Core Indicators for Monitoring the Ending the HIV Epidemic Initiative (Preliminary Data): National HIV Surveillance System Data Reported through September 2021; and Preexposure Prophylaxis (PrEP) Data Reported through June 2021

HIV Surveillance Data Tables

Core Indicators for Monitoring the Ending the HIV Epidemic Initiative (Preliminary Data):
National HIV Surveillance System Data Reported through September 2021; and Preexposure Prophylaxis (PrEP) Data Reported through June 2021

This issue of HIV Surveillance Data Tables is published by the Division of HIV Prevention (DHP), National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), U.S. Department of Health and Human Services, Atlanta, Georgia.

Data are presented for diagnoses of HIV infection reported to CDC through September 2021 and preexposure prophylaxis (PrEP) data reported through June 2021.

HIV Surveillance Data Tables is not copyrighted and may be used and copied without permission. Citation of the source is, however, appreciated.

Suggested Citation

Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative (preliminary data): National HIV Surveillance System data reported through September 2021; and preexposure prophylaxis (PrEP) data reported through June 2021. HIV Surveillance Data Tables 2021;2(No. 5). https://www.cdc.gov/hiv/library/reports/surveillance-data-tables/index.html. Published December 2021. Accessed [date].

Download the full report pdf icon[PDF – 2 MB].

Technical Notes

The Ending the HIV Epidemic in the U.S. (EHE) ini­tiative leverages critical scientific advances in HIV prevention, diagnosis, treatment, and outbreak response [1]. The goal of the initiative is to reduce new HIV infections by 75% by 2025 and then by at least 90% by 2030. The Centers for Disease Control and Prevention (CDC) routinely releases HIV Surveil­lance Data Tables on the core indicators for EHE to allow for more timely monitoring of progress. The full list of EHE core indicators and their definitions can be found in the Technical Notes of the Core Indi­cators for Monitoring the Ending the HIV Epidemic Initiative report at https://www.cdc.gov/hiv/pdf/library/reports/surveillance-data-tables/vol-1-no-1/cdc-hiv-surveillance-tables-vol-1-no-1.pdf pdf icon[PDF – 1 MB].

The tables included in this report provide prelimi­nary data on HIV diagnoses and linkage to HIV medi­cal care reported to CDC as of September 2021 for the years 2020 and 2021, and data on preexposure prophy­laxis (PrEP) coverage for the years 2019, 2020, and 2021 (preliminary). Data for the 3 indicators are provided at the national, state, and county levels (EHE Phase I jurisdictions only). See Tabulation and Presentation of Data for details on how the indicators are calculated.

Tabulation and Presentation of Data

Diagnoses of HIV Infection

Diagnoses of HIV infection are the numbers of per­sons aged ≥ 13 years with HIV diagnosed during Janu­ary 2020 through September 2021 (Tables 1a–d). Data presented were reported (after the removal of person­ally identifiable information) to CDC.

An evaluation of surveillance data (2011–2015 diagnoses) found that, on average, approximately 75% of HIV diagnoses are reported to CDC during the year of diagnosis and approximately 95% of HIV diagnoses are reported to CDC by the end of the fol­lowing year. Data reported to CDC’s National HIV Sur­veillance System (NHSS) are considered preliminary until a 12-month reporting lag has been reached and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions [2].

More information on counting diagnoses of HIV infection can be found at https://www.cdc.gov/hiv/library/reports/hiv-surveillance/vol-32/index.html (HIV Surveillance Report, 2019).

Linkage to HIV Medical Care

Linkage to HIV medical care within 1 month of HIV diagnosis is measured for persons aged ≥ 13 years whose infection was diagnosed during January 2020 through June 2021, and who resided in any of the jurisdictions (including EHE Phase I jurisdictions) with complete reporting of labo­ratory data to CDC at the time of diagnosis (Tables 2a–c). The numerator is the number of persons aged ≥ 13 years whose HIV infection was diagnosed during January 2020 through June 2021 and who had ≥ 1 CD4 T-lymphocyte (CD4) or viral load (VL) tests within 1 month of HIV diagno­sis. The denominator is the number of persons aged ≥ 13 years whose HIV infection was diagnosed during January 2020 through June 2021. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to NHSS; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during 2020 and 2021 and that were reported to NHSS through September 2021. Data are not provided for states and associated jurisdictions that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Puerto Rico, and Vermont.

Data reported to NHSS are considered preliminary until a 12-month reporting lag has been reached and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions [2].

More information on calculating linkage to care can be found at (Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2019) pdf icon[PDF – 17 MB].

Preexposure Prophylaxis (PrEP) Coverage

Preexposure prophylaxis (PrEP) coverage, reported as a percentage, is defined as the number of persons aged ≥ 16 years classified as having been prescribed PrEP during the specified year divided by the estimated number of persons aged ≥ 16 years who had indications for PrEP during the speci­fied year (Tables 3a–3c). PrEP coverage is an EHE indicator that is not a reportable disease or condition and is not reported to NHSS. Multiple data sources, described below, are used to calculate PrEP coverage.

Please use caution when interpreting PrEP data. Different data sources were used in the numerator and denominator to calculate PrEP coverage.

Persons with PrEP indications

National pharmacy data from the IQVIA Real World Data—Longitudinal Prescriptions database (hereafter, IQVIA database) are used to classify persons aged ≥ 16 years who have been prescribed PrEP in the spe­cific year. The IQVIA database captures prescriptions from all payers and represents approximately 92% of all prescriptions from retail pharmacies and 60%–86% from mail-order outlets in the United States. The database does not include prescriptions from some closed health care systems that do not make their pre­scription data available to IQVIA. Therefore, these are minimum estimates of PrEP coverage. The annual number of persons classified as having been pre­scribed PrEP was based on a validated algorithm that discerns whether tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) was prescribed for PrEP after excluding prescriptions for HIV treatment, hepa­titis B treatment, or HIV postexposure prophylaxis [3–5]. Tenofovir alafenamide and emtricitabine (TAF/FTC) was approved as an alternative drug for PrEP by the U.S. Food and Drug Administration (FDA) in October 2019. Starting with the 2019 data, TAF/FTC was included in the algorithm to classify the number of persons prescribed PrEP. In addition, generic TDF/FTC for PrEP became available in the United States in October 2020. Starting with the 2020 data, generic TDF/FTC was included in the algorithm to classify the number of persons prescribed PrEP.

