FAQs

Why are the data not from this year?

Each year, AIDSVu publishes the latest HIV data available from CDC and over 50 local health departments. The state-, county-, and city-level prevalence and new diagnoses data have about a one-year compilation period to allow for reporting time, data corrections, resolution of duplicate diagnoses across states, analyses, and report preparation. New diagnoses data offer a look at recent changes in the epidemic.

City-level data are available more quickly than the state- and county-level data due to the different data sources and their independent timelines.

Why aren’t some data shown?

To protect the privacy of those living with diagnosed HIV, AIDSVu does not display data where the number of people living with diagnosed HIV is less than five and/or the number of people in the area is less than 100 for states/counties and less than 500 for ZIP Codes/census tracts.

Areas appear white when one or both conditions are met. The darker shade of gray indicates an area where data are not shown because the data are either not available for the area or were not released to AIDSVu.

Why do the maps look different compared to last year?

The state- and county-level HIV surveillance data on AIDSVu are obtained from the CDC. Each state provides their HIV surveillance data to the CDC, and indicates, through a data re-release agreement, if they want their data to be released to the public, and if so, the criteria that must be met in order for the CDC to release their data publicly (i.e., the data suppression threshold). For example, a state may not allow the CDC to release their data to the public if a county within the state (or the whole state at the state-level) has a total population less than a specific threshold (50,000, 500,000, etc.). Data re-release agreements between the states and CDC were updated this year. Several states requested changes in the data suppression thresholds in their data re-release agreements, which is why the maps and the data look different from last year.

What is the difference between data not shown, data not released to AIDSVu, and no cases reported?

The white denotes data not shown to protect privacy because of a small number of cases and/or a small population. This means the number of cases is between 1-4 or the population is less than 100 so the county/state is suppressed to protect the privacy of those individuals.

The lighter grey denotes zero cases reported. This means there were zero people either living with HIV or newly diagnosed with HIV reported to the CDC.

The darker grey denotes data not released to AIDSVu. This means the state has chosen to not allow the CDC to release their data to the public if a county within the state (or the whole state at the state-level) has a total population less than a specific threshold (50,000, 500,000, etc). Each state fills out a data re-release agreement with the CDC where they indicate what level of suppression they would like applied to their state.

These suppression rules apply at both the state and county-level. They also differ depending on the level of stratification. See the data methods for more details.

How does AIDSVu account for prison and jail data and what do the correctional disclaimers on the map mean?

Some counties have state or federal correctional facilities where inmates may have been diagnosed with HIV. Because the data displayed on AIDSVu count these inmates, and because the “persons living with diagnosed HIV” are analyzed by “most recent known address” and “persons newly diagnosed with HIV” data on AIDSVu are analyzed by “residence at HIV diagnosis,” inmates living in or diagnosed at correctional facilities are counted as cases in the county where the facility is located. This may inflate the rate and case count of persons living with an HIV diagnosis in the county and may not represent HIV infection in the county’s community as a whole. In cases where this inflation may occur, a note is included in the pop-up window for the relevant geographic area. See the Data Methods page for additional information about how the inclusion of these correctional notes was determined.

Some AIDSVu cities have excluded case counts where the HIV diagnosis may have occurred in a correctional facility. Correctional disclaimers on AIDSVu’s city maps are on a case-by-case basis. To see cities that display correctional disclaimers, see the Data Methods page.

How are transgender cases defined on AIDSVu?

According to CDC, transgender is defined as people whose gender identity or expression is different from their sex assigned at birth. In 2022, AIDSVu included data provided by 23 city jurisdictions from the electronic HIV/AIDS Reporting System (eHARS) on individuals who are transgender women (Male-to-Female) and/or transgender men (Female-to-Male). The data provided are the estimated number of people living with diagnosed HIV and had a reported difference between birth sex and current gender.

What is the HIV care continuum and why is it important?

The HIV care continuum is a public health model that outlines the stages of care that people living with HIV go through from diagnosis to achieving and maintaining viral suppression – a very low or undetectable amount of HIV in the body. The HIV care continuum is vital in assessing individual care outcomes and population-level progress towards ending the HIV epidemic. Data on the HIV care continuum helps determine if people living with HIV in a given community are engaged in each successive step and where they may be facing barriers and falling out of care. This helps policymakers and service providers better determine where resources and strategies are needed to support people living with HIV to achieve the goal of viral suppression and live long, healthy lives.

