HIV Infection in Hard-to-Reach Populations

By Carlos del Rio, MD, at the IAS–USA continuing education program, Improving the Management of HIV Disease, held in New York, New York, in March 2016

The HIV epidemic in the United States disproportionately affects populations that have historically suffered from health disparities. Thus, addressing HIV prevention and care requires that practitioners consider health disparities and social determinants of health as major drivers of outcomes.

In the United States, there are approximately 50,000 new HIV infections per year, with men who have sex with men(MSM) accounting for approximately 62% of infections and black and Hispanic persons accounting for more than 50% of new infections. National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2012 indicate an HIV prevalence of 0.39% in the general adult population, with HIV prevalence being higher among men than women (0.61% and 0.16%, respectively; P < .01), among non-Hispanic black individuals than other racial or ethnic groups combined (1.6% and 0.23%, respectively; P < .001), and among MSM than men who have sex with women (7.7% and 0.17%, respect- ively; P < .01).

The goals of the National HIV/AIDS Strategy (NHAS) for the United States through 2020 are to: 1) reduce the rate of new HIV infections; 2) increase access to care and improve health outcomes for HIV-infected persons; 3) reduce HIV-related disparities and health inequities; and 4) achieve a more coordinated national response to the HIV epidemic. Indicators for the NHAS include increasing the percentage of HIV-infected persons who are aware of their HIV serostatus to 90%, of persons who are linked to care within 30 days of HIV diagnosis.


By: Dr del Rio is Professor of Global Health at Rollins School of Public Health and Professor of Medicine at Emory University School of Medicine in Atlanta, Georgia.

This article summarizes a presentation by Dr. del Rio, MD, given at the IAS–USA continuing education program, “Improving the Management of HIV Disease”, held in New York, New York, in March 2016.

filed under: HIV