The number of persons classified as having been prescribed PrEP is reported by sex, age group, and race/ethnicity. Transmission category data are not available in the IQVIA database, and race/ethnicity data are available for < 40% of persons with PrEP prescriptions. Please use caution when interpreting PrEP data by race/ethnicity. Race/ethnicity catego­ries available in the IQVIA database include White, Black/African American, Hispanic/Latino, and other. The number of persons prescribed PrEP for each racial/ethnic group presented in this report was extrapolated by applying the racial/ethnic distribu­tion of known records to those for which data on race/ethnicity were unknown.

Geographic Designations

In the IQVIA database, a person’s location is reported as a 3-digit ZIP code prefix (hereafter, ZIP3) assigned by the U.S. Postal Service. To estimate the number of persons prescribed PrEP at the state or county level, a probability-based approach is used to crosswalk between ZIP3s and states/counties by using data from (a) the U.S. Census Bureau’s American Community Survey (ACS) 5-year estimates by ZIP Code Tabulation Areas (ZCTAs) [6], and (b) the U.S Department of Housing and Urban Development’s ZIP Code Crosswalk Files [7]. Because of reliability concerns, subnational estimates of <40 are not included.

Persons with PrEP indications

The ACS and U.S. Census Bureau files were used to estimate the number of men who have sex with men (MSM) in a jurisdiction [8, 9]. Next, behavioral data from the National Health and Nutrition Examination Survey (NHANES) were used to estimate the proportion of HIV-negative MSM with indications for PrEP [10].

The number of HIV-negative MSM with indications for PrEP was multiplied by the ratio of percentage of diagnoses during the specified year attributed to other major transmission risk groups compared to the percentage among MSM in a given state or county. The estimated numbers of persons with indications for PrEP in the 3 major transmission risk groups (MSM, heterosexuals, persons who inject drugs) in each jurisdiction were then summed to yield a state- or county-specific estimate. State estimates were then summed for a national total of persons with indications for PrEP [8]. Jurisdictional estimates were rounded to the nearest 10.

The tables included in this report provide updated data on PrEP coverage for the years 2019 through June 2021 by using the IQVIA data reported through June 2021. IQVIA conducts data quality assurance activities. As a result, the number of persons classified as having been prescribed PrEP in a given year might change from time to time. The impact of the changes may vary by demographic category nationally and by jurisdiction. The data sources used to estimate the number of persons with indications for PrEP have different schedules of availability. Consequently, the availability of a denominator lags the availability of a numerator by approximately 1 year or more. PrEP coverage data with a lagged denominator are considered preliminary.

For this release of HIV Surveillance Data Tables, 2018 denominators were used for 2019, 2020, and 2021 PrEP coverage data; consequently, 2019 through June 2021 PrEP coverage data are considered preliminary. In addition to being preliminary, data for the year 2020 through June 2021 should be interpreted with caution and with an awareness of the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions.

More information on calculating PrEP coverage can be found at (Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2019).

References

  1. HHS. What is Ending the HIV Epidemic in the U.S.? https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overviewexternal icon. Updated June 2, 2021. Accessed October 25, 2021.
  2. CDC [Schuchat A, CDC COVID-19 Response Team]. Public health response to the initiation and spread of pandemic COVID-19 in the United States, February 24–April 21, 2020. MMWR 2020;69(18):551–556. doi:http://dx.doi.org/10.15585/mmwr.mm6918e2external icon
  3. Wu H, Mendoza MC, Huang YA, Hayes T, Smith DK, Hoover KW. Uptake of HIV preexposure prophylaxis among commercially insured persons—United States, 2010–2014. Clin Infect Dis 2017; 64(2):144–149. doi:10.1093/cid/ciw701
  4. CDC [Huang YA, Zhu W, Smith DK, Harris N, Hoover KW]. HIV preexposure prophylaxis, by race and ethnicity—United States, 2014–2016. MMWR 2018;67(41):1147–1150. doi:10.15585/mmwr.mm6741a3
  5. Furukawa NW, Smith DK, Gonzalez CJ, et al. Evaluation of algorithms used for PrEP surveillance using a reference population from New York City, July 2016– June 2018. Public Health Rep 2020;135(2):202–210. doi:10.1177/0033354920904085
  6. U.S. Census Bureau. American Community Survey 5- year data (2009–2019). https://www.census.gov/data/developers/data-sets/acs-5year.2019.htmlexternal icon. Published December 10, 2020. Accessed October 25, 2021.
  7. U.S. Department of Housing and Urban Development (HUD). HUD USPS ZIP code crosswalk files. https://www.huduser.gov/portal/datasets/usps_crosswalk.htmlexternal icon. Updated June 2021. Accessed October 25, 2021.
  8. Grey JA, Bernstein KT, Sullivan PS, Purcell DW, Chesson HW, Gift TL, Rosenberg ES. Estimating the population sizes of men who have sex with men in US states and counties using data from the American Community Survey. JMIR public health and surveillance. 2016;2(1):e14.
  9. Purcell DW, Johnson CH, Lansky A, Prejean J, Stein R, Denning P, et al. Estimating the population size of men who have sex with men in the United States to obtain HIV and syphilis rates. Open AIDS J 2012;6:98-107.
  10. CDC [Smith DK, Van Handel M, Wolitski RJ, et al]. Vital Signs: Estimated percentages and numbers of adults with indications for preexposure prophylaxis to prevent HIV acquisition—United States, 2015. MMWR 2015;64(46):1291–1295. doi:10.15585/mmwr.mm6446a4

Suggested Citation

Centers for Disease Control and Prevention. Core indicators for monitoring the Ending the HIV Epidemic initiative (preliminary data): National HIV Surveillance System data reported through September 2021; and preexposure prophylaxis (PrEP) data reported through June 2021. HIV Surveillance Data Tables 2021;2(No. 5). https://www.cdc.gov/hiv/library/reports/surveillance-data-tables/index.html. Published December 2021. Accessed [date].

