The Current State of HIV in the United States


A John Hopkins expert and major study leader details the evolving epidemiology of the virus.

Video highlights

0:08 Catching up on HIV trends
2:00 The Lancet papers
2:08 Changing epidemiology
3:33 HIV populations
5:35 The HIV and opioid epidemic overlap
8:11 The effect of the US healthcare system
10:24 The adaptability of HIV

A new series of research articles and insights from nationally-leading HIV investigators highlight the gross and evolving disparities of the endemic virus in the United States.

Published to The Lancet last week, the half-dozen features highlight a continued failure by the US to reach HIV’s most at-need prevention and treatment populations, as well as a migration of the majority virus cases from urban coastal regions, to the rural south, where state-level treatment access and prevention messaging is still greatly lagging.

The pieces also highlight the burden continually faced by racial, sexual, and gender minorities with HIV, and such correlations with the ongoing COVID-19 pandemic.

In an interview with Contagion, feature series lead author Chris Beyrer, MD, MPH, a professor of Public Health and Human Rights in the Johns Hopkins Bloomberg School of Public Health, discussed the lack of success in HIV mitigation in the US—despite world-leading funding and a bevy of available resources and agents now proven to combat the former epidemic.

As he noted, HIV decline has been estimated at just 2% annually—a minimal result from massive, but disjointed efforts against the virus.

Additionally, Beyrer discussed the growing disproportion of HIV patient demographics, and the virus’ geographical move in the US from bi-coastal regions, to the South.

“When you see the map in the series, it really speaks volumes on where HIV is and where it’s concentrated,” Beyrer said. “It’s actually the same map as the map of syphilis in the United States, it’s the same map as under-insurance. It’s the map of American slavery and Jim Crow, to be perfectly honest, and that’s striking.”

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