Human Immunodeficiency Virus in the State of Texas of the United States: Past Reflections, Present Shortcomings, and Future Needs of the Public Health Response

Abstract

Ending the HIV Epidemic: A Plan for America aims to reduce HIV incidence in the United States by at least 90% by 2030, using diagnosis, treatment and prevention strategies. Texas is a Southern state, that has one of the highest numbers of new HIV diagnoses and people with HIV in the country, and where HIV disproportionately impacts minorities. We retrace the historical epidemic in its largest city, Houston, to illustrate the lessons learned and milestones accomplished; that could serve as guideposts for the future. We examine the current epidemic in Texas, including the achieved levels of HIV testing, treatment continua and pre-exposure prophylaxis prescription, and compare and contrast these with the national estimates and Plan targets. Our findings call for urgent and accelerated expansion of efforts to end HIV in Texas.

The Relationship Between Adverse Childhood Experiences and Utilization of Different HIV Testing Strategies Among Young Men Who Have Sex with Men in Texas

“…For example, recent molecular clusters of rapid HIV transmission among young MSM (YMSM; 18–35 years old) throughout Texas highlight missed opportunities for prevention and screening, resulting in late HIV diagnosis and delays in care [ 2 ] producing worse outcomes, such as increase risk for opportunistic infections and death within following 12 months post diagnosis, and higher healthcare costs compared to those who initiate care sooner [ 3 ]. Nearly 1 in 5 MSM in Texas receive a late HIV diagnosis [ 4 , 5 ]. Improving access to timely and routine HIV testing in Texas will increase status awareness, reduce late diagnoses, and link YMSM into status neutral care (i.e., prevention and treatment) resulting in fewer new HIV cases in this priority population.…”

Infección por virus de inmunodeficiencia humana: prevalencia, complicaciones y diagnóstico.

“…En los Estados Unidos el VIH se ha mantenido constante durante más de una década, y desde el primer informe de caso en 1981, aproximadamente 700 000 personas han muerto. Solo en el año 2018, 37 515 de personas fueron diagnosticadas que eran desproporcionadamente afroamericanos e hispanos/latinos (Abbas et al, 2020). A fines del año 2020, había 1,053 millones de personas que vivían con el VIH (PLWH) y 351,000 muertes acumuladas reportadas en China (He, 2021).…”

Expanding Medicaid to Reduce Human Immunodeficiency Virus Transmission in Houston, Texas

“…As of a recent CDC report, the Houston metropolitan area ranked ninth nationally in rate of new HIV diagnoses 9 and reports lower rates of retention in HIV care and viral suppression than the United States overall. 10 Of all new diagnoses in 2019, men who have sex with men (MSM) are believed to have constituted nearly 71% of diagnoses in Houston/Harris County. Among MSM 18–34 years of age, the highest burden was among young, Black men who have sex with men (YBMSM) who made up 19% of all new diagnoses per internal calculations from the Houston Health Department (HHD) where missing risk group information was imputed.…”

“…As of a recent CDC report, the Houston metropolitan area ranked ninth nationally in rate of new HIV diagnoses9 and reports lower rates of retention in HIV care and viral suppression than the United States overall 10. Of all new diagnoses in 2019, men who have sex with men (MSM) are believed to have constituted nearly 71% of diagnoses in Houston/Harris County.…”