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Acknowledgments

HIV Surveillance Data Tables was prepared by the following staff and contractors of the Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, CDC: Anna Satcher Johnson, Zanetta Gant, Ya-lin Huang, Dawn Smith, Jianmin Li, Xiaohong Hu, Baohua Wu, Kyung Lee, Weiming Zhu, Lei Yu, Norma Harris.

 Michael Friend and the Web and Consumer Services Team of the Prevention Communications Branch are acknowledged for editing and desktop publishing this report.

 Publication of HIV Surveillance Data Tables was made possible by the contributions of the state and territorial health departments and the HIV surveillance programs that provided surveillance data to CDC.

Table 1a. Diagnoses of HIV infection among persons aged ≥13 years, by selected characteristics, January 2020 through June 2021—United States (preliminary)
2020 2021
(January–September)
No. No.
Gender
Male 23,772 17,817
Female 5,307 3,985
Transgender womana 610 431
Transgender mana 40 31
Additional gender identityb 15 20
Age at diagnosis (yr)
13–24 5,982 4,242
25–34 11,059 8,238
35–44 5,783 4,671
45–54 3,843 2,769
≥55 3,077 2,364
Race/ethnicity
American Indian/Alaska Native 190 144
Asian 607 426
Black/African American 12,677 9,302
Hispanic/Latinoc 7,847 6,130
Native Hawaiian/other Pacific Islander 64 48
White 7,662 5,872
Multiracial 697 362
Transmission categoryd
Male-to-male sexual contact 20,272 15,228
Injection drug use
      Male 1,136 865
      Female 830 647
Male-to-male sexual contact and injection drug use 1,057 805
Heterosexual contacte
      Male 1,908 1,347
      Female 4,490 3,353
Otherf
      Male 25 22
      Female 27 18
Region of residenceg
Northeast 4,203 2,882
Midwest 4,071 2,822
South 15,455 12,419
West 6,015 4,161
Total 29,744 22,284

Abbreviation: CDC, Centers for Disease Control and Prevention [footnotes only].

Note. Data are for cases reported to CDC through September 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions.

a“Transgender woman” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender man” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
bAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
cHispanic/Latino persons can be of any race.
dData have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total. Data presented based on sex at birth and include transgender persons.
eHeterosexual contact with a person known to have, or with a risk factor for, HIV infection.
fIncludes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
gData are based on residence at time of diagnosis of HIV infection.

Table 1b. Diagnoses of HIV infection among persons aged ≥13 years, by selected characteristics, January 2020 through September 2021—United States and 6 dependent areas (preliminary)
2020 2021
(January–September)
No. No.
Gender
Male 24,020 18,014
Female 5,348 4,022
Transgender womana 612 431
Transgender mana 40 31
Additional gender identityb 15 20
Age at diagnosis (yr)
13–24 6,034 4,280
25–34 11,140 8,308
35–44 5,842 4,717
45–54 3,891 2,818
≥55 3,128 2,395
Race/ethnicity
American Indian/Alaska Native 190 144
Asian 607 426
Black/African American 12,680 9,305
Hispanic/Latinoc 8,135 6,357
Native Hawaiian/other Pacific Islander 64 48
White 7,662 5,876
Multiracial 697 362
Transmission categoryd
Male-to-male sexual contact 20,455 15,380
Injection drug use
      Male 1,156 876
      Female 833 647
Male-to-male sexual contact and injection drug use 1,062 806
Heterosexual contacte
      Male 1,950 1,379
      Female 4,529 3,390
Otherf
      Male 25 22
      Female 27 18
Region of residenceg
Northeast 4,203 2,882
Midwest 4,071 2,822
South 15,455 12,419
West 6,015 4,161
U.S. dependent areas 291 234
Total 30,035 22,518

Abbreviation: CDC, Centers for Disease Control and Prevention [footnotes only].

Note. Data are for cases reported to CDC through September 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions.

a“Transgender woman” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender man” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
bAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
cHispanic/Latino persons can be of any race.
dData have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total. Data presented based on sex at birth and include transgender persons.
eHeterosexual contact with a person known to have, or with a risk factor for, HIV infection.
fIncludes hemophilia, blood transfusion, perinatal exposure, and risk factor not reported or not identified.
gData are based on residence at time of diagnosis of HIV infection.

Table 1c. Diagnoses of HIV infection among persons aged ≥13 years, by area of residence, January 2020 through September 2021—United States and 6 dependent areas (preliminary)
2020 2021
(January–September)
Area of residence No. No.
Alabama 586 314
Alaska 29 13
Arizona 668 505
Arkansas 244 264
California 3,636 2,308
Colorado 326 256
Connecticut 171 136
Delaware 95 55
District of Columbia 198 64
Florida 3,424 3,463
Georgia 1,833 1,218
Hawaii 50 41
Idaho 32 24
Illinois 1,055 533
Indiana 434 329
Iowa 100 81
Kansas 138 112
Kentucky 301 269
Louisiana 725 663
Maine 16 25
Maryland 708 506
Massachusetts 431 157
Michigan 521 460
Minnesota 226 203
Mississippi 401 275
Missouri 359 367
Montana 15 9
Nebraska 73 62
Nevada 391 359
New Hampshire 29 22
New Jersey 763 601
New Mexico 123 93
New York 1,958 1,243
North Carolina 1,077 966
North Dakota 36 15
Ohio 885 484
Oklahoma 235 163
Oregon 181 130
Pennsylvania 773 661
Rhode Island 53 33
South Carolina 679 446
South Dakota 34 16
Tennessee 642 560
Texas 3,553 2,539
Utah 129 85
Vermont 9 4
Virginia 625 563
Washington 421 335
West Virginia 129 91
Wisconsin 210 160
Wyoming 14 3
Subtotal 29,744 22,284
U.S. dependent areas
American Samoa 0 0
Guam 0 1
Northern Mariana Islands 0 0
Puerto Rico 288 230
Republic of Palau 0 0
U.S. Virgin Islands 3 3
Subtotal 291 234
Total 30,035 22,518

Abbreviation: CDC, Centers for Disease Control and Prevention [footnotes only].

Note. Data are based on residence at time of diagnosis of HIV infection. Data are for cases reported to CDC through September 2021 are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions.

