the possibility of HIV transmission is significantly reduced or even eliminated. Black Americans also experience longer periods with viral loads over 1,500 copies/mL. Black youth 13-24 years old experienced the poorest outcomes in terms of reaching sustained viral suppression (29.2%) . Across different transmission categories, people who inject drugs showed generally low levels of viral suppression, with Black Americans experiencing the poorest outcomes. These findings from the Centers for Disease Control and Prevention’s (CDC) analysis of National HIV Surveillance System (NHSS) data add to the picture of racial disparities in HIV: Black Americans represent 12% of the U.S. population but 43% of PLHIV and 44% of all new HIV diagnoses.

The CDC explains that these disparities may be caused by barriers such as lack of health insurance, limited access to health services, stigma, health literacy, and lack of trust in providers and the care system. Addressing these barriers will require collaboration among health care providers, community-based organizations, and state and local health departments. These findings also highlight the need to avoid reliance on viral load or compliance with medical treatment as a basis for reform of HIV criminal laws, due to racial inequalities in access to health care, including ART.