Assessing Differences in CDC-Funded HIV Testing by Urbanicity, United States, 2016

Abstract

HIV prevention efforts have contributed to a decline in annual HIV infections in the United States. However, progress has been uneven and certain groups and geographic areas continue to be disproportionately affected. Subsequent to implementation of CDC's high-impact HIV prevention approach to reducing new infections, we analyzed national-level CDC-funded HIV test data from 2016 to describe the population being reached in three urbanicity settings (metropolitan: ≥ 1,000,000 population; urban: 50,000-999,999; rural: < 50,000). Over 70% of CDC-funded HIV tests and almost 80% of persons newly diagnosed with HIV as a result of CDC-funded testing occurred in metropolitan areas. Nonetheless, CDC-funded testing efforts are reaching urban and rural areas, especially in the South, providing opportunities to identify persons unaware of their HIV status and link those with newly diagnosed HIV to medical care and prevention services. While CDC-funded testing efforts have continued to focus on population subgroups and geographic areas at greatest risk, efforts should also continue in rural areas and among groups in need with a low national burden.

Prevalência do Vírus da Imunodeficiência Humana e fatores associados em gestantes no estado do Pará

“…Estudo realizado na Catalunha, Espanha, identificou que as maiores taxas de novos diagnósticos de HIV ocorreram em regiões localizadas em áreas urbanas, especialmente na cidade de Barcelona (28) . Outra pesquisa realizada nos Estados Unidos revelou diferenças estatisticamente significativas na distribuição de novos diagnósticos por características demográficas e ambiente urbano, com taxas de positividade para o HIV mais altas nas áreas urbanas (29) . Tais resultados corroboram com os achados desta pesquisa.…”

Prevalence of the Human Immunodeficiency Virus and associated factors in pregnant women in the state of Pará

“…A study conducted in Catalonia, Spain, identified that the highest rates of new HIV diagnoses occurred in regions located in urban areas, especially in the city of Barcelona ( 28 ) . Another study conducted in the United States revealed statistically significant differences in the distribution of new diagnoses by demographic characteristics and urban environment, with higher HIV positivity rates in urban areas ( 29 ) . These results corroborate the findings of the present study.…”

The role of socio-demographic determinants in the geo-spatial distribution of newly diagnosed HIV infections in small areas of Catalonia (Spain)

“…The highest rates of new HIV diagnoses were in ABSs located in urban areas, especially the city of Barcelona. While differences between urban and rural areas have been reported [2], the fact that people living with HIV in rural areas are more likely to be diagnosed later than their urban counterparts [26,27] should be taken into account. Rural residents at risk for or living with HIV experience barriers that include greater local stigma about HIV infection, a socially conservative climate, and scarcity of funding for widespread testing and treatment programs [3].…”

“…Factors associated with the incidence of HIV infection have proven to be diverse and distributed both worldwide and within countries and transmission groups. Previous studies have revealed statistically significant differences in the distribution of new diagnoses by demographic characteristics and urban setting, with HIV positivity rates being higher in urban areas [2]. On the other hand, rural residents at risk for or living with HIV infection face unique challenges [2,3], namely, they are less likely to have been tested for HIV or have been tested in the past year than urban residents [4].…”