Table 1d. Diagnoses of HIV infection among persons aged ≥13 years, by area of residence, January 2020 through September 2021—Ending the HIV Epidemic Phase I jurisdictions (preliminary)
2020 2021
(January–September)
Area of residence No. No.
Arizona
Maricopa County 482 341
California
Alameda County 151 121
Los Angeles County 1,306 783
Orange County 263 195
Riverside County 231 155
Sacramento County 68 43
San Bernardino County 259 164
San Diego County 275 107
San Francisco County 152 128
District of Columbia 198 64
Florida
Broward County 460 510
Duval County 230 221
Hillsborough County 249 233
Miami-Dade County 811 899
Orange County 375 367
Palm Beach County 216 170
Pinellas County 154 110
Georgia
Cobb County 122 75
DeKalb County 242 177
Fulton County 477 342
Gwinnett County 135 76
Illinois
Cook County 758 397
Indiana
Marion County 166 143
Louisiana
East Baton Rouge Parish 124 109
Orleans Parish 106 104
Maryland
Baltimore City 176 94
Montgomery County 80 68
Prince George’s County 214 165
Massachusetts
Suffolk County 133 59
Michigan
Wayne County 228 184
Nevada
Clark County 340 322
New Jersey
Essex County 191 145
Hudson County 117 79
New York
Bronx County 341 243
Kings County 442 246
New York County 296 199
Queens County 315 177
North Carolina
Mecklenburg County 209 207
Ohio
Cuyahoga County 186 105
Franklin County 203 117
Hamilton County 133 55
Pennsylvania
Philadelphia County 327 214
Puerto Rico
San Juan Municipio 73 56
Tennessee
Shelby County 232 199
Texas
Bexar County 286 209
Dallas County 661 491
Harris County 913 716
Tarrant County 294 209
Travis County 165 146
Washington
King County 199 159

Abbreviation: CDC, Centers for Disease Control and Prevention [footnotes only].

Note. Data are based on residence at time of diagnosis of HIV infection. Data are for cases reported to CDC through September 2021 are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions.

Table 2a. Linkage to HIV medical care within 1 month of HIV diagnosis among persons aged ≥ 13 years, by selected characteristics, January 2020–June 2021—44 states and the District of Columbia (preliminary)
2020 2021 (January–June)
Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test
No. No. % No. % No. No. % No. %
Gender
Male 22,181 18,317 82.6 3,864 17.4 12,531 10,361 82.7 2,170 17.3
Female 4,925 4,060 82.4 865 17.6 2,735 2,233 81.6 502 18.4
Transgender womana 572 465 81.3 107 18.7 313 263 84.0 50 16.0
Transgender mana 37 33 89.2 4 10.8 26 23 89.2 3 11.5
Additional gender identityb 13 12 92.3 1 7.7 13 12 92.3 1 7.7
Age at diagnosis (yr)
13–24 5,606 4,494 80.2 1,112 19.8 3,064 2,450 80.0 614 20.0
25–34 10,329 8,515 82.4 1,814 17.6 5,781 4,748 82.1 1,033 17.9
35–44 5,390 4,452 82.6 938 17.4 3,255 2,713 83.3 542 16.7
45–54 3,548 3,007 84.8 541 15.2 1,919 1,624 84.6 295 15.4
≥55 2,855 2,419 84.7 436 15.3 1,599 1,357 84.9 242 15.1
Race/ethnicity
American Indian/Alaska Native 185 150 81.1 35 18.9 112 92 82.1 20 17.9
Asian 582 512 88.0 70 12.0 308 275 89.3 33 10.7
Black/African American 11,889 9,481 79.7 2,408 20.3 6,602 5,315 80.5 1,287 19.5
Hispanic/Latinoc 7,343 6,270 85.4 1,073 14.6 4,298 3,631 84.5 667 15.5
Native Hawaiian/other Pacific Islander 63 54 85.7 9 14.3 38 30 78.9 8 21.1
White 7,034 5,887 83.7 1,147 16.3 4,011 3,339 83.2 672 16.8
Multiracial 632 533 84.3 99 15.7 249 210 84.3 39 15.7
Transmission categoryd
Male-to-male sexual contact 19,049 15,814 83.0 3,235 17.0 10,822 8,991 83.1 1,832 16.9
Injection drug use
      Male 1,001 781 78.0 220 22.0 565 425 75.1 140 24.9
      Female 771 605 78.5 166 21.5 429 343 80.0 86 20.0
Male-to-male sexual contact and injection drug use 967 777 80.3 191 19.7 548 443 80.8 105 19.2
Heterosexual contacte
      Male 1,727 1,403 81.2 324 18.8 905 763 84.4 141 15.6
      Female 4,166 3,465 83.2 700 16.8 2,320 1,903 82.0 417 18.0
Totalf 27,728 22,887 82.5 4,841 17.5 15,618 12,892 82.5 2,726 17.5

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, Centers for Disease Control and Prevention [footnotes only].

Note. Data are based on residence at diagnosis of HIV infection. Data are for cases reported to CDC through September 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. Linkage to HIV medical care was measured by documentation of ≥ 1 CD4 or VL tests ≤ 1 month after HIV diagnosis. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to CDC; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during January 2020 through June 2021 and reported to CDC through September 2021. Data are not provided for states and associated jurisdictions that do not have laws requiring reporting of all CD4 and viral loads or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Puerto Rico, and Vermont.

a“Transgender woman” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender man” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
bAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
cHispanic/Latino persons can be of any race.
dData have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total. Data presented based on sex at birth and include transgender persons.
eHeterosexual contact with a person known to have, or with a risk factor for, HIV infection.
fIncludes persons whose infection was attributed to hemophilia, blood transfusion, or perinatal exposure or whose risk factor was not reported or not identified. Data not displayed because the numbers were too small to be meaningful.