What is viral suppression and why is viral suppression important?

Viral suppression is the last step in the HIV care continuum. Viral suppression is when people living with HIV take HIV medication daily as prescribed and reduce the amount of HIV in their blood to a very low, or undetectable, level. People who achieve viral suppression can experience better health outcomes and have effectively no risk of sexually transmitting HIV to their partners. In the U.S., viral suppression is defined as less than 200 copies/mL of HIV in the blood.

Viral suppression is the foundational concept of Undetectable = Untransmittable (U = U) and the “Treatment as Prevention” strategy (TasP), which refers to taking HIV medication to prevent the sexual transmission of HIV. It is a highly effective option for preventing HIV transmission.

At a community level, a high rate of viral suppression indicates a lower chance of HIV transmission among members of the community. A high rate of viral suppression can only be achieved by diagnosing individuals and engaging them in HIV care and treatment.

What HIV care continuum indicators does AIDSVu map?

AIDSVu maps the following steps of the HIV care continuum at the state-level:

• New HIV Diagnoses – Individuals who received a new HIV diagnosis in 2019/2020.
• Late HIV Diagnoses – Individuals diagnosed with stage 3 HIV (AIDS) within 3 months of an initial HIV diagnosis in 2019/2020.
• Linkage to HIV Care – Individuals who visited an HIV health care provider within 1 month of being diagnosed with HIV in 2019/2020.
• Receipt of HIV Care – Individuals living with diagnosed HIV who received medical care for HIV in 2019/2020.
• Viral Suppression – Individuals living with diagnosed HIV who had a low or undetectable viral load (the amount of HIV in the blood) in 2019/2020.

AIDSVu also maps the following steps of the HIV care continuum at the ZIP Code-level:

• New HIV Diagnoses – Individuals who received a new HIV diagnosis between 2014 and 2019/2020.
• Late HIV Diagnoses – Individuals diagnosed with stage 3 HIV (AIDS) within 3 months of an initial HIV diagnoses between 2014 and 2019/2020.
• Linkage to HIV Care – Individuals who visited an HIV health care provider within 1 month of being diagnosed with HIV between 2014-2019/2020.
• Receipt of HIV Care – Individuals living with diagnosed HIV who received medical care for HIV in 2019/2020.
• Viral Suppression – Individuals living with diagnosed HIV who had a low or undetectable viral load (the amount of HIV in the blood) in 2019/2020.

What inspired AIDSVu to add HIV care continuum data and maps?

These data and maps began as a proof of concept with the inaugural Powered By AIDSVu project HIVContinuum.org in February 2015, and now AIDSVu has expanded on this model to include more than 40 states, Washington, DC, and over 35 cities at ZIP Code-level across the U.S. The initial project displayed data and maps illustrating the HIV care continuum in eight cities in the U.S. – Atlanta, Chicago, Dallas, New Orleans, New York, Philadelphia, San Francisco, and Washington, D.C. – and two states – Illinois and Texas.

What is the source of AIDSVu’s HIV care continuum data?

State-level HIV care continuum data is obtained from CDC. AIDSVu also collaborates with health departments across the country to display steps of the HIV care continuum, including new diagnoses, late diagnoses, linkage to care, receipt of care, and viral suppression by ZIP Code. To facilitate this, AIDSVu obtained data release agreements directly from the state or local public health departments. As a result, ZIP Code-level data are not directly comparable to the state- and county-level HIV data displayed on AIDSVu, which are obtained from CDC.

For more information about AIDSVu’s data sources and methods, please see the Data Methods.

Why do AIDSVu’s HIV care continuum indicators differ from others like CDC?

AIDSVu emphasizes and continually strives to increase the granularity of its publicly-available data, a perspective that complements CDC’s perspective – which focuses primarily on national, state, and large metropolitan area-level data. As a result, it is not always possible for AIDSVu to follow the same definitions and calculation methods for HIV-related indicators as CDC, but instead follow stricter rules especially for areas below the state level because of issues concerning small numbers (e.g., confidentiality concerns, unstable estimates).

AIDSVu is guided by a decision-making process that includes CDC input, but is separate from CDC. For more information about AIDSVu’s data sources and methods, please see the Data Methods.

Why does AIDSVu map the HIV care continuum?

