Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 May;107(5):794-799.
doi: 10.2105/AJPH.2017.303697.

Sustained Reduction in HIV Diagnoses in Massachusetts, 2000-2014

Kevin Cranston  1 , Betsey John  1 , H Dawn Fukuda  1 , Liisa M Randall  1 , Jonathan Mermin  1 , Kenneth H Mayer  1 , Alfred DeMaria Jr  1
Affiliations

Sustained Reduction in HIV Diagnoses in Massachusetts, 2000-2014

Kevin Cranston et al. Am J Public Health. 2017 May.

Abstract

Objectives: To describe secular trends in reported HIV diagnoses in Massachusetts concurrent with treatment access expansion.

Methods: We characterized cases of HIV infection reported to the Massachusetts HIV/AIDS Surveillance Program between 2000 and 2014 by sex, age, race/ethnicity, and exposure mode. We used Poisson regression to test the statistical significance of trends in diagnoses.

Results: Between 2000 and 2014, annual new HIV infections diagnosed in Massachusetts decreased by 47% (P < .001 for trend). We observed significant reductions in diagnoses among women (58% when comparing 2000 with 2014), men (42%), Whites (54%), Blacks (51%), and Hispanics (35%; P < .001 for trend). New diagnoses decreased significantly among men who have sex with men (19%), persons who inject drugs (91%), and heterosexuals (86%; P < .001 for trend). We saw statistically significant downward trends among all men by race/ethnicity, but the trend among Black men who have sex with men was nonsignificant.

Conclusions: Sustained reduction in new HIV diagnoses was concurrent with Massachusetts's Medicaid expansion, state health care reform, and public health strategies to improve care access. A contributory effect of expanded HIV treatment and population-level viral suppression is hypothesized for future research.

PubMed Disclaimer

Figures

FIGURE 1—
FIGURE 1—
HIV Infection, Deaths Among People Reported With HIV/AIDS, and HIV Prevalence by Year: Massachusetts, 2000–2014 Source. Massachusetts Department of Public Health HIV/AIDS Surveillance Program, data as of March 1, 2016.
FIGURE 2—
FIGURE 2—
People Diagnosed With HIV Infection by Race/Ethnicity and Year of Diagnosis: Massachusetts, 2000–2014 Note. API = Asian/Pacific Islander; NH = non-Hispanic. Source. Massachusetts Department of Public Health HIV/AIDS Surveillance Program, cases reported through January 1, 2016.
FIGURE 3—
FIGURE 3—
Stages of HIV Care Among People Living With HIV/AIDS in Massachusetts: 2014 Note. PLWHA = people living with HIV/AIDS. Includes individuals diagnosed through 2013 and living in Massachusetts as of December 31, 2014, based on last known address, regardless of state of diagnosis. Viral load data missing on 27.5% of cases; 7.7% of cases have evidence of nonsuppression. aLaboratory test result received by Massachusetts Department of Public Health.
See this image and copyright information in PMC

References

    1. Hall HI, Song R, Rhodes P, et al. HIV Incidence Surveillance Group. Estimation of HIV incidence in the United States. JAMA. 2008;300(5):520–529. - PMC - PubMed
    1. Prejean J, Song R, Hernandez A, et al. HIV Incidence Surveillance Group. Estimated HIV incidence in the United States, 2006–2009. PLoS One. 2011;6(8):e17502. - PMC - PubMed
    1. Frieden TR, Foti K, Mermin J. Applying public health principles to the HIV epidemic—how are we doing? N Engl J Med. 2015;373(23):2281–2287. - PubMed
    1. Des Jarlais DC, Arasteh K, McKnight C, et al. Consistent estimates of very low HIV incidence among people who inject drugs: New York City, 2005–2014. Am J Public Health. 2016;106(3):503–508. - PMC - PubMed
    1. The White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States. 2010. Available at: https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas.pdf. Accessed March 17, 2017.

Publication types

LinkOut - more resources