Table 2b. Linkage to HIV medical care within 1 month of HIV diagnosis among persons aged ≥ 13 years, by area of residence, January 2020–June 2021—44 states and the District of Columbia (preliminary)
2020 2021 (January–June)
Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test
No. No. % No. % No. No. % No. %
Alabama 586 468 79.9 118 20.1 286 221 77.3 65 22.7
Alaska 29 28 96.6 1 3.4 10 10 100 0 0.0
Arizona 668 566 84.7 102 15.3 417 355 85.1 62 14.9
Arkansas 244 198 81.1 46 18.9 181 135 74.6 46 25.4
California 3,636 3,035 83.5 601 16.5 1,805 1,521 84.3 284 15.7
Colorado 326 285 87.4 41 12.6 186 161 86.6 25 13.4
Connecticut 171 144 84.2 27 15.8 107 95 88.8 12 11.2
Delaware 95 76 80.0 19 20.0 44 38 86.4 6 13.6
District of Columbia 198 173 87.4 25 12.6 56 49 87.5 7 12.5
Florida 3,424 2,879 84.1 545 15.9 2,344 2,004 85.5 340 14.5
Georgia 1,833 1,508 82.3 325 17.7 1,020 875 85.8 145 14.2
Hawaii 50 43 86.0 7 14.0 30 23 76.7 7 23.3
Illinois 1,055 888 84.2 167 15.8 453 397 87.6 56 12.4
Indiana 434 321 74.0 113 26.0 252 202 80.2 50 19.8
Iowa 100 90 90.0 10 10.0 59 54 91.5 5 8.5
Louisiana 725 551 76.0 174 24.0 494 403 81.6 91 18.4
Maine 16 15 93.8 1 6.3 17 14 82.4 3 17.6
Maryland 708 619 87.4 89 12.6 382 338 88.5 44 11.5
Massachusetts 431 376 87.2 55 12.8 137 130 94.9 7 5.1
Michigan 521 440 84.5 81 15.5 296 261 88.2 35 11.8
Minnesota 226 199 88.1 27 11.9 152 126 82.9 26 17.1
Mississippi 401 292 72.8 109 27.2 209 151 72.2 58 27.8
Missouri 359 286 79.7 73 20.3 259 200 77.2 59 22.8
Montana 15 13 86.7 2 13.3 8 8 100 0 0.0
Nebraska 73 65 89.0 8 11.0 51 43 84.3 8 15.7
Nevada 391 336 85.9 55 14.1 253 229 90.5 24 9.5
New Hampshire 29 23 79.3 6 20.7 19 19 100 0 0.0
New Mexico 123 105 85.4 18 14.6 71 63 88.7 8 11.3
New York 1,958 1,687 86.2 271 13.8 991 861 86.9 130 13.1
North Carolina 1,077 886 82.3 191 17.7 696 569 81.8 127 18.2
North Dakota 36 31 86.1 5 13.9 15 12 80.0 3 20.0
Ohio 885 758 85.6 127 14.4 419 363 86.6 56 13.4
Oklahoma 235 182 77.4 53 22.6 121 86 71.1 35 28.9
Oregon 181 151 83.4 30 16.6 98 80 81.6 18 18.4
Rhode Island 53 48 90.6 5 9.4 30    9 30.0 21 70.0
South Carolina 679 598 88.1 81 11.9 381 347 91.1 34 8.9
South Dakota 34 30 88.2 4 11.8 15 12 80.0 3 20.0
Tennessee 642 477 74.3 165 25.7 381 254 66.7 127 33.3
Texas 3,553 2,735 77.0 818 23.0 1,979 1,410 71.2 569 28.8
Utah 129 109 84.5 20 15.5 65 58 89.2 7 10.8
Virginia 625 511 81.8 114 18.2 423 354 83.7 69 16.3
Washington 421 373 88.6 48 11.4 224 201 89.7 23 10.3
West Virginia 129 94 72.9 35 27.1 65 45 69.2 20 30.8
Wisconsin 210 182 86.7 28 13.3 115 104 90.4 11 9.6
Wyoming 14 13 92.9 1 7.1 2 2 100 0 0.0
Total 27,728 22,887 82.5 4,841 17.5 15,618 12,892 82.5 2,726 17.5

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, Centers for Disease Control and Prevention [footnotes only].

Note. Data are based on residence at diagnosis of HIV infection. Data are for cases reported to CDC through September 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. Linkage to HIV medical care was measured by documentation of ≥ 1 CD4 or VL tests ≤ 1 month after HIV diagnosis. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to CDC; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during January 2020 through June 2021 and reported to CDC through September 2021. Data are not provided for states and associated jurisdictions that do not have laws requiring reporting of all CD4 and viral loads or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Puerto Rico, and Vermont.