AIDSVu’s mission is to make HIV-related data widely available, easily accessible, and locally relevant to inform public health decision making. By visualizing data across the HIV care continuum on AIDSVu, health departments, policymakers, researchers, and community leaders are better able to identify disparities in outcomes, develop programs, and allocate resources to improve each step of the care continuum and achieve the goal of viral suppression in their communities.

As community leaders continue to use the HIV care continuum to measure progress toward HIV goals, pinpointing where gaps in services exist is vital. Visualizing where drop-offs are most pronounced, and for what populations, helps decision-makers implement system-wide improvements to support all people living with HIV to successfully navigate the continuum and achieve viral suppression.

What Ending the HIV Epidemic: A Plan for America initiative goals are linked to HIV care continuum indicators?

Progress towards the Ending the HIV Epidemic: A Plan for America (EHE) initiative goals are measured by tracking six indicators. Each indicator reflects public health goals and aligns with the four key strategies of the EHE initiative: diagnose, prevent, treat, and respond. The six EHE indicators are incidence, new diagnoses, knowledge of status, viral suppression, and PrEP use. These indicators represent important steps on the HIV care continuum. For more information on the EHE initiative, visit AIDSVu’s Deeper Look page.

How else can the HIV care continuum data on AIDSVu be utilized, and what continuum resources does AIDSVu have?

State- and ZIP Code-level HIV care continuum maps on AIDSVu can be viewed alongside social determinants of health. Additionally, AIDSVu provides downloadable datasets that researchers, health departments and others can utilize in their own analyses. Check the AIDSVu blog for recent examples data utilization.

AIDSVu also provides aggregated, national-, state-, county- and city-level HIV care continuum data on the local data profiles, including new diagnoses, late diagnoses, linkage to care, receipt of care, and viral suppression with data stratified by age, sex, and race/ethnicity. These data can be viewed with other HIV data to help contextualize the HIV care continuum.

In addition to the data and maps, AIDSVu also features a Deeper Look: Viral Suppression page, which is dedicated to highlighting the importance of the final HIV care continuum step. The page features insights from the data, infographics, and blogs by HIV experts and is updated on an ongoing basis.

Why are HIV care continuum data not available for all AIDSVu cities?

AIDSVu continually strives to increase the granularity of its publicly-available data to support more-informed local public health decision making. To that end, AIDSVu released HIV care continuum data for the cities that were available and able to provide data at this time. AIDSVu will continue to work with additional cities in the coming months to bring more ZIP Code-level continuum data and maps to the site, further empowering communities to understand and visualize their local HIV epidemic.

You can sign up to receive email notifications when new features or data are added to the site.

What is Pre-Exposure Prophylaxis (PrEP)?

Pre-exposure prophylaxis (PrEP) is when people at risk for HIV take or receive HIV medicine regularly to lower their chances of getting infected with HIV. When taken regularly, PrEP medication can provide a high level of protection against HIV. It can be used as part of a comprehensive prevention strategy, including condoms and other prevention methods, to reduce the risk of sexually transmitted infections (STIs). When someone is exposed to HIV, PrEP can help prevent the virus from establishing a permanent infection in the body. Visit CDC’s “PrEP” page to learn more.

The U.S. Food and Drug Administration (FDA) approved the HIV medicine tenofovir disoproxil fumarate [TDF] in combination with emtricitabine [FTC] (TDF/FTC) for daily use as PrEP in 2012, as well as tenofovir alafenamide [TAF] in combination with emtricitabine [FTC] (TAF/FTC) for daily use as PrEP in 2019. In December 2021, the FDA approved cabotegravir extended-release injectable suspension for use in at-risk adults and adolescents weighing at least 35 kilograms (77 pounds) for PrEP to reduce the risk of sexually acquired HIV.

AIDSVu currently displays PrEP utilization data through 2021 and includes prescriptions of TDF/FTC and TAF/FTC for PrEP, after their approvals in 2012 and 2019, respectively. However, AIDSVu’s dataset does not yet include prescriptions of cabotegravir since it was approved on December 20, 2021.  Please see “Which PrEP medications are included in PrEP use data?” below for additional information.

What data do the AIDSVu PrEP maps visualize?