Table 2c. Linkage to HIV medical care within 1 month of HIV diagnosis among persons aged ≥ 13 years, by area of residence, January 2020–June 2021—Ending the HIV Epidemic Phase I jurisdictions (preliminary)
2020 2021 (January–June)
Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test Total diagnoses ≥1 CD4 or VL tests No CD4 or VL test
No. No. % No. % No. No. % No. %
Arizona
Maricopa County 482 412 85.5 70 14.5 274 235 85.8 39 14.2
California
Alameda County 151 128 84.8 23 15.2 83 75 90.4 8 9.6
Los Angeles County 1,306 1,079 82.6 227 17.4 628 536 85.4 92 14.6
Orange County 263 236 89.7 27 10.3 137 119 86.9 18 13.1
Riverside County 231 189 81.8 42 18.2 112 84 75.0 28 25.0
Sacramento County 68 58 85.3 10 14.7 41 37 90.2 4 9.8
San Bernardino County 259 182 70.3 77 29.7 139 102 73.4 37 26.6
San Diego County 275 238 86.5 37 13.5 105 91 86.7 14 13.3
San Francisco County 152 144 94.7 8 5.3 87 81 93.1 6 6.9
District of Columbia 198 173 87.4 25 12.6 56 49 87.5 7 12.5
Florida
Broward County 460 401 87.2 59 12.8 339 295 87.0 44 13.0
Duval County 230 185 80.4 45 19.6 151 120 79.5 31 20.5
Hillsborough County 249 211 84.7 38 15.3 161 138 85.7 23 14.3
Miami-Dade County 811 679 83.7 132 16.3 607 531 87.5 76 12.5
Orange County 375 323 86.1 52 13.9 240 198 82.5 42 17.5
Palm Beach County 216 173 80.1 43 19.9 154 126 81.8 28 18.2
Pinellas County 154 130 84.4 24 15.6 74 61 82.4 13 17.6
Georgia
Cobb County 122 103 84.4 19 15.6 63 56 88.9 7 11.1
DeKalb County 242 200 82.6 42 17.4 152 136 89.5 16 10.5
Fulton County 477 402 84.3 75 15.7 282 241 85.5 41 14.5
Gwinnett County 135 105 77.8 30 22.2 66 59 89.4 7 10.6
Illinois
Cook County 758 644 85.0 114 15.0 334 294 88.0 40 12.0
Indiana
Marion County 166 127 76.5 39 23.5 112 88 78.6 24 21.4
Louisiana
East Baton Rouge Parish 124 100 80.6 24 19.4 85 65 76.5 20 23.5
Orleans Parish 106 85 80.2 21 19.8 74 67 90.5 7 9.5
Maryland
Baltimore City 176 152 86.4 24 13.6 77 70 90.9 7 9.1
Montgomery County 80 70 87.5 10 12.5 52 48 92.3 4 7.7
Prince George’s County 214 193 90.2 21 9.8 130 109 83.8 21 16.2
Massachusetts
Suffolk County 133 119 89.5 14 10.5 52 50 96.2 2 3.8
Michigan
Wayne County 228 188 82.5 40 17.5 120 103 85.8 17 14.2
Nevada
Clark County 340 292 85.9 48 14.1 227 205 90.3 22 9.7
New York
Bronx County 341 292 85.6 49 14.4 184 162 88.0 22 12.0
Kings County 442 376 85.1 66 14.9 202 173 85.6 29 14.4
New York County 296 255 86.1 41 13.9 153 126 82.4 27 17.6
Queens County 315 279 88.6 36 11.4 146 131 89.7 15 10.3
North Carolina
Mecklenburg County 209 173 82.8 36 17.2 149 128 85.9 21 14.1
Ohio
Cuyahoga County 186 166 89.2 20 10.8 88 80 90.9 8 9.1
Franklin County 203 179 88.2 24 11.8 91 80 87.9 11 12.1
Hamilton County 133 115 86.5 18 13.5 55 50 90.9 5 9.1
Pennsylvania
Philadelphia County 327 281 85.9 46 14.1 140 115 82.1 25 17.9
Tennessee
Shelby County 232 155 66.8 77 33.2 134 72 53.7 62 46.3
Texas
Bexar County 286 204 71.3 82 28.7 172 125 72.7 47 27.3
Dallas County 661 500 75.6 161 24.4 357 266 74.5 91 25.5
Harris County 913 691 75.7 222 24.3 548 380 69.3 168 30.7
Tarrant County 294 214 72.8 80 27.2 167 87 52.1 80 47.9
Travis County 165 133 80.6 32 19.4 100 79 79.0 21 21.0
Washington
King County 199 179 89.9 20 10.1 97 88 90.7 9 9.3

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, Centers for Disease Control and Prevention [footnotes only].

Note. Data are based on residence at diagnosis of HIV infection. Data are for cases reported to CDC through September 2021, are considered preliminary until a 12-month reporting lag has been reached, and should be interpreted with caution. In addition to being preliminary, data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions. Linkage to HIV medical care was measured by documentation of ≥ 1 CD4 or VL tests ≤ 1 month after HIV diagnosis. Reporting of linkage to HIV medical care data requires a minimum 3-month reporting lag to account for delays in reporting of laboratory results to CDC; therefore, data on linkage to HIV medical care in these surveillance tables are for persons with HIV diagnosed during January 2020 through June 2021 and reported to CDC through September 2021. Data are not provided for states and associated jurisdictions that do not have laws requiring reporting of all CD4 and viral loads or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho and New Jersey. Areas with incomplete reporting: Kansas, Kentucky, Pennsylvania, Puerto Rico, and Vermont.

Table 3a. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage during January 2019 through June 2021, among persons aged ≥16 years, by selected characteristics—United States
2019 2020 2021 (January-June)
Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec
No. No. % No. No. % No. No. %
Sex at birth
Male 252,268 989,200 25.5 276,978 989,200 28.0 240,158 989,200 24.3
Female 21,002 227,010 9.3 23,675 227,010 10.4 17,102 227,010 7.5
Age (yr)
16–24 36,865 246,290 15.0 38,434 246,290 15.6 27,624 246,290 11.2
25–34 112,042 434,680 25.8 119,177 434,680 27.4 101,205 434,680 23.3
35–44 63,316 238,470 26.6 72,086 238,470 30.2 65,637 238,470 27.5
45–54 36,927 173,420 21.3 40,646 173,420 23.4 35,022 173,420 20.2
≥55 24,179 123,350 19.6 30,343 123,350 24.6 27,981 123,350 22.7
Race/ethnicityd
Black/African American 36,905 468,540 7.9 42,336 468,540 9.0 35,316 468,540 7.5
Hispanic/Latinoe 43,045 312,820 13.8 48,958 312,820 15.7 42,164 312,820 13.5
Other 11,483 131,180 8.8 12,184 131,180 9.3 10,340 131,180 7.9
White 181,981 300,650 60.5 197,305 300,650 65.6 169,732 300,650 56.5
Total 273,414 1,216,210 22.5 300,783 1,216,210 24.7 257,552 1,216,210 21.2

Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].

Note. For this release, 2019 through June 2021 PrEP coverage data are considered preliminary. Data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions.

aEstimated using data from IQVIA pharmacy database reported through June 2021 based on an algorithm that included FDA approved drugs for PrEP. Data for which values are unknown were not reported thus values may not sum to column total.
bEstimated using 2018 data from National HIV Surveilance System, National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey. Data are rounded to the nearest 10. Data for which values are unknown were not reported thus values may not sum to column total. The data sources used to estimate the number of persons with indications for PrEP have different schedules of data availability. Consequently, the availability of a denominator may lag the availability of a numerator. In this table, 2018 denominators were used for 2019, 2020 and January – June 2021 PrEP coverage data.
cPrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.
dRace/ethnicity data were only available for <40% of persons prescribed PrEP each year. Number prescribed PrEP and PrEP coverage for race/ethnicity reported in the table were adjusted by applying the distribution of records with known race/ethnicity to records with missing race/ethnicity.
eHispanic/Latino persons can be of any race.

Table 3b. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage during January 2019 through June 2021, among persons aged ≥16 years, by area of residence—United States and Puerto Rico
2019 2020 2021 (January-June)
Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec
No. No. % No. No. % No. No. %
Alabama 1,837 11,020 16.7 1,922 11,020 17.4 1,921 11,020 17.4
Alaska 231 1,780 13.0 245 1,780 13.8 202 1,780 11.3
Arizona 4,547 25,780 17.6 5,051 25,780 19.6 4,583 25,780 17.8
Arkansas 739 5,130 14.4 874 5,130 17.0 874 5,130 17.0
California 41,466 165,030 25.1 42,336 165,030 25.7 35,454 165,030 21.5
Colorado 4,331 25,120 17.2 4,754 25,120 18.9 4,218 25,120 16.8
Connecticut 2,660 9,560 27.8 2,474 9,560 25.9 2,077 9,560 21.7
Delaware 474 4,400 10.8 464 4,400 10.5 431 4,400 9.8
District of Columbia 5,801 12,950 44.8 5,945 12,950 45.9 5,180 12,950 40.0
Florida 21,684 125,330 17.3 34,594 125,330 27.6 28,141 125,330 22.5
Georgia 8,586 39,030 22.0 9,745 39,030 25.0 8,865 39,030 22.7
Hawaii 812 4,360 18.6 902 4,360 20.7 789 4,360 18.1
Idaho 471 4,790 9.8 656 4,790 13.7 591 4,790 12.3
Illinois 16,567 55,860 29.7 15,930 55,860 28.5 13,599 55,860 24.3
Indiana 2,963 22,170 13.4 3,204 22,170 14.5 2,977 22,170 13.4
Iowa 1,420 4,760 29.8 1,517 4,760 31.9 1,291 4,760 27.1
Kansas 905 5,060 17.9 950 5,060 18.8 867 5,060 17.1
Kentucky 1,613 12,990 12.4 1,670 12,990 12.9 1,488 12,990 11.5
Louisiana 3,922 15,920 24.6 3,608 15,920 22.7 3,107 15,920 19.5
Maine 639 3,950 16.2 663 3,950 16.8 627 3,950 15.9
Maryland 4,938 27,300 18.1 4,810 27,300 17.6 4,119 27,300 15.1
Massachusetts 9,280 24,900 37.3 9,375 24,900 37.7 7,009 24,900 28.1
Michigan 4,364 29,570 14.8 4,690 29,570 15.9 4,213 29,570 14.2
Minnesota 4,184 21,720 19.3 4,198 21,720 19.3 3,672 21,720 16.9
Mississippi 938 4,530 20.7 1,097 4,530 24.2 1,158 4,530 25.6
Missouri 3,474 18,370 18.9 3,585 18,370 19.5 2,976 18,370 16.2
Montana 267 2,290 11.7 300 2,290 13.1 273 2,290 11.9
Nebraska 614 2,180 28.2 725 2,180 33.3 675 2,180 31.0
Nevada 2,161 11,390 19.0 2,491 11,390 21.9 2,663 11,390 23.4
New Hampshire 620 3,020 20.5 652 3,020 21.6 555 3,020 18.4
New Jersey 5,662 25,280 22.4 5,928 25,280 23.4 5,164 25,280 20.4
New Mexico 1,075 6,800 15.8 1,239 6,800 18.2 1,110 6,800 16.3
New York 34,998 72,640 48.2 34,080 72,640 46.9 27,971 72,640 38.5
North Carolina 5,369 32,490 16.5 6,164 32,490 19.0 5,583 32,490 17.2
North Dakota 193 1,520 12.7 218 1,520 14.3 184 1,520 12.1
Ohio 6,104 40,320 15.1 6,834 40,320 16.9 6,090 40,320 15.1
Oklahoma 1,141 11,030 10.3 1,525 11,030 13.8 1,571 11,030 14.2
Oregon 3,365 19,750 17.0 3,817 19,750 19.3 3,183 19,750 16.1
Pennsylvania 10,113 36,490 27.7 10,610 36,490 29.1 9,334 36,490 25.6
Puerto Rico 330 9,700 3.4 368 9,700 3.8 387 9,700 4.0
Rhode Island 1,082 3,880 27.9 1,150 3,880 29.6 1,097 3,880 28.3
South Carolina 1,728 10,390 16.6 2,124 10,390 20.4 2,080 10,390 20.0
South Dakota 148 910 16.3 146 910 16.0 143 910 15.7
Tennessee 3,886 22,460 17.3 5,163 22,460 23.0 5,108 22,460 22.7
Texas 22,977 123,790 18.6 27,527 123,790 22.2 25,331 123,790 20.5
Utah 2,024 6,840 29.6 2,380 6,840 34.8 2,336 6,840 34.2
Vermont 337 1,060 31.8 321 1,060 30.3 306 1,060 28.9
Virginia 4,399 31,430 14.0 5,138 31,430 16.3 4,257 31,430 13.5
Washington 9,817 40,050 24.5 10,016 40,050 25.0 8,085 40,050 20.2
West Virginia 570 5,250 10.9 523 5,250 10.0 501 5,250 9.5
Wisconsin 2,464 12,980 19.0 2,526 12,980 19.5 1,944 12,980 15.0
Wyoming 94 890 10.6 99 890 11.1 90 890 10.1

Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].

Note. For this release, 2019 through June 2021 PrEP coverage data are considered preliminary. Data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions.

aEstimated using data from IQVIA pharmacy database reported through June 2021 based on an algorithm that included FDA approved drugs for PrEP. Data for which values are unknown were not reported thus values may not sum to column total.
bEstimated using 2018 data from National HIV Surveilance System, National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey. Data are rounded to the nearest 10. Data for which values are unknown were not reported thus values may not sum to column total. The data sources used to estimate the number of persons with indications for PrEP have different schedules of data availability. Consequently, the availability of a denominator may lag the availability of a numerator. In this table, 2018 denominators were used for 2019, 2020 and January – June 2021 PrEP coverage data.
cPrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.