The PrEP use data on AIDSVu represent a reliable and consistent estimate of the number of people who were prescribed TDF/FTC or TAF/FTC for PrEP in a calendar year from 2012 to 2021, excluding prescriptions for TDF/FTC and TAF/FTC that were made for other known indications, such as post-exposure prophylaxis, chronic Hepatitis B management, and treatment for HIV and other opportunistic infection. These individuals are referred to as “PrEP users.” AIDSVu’s PrEP use data are calculated to represent the estimated number of PrEP users in each county and state in the U.S. by year. Please see “What are the limitations of the PrEP use data?” below for additional information.

The PrEP use data on AIDSVu are presented at the county- and state-level and can be viewed as number of PrEP users and rate of PrEP use, expressed as the number of PrEP users per 100,000 people in the population. PrEP-to-Need Ratio (PNR) data can also be viewed, which is the ratio of the number of PrEP users in a given year to the number of people newly diagnosed with HIV in a given year. The data can be broken down by age (year of birth, displayed as 24 and under (13-24), 25 to 34, 35 to 44, 45 to 54, 55+) and sex (sex at birth, displayed as male or female). State-level data can also be broken down by race/ethnicity (Black, Hispanic, and White). Data on PrEP use can also be viewed alongside social determinants of health at the county- and state-level, such as poverty, high school education, median household income, income inequality, and people without health insurance.

Please see the Data Methods page for additional information.

What is the source of the PrEP use data?

The release of the PrEP use data on AIDSVu was made possible through a data-sharing agreement in which data were obtained from IQVIA Inc. with the support of Gilead Sciences, Inc., and compiled by researchers at the Rollins School of Public Health at Emory University.

IQVIA provides Emory with a limited dataset of aggregated and anonymized pre-exposure prophylaxis (PrEP) use data, along with age, sex, and race/ethnicity classifications. The IQVIA database contains anonymized individual-level prescription records collected electronically from US retail pharmacies, traditional pharmacies, specialty mail-order pharmacies, long-term care (LTC) facilities, and “other” pharmacies (e.g., in-hospital pharmacies, HMO pharmacies). The IQVIA database uses national estimates of prescription fills to estimate PrEP prescriptions for the small percentage of US prescriptions that are not tracked directly by IQVIA. The prescriptions database includes age and sex and was linked to a claims database to obtain diagnoses codes.  Race/ethnicity data were self-reported and assembled from the Experian Consumer Database. Race/ethnicity data were available for about a third of PrEP users, and data summarized by race/ethnicity are based on that subset of users.

An algorithm was used to differentiate the HIV treatment and HIV PrEP indications using prescription and diagnoses data for individuals taking FTC/TDF (starting in 2020), or FTC/TAF after its approval in 2019. For AIDSVu, the analyses determined total PrEP usage with FTC/TDF and FTC/TAF and not individually for each product. IQVIA excluded prescriptions for TDF/FTC and TAF/FTC that were made for other known indications, such as post-exposure prophylaxis (PEP), chronic Hepatitis B management, and treatment for HIV and other opportunistic infections. An individual with diagnosis or treatment codes for HIV, chronic Hepatitis B or codes for PEP prior to the exposure era of FTC/TDF or FTC/TAF would be considered not to be taking PrEP.

The statements, findings, conclusions, views, and opinions contained and expressed on the AIDSVu website are based in part on data obtained under license from the following information service(s): LAAD Longitudinal Access and Adjudication Dataset HIV data, January 2012 – December 2021), IQVIA Inc. All Rights Reserved. The statements, findings, conclusions, views, and opinions contained and expressed herein are not necessarily those of IQVIA Inc. or any of its affiliated or subsidiary entities. Any analysis is independently arrived at by Emory University, on the basis of the data and other information.

Please see the Data Methods page for additional information.

What is IQVIA?

IQVIA is a leading global provider of advanced analytics, technology solutions, and clinical research services dedicated to creating intelligent connections that deliver unique innovations and actionable insights for healthcare and life sciences manufacturers, payers, and providers.  For more information, visit https://www.iqvia.com.

How was the number of PrEP users by county and state calculated?

To account for underestimations of PrEP use due to misclassified prescriptions, researchers at the Rollins School of Public Health at Emory University upweighted the county-level PrEP users’ data by using state-specific percentages of unclassified prescriptions (prescriptions that have an unknown indication).

Although the exact number of PrEP users is unknown, this calculation method accounts for a known source of missing data and provides a reliable and consistent metric for PrEP users at the county- and state-level. The method was adopted from Sullivan et al.’s published article in Annals of Epidemiology