Table 3c. Number of persons prescribed PrEP, number of persons with PrEP indications, and PrEP coverage during January 2019 through June 2021, among persons aged ≥16 years, by area of residence—Ending the HIV Epidemic Phase I jurisdictions
2019 2020 2021 (January-June)
Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec Persons Prescribed PrEPa Persons with PrEP Indicationsb PrEP Coveragec
No. No. % No. No. % No. No. %
Arizona
Maricopa County 3,519 22,720 15.5 3,887 22,720 17.1 3,547 22,720 15.6
California
Alameda County 2,154 8,930 24.1 2,025 8,930 22.7 1,528 8,930 17.1
Los Angeles County 13,667 67,450 20.3 14,797 67,450 21.9 13,062 67,450 19.4
Orange County 2,030 10,510 19.3 2,223 10,510 21.2 1,993 10,510 19.0
Riverside County 1,762 11,080 15.9 1,910 11,080 17.2 1,770 11,080 16.0
Sacramento County 948 5,920 16.0 969 5,920 16.4 754 5,920 12.7
San Bernardino County 750 11,890 6.3 817 11,890 6.9 781 11,890 6.6
San Diego County 3,705 14,500 25.6 3,774 14,500 26.0 3,089 14,500 21.3
San Francisco County 8,788 10,840 81.1 8,088 10,840 74.6 6,074 10,840 56.0
District of Columbia 5,801 12,950 44.8 5,945 12,950 45.9 5,180 12,950 40.0
Florida
Broward County 3,767 20,470 18.4 6,711 20,470 32.8 5,684 20,470 27.8
Duval County 503 8,970 5.6 744 8,970 8.3 629 8,970 7.0
Hillsborough County 1,377 12,910 10.7 1,520 12,910 11.8 1,353 12,910 10.5
Miami-Dade County 6,491 21,760 29.8 10,272 21,760 47.2 7,891 21,760 36.3
Orange County 2,765 15,310 18.1 3,865 15,310 25.2 3,385 15,310 22.1
Palm Beach County 876 9,170 9.6 3,025 9,170 33.0 1,778 9,170 19.4
Pinellas County 1,118 9,530 11.7 1,214 9,530 12.7 1,132 9,530 11.9
Georgia
Cobb County 557 3,070 18.1 644 3,070 21.0 569 3,070 18.5
DeKalb County 1,550 6,290 24.6 1,708 6,290 27.2 1,546 6,290 24.6
Fulton County 3,272 13,120 24.9 3,563 13,120 27.2 3,236 13,120 24.7
Gwinnett County 676 3,240 20.9 788 3,240 24.3 705 3,240 21.8
Illinois
Cook County 13,533 39,060 34.6 12,842 39,060 32.9 10,982 39,060 28.1
Indiana
Marion County 1,120 9,150 12.2 1,196 9,150 13.1 1,149 9,150 12.6
Louisiana
East Baton Rouge Parish 489 1,810 27.0 524 1,810 29.0 440 1,810 24.3
Orleans Parish 1,505 4,590 32.8 1,340 4,590 29.2 1,137 4,590 24.8
Maryland
Baltimore City 897 6,330 14.2 854 6,330 13.5 707 6,330 11.2
Montgomery County 903 5,770 15.6 910 5,770 15.8 790 5,770 13.7
Prince George’s County 810 4,040 20.0 822 4,040 20.3 734 4,040 18.2
Massachusetts
Suffolk County 2,747 6,520 42.1 2,801 6,520 43.0 1,934 6,520 29.7
Michigan
Wayne County 1,206 9,270 13.0 1,228 9,270 13.2 1,103 9,270 11.9
Nevada
Clark County 1,849 11,670 15.8 2,094 11,670 17.9 2,288 11,670 19.6
New Jersey
Essex County 680 4,090 16.6 709 4,090 17.3 592 4,090 14.5
Hudson County 1,041 4,650 22.4 1,045 4,650 22.5 896 4,650 19.3
New York
Bronx County 2,214 5,570 39.7 2,038 5,570 36.6 1,512 5,570 27.1
Kings County 7,481 15,650 47.8 7,401 15,650 47.3 6,253 15,650 40.0
New York County 13,927 15,540 89.6 13,648 15,540 87.8 11,558 15,540 74.4
Queens County 3,848 9,230 41.7 3,813 9,230 41.3 3,059 9,230 33.1
North Carolina
Mecklenburg County 1,341 8,450 15.9 1,570 8,450 18.6 1,454 8,450 17.2
Ohio
Cuyahoga County 954 7,520 12.7 961 7,520 12.8 884 7,520 11.8
Franklin County 2,032 11,620 17.5 2,307 11,620 19.9 2,056 11,620 17.7
Hamilton County 555 7,720 7.2 628 7,720 8.1 560 7,720 7.3
Pennsylvania
Philadelphia County 3,645 9,840 37.0 3,485 9,840 35.4 2,872 9,840 29.2
Puerto Rico
San Juan Municipio d 2,190 n/a d 2,190 n/a d 2,190 n/a
Tennessee
Shelby County 637 6,450 9.9 809 6,450 12.5 691 6,450 10.7
Texas
Bexar County 1,492 11,920 12.5 1,768 11,920 14.8 1,659 11,920 13.9
Dallas County 4,048 28,670 14.1 5,158 28,670 18.0 4,813 28,670 16.8
Harris County 4,905 40,670 12.1 5,973 40,670 14.7 5,566 40,670 13.7
Tarrant County 1,451 11,340 12.8 1,650 11,340 14.6 1,539 11,340 13.6
Travis County 4,539 11,590 39.2 5,063 11,590 43.7 4,406 11,590 38.0
Washington
King County 6,873 17,890 38.4 6,969 17,890 39.0 5,590 17,890 31.2

Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].

Note. For this release, 2019 through June 2021 PrEP coverage data are considered preliminary. Data for years 2020 and 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions.

aEstimated using data from IQVIA pharmacy database reported through June 2021 based on an algorithm that included FDA approved drugs for PrEP. Data for which values are unknown were not reported thus values may not sum to column total.
bEstimated using 2018 data from National HIV Surveilance System, National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey. Data are rounded to the nearest 10. Data for which values are unknown were not reported thus values may not sum to column total. The data sources used to estimate the number of persons with indications for PrEP have different schedules of data availability. Consequently, the availability of a denominator may lag the availability of a numerator. In this table, 2018 denominators were used for 2019, 2020 and January – June 2021 PrEP coverage data.
cPrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.
dData value <40 was not reported due to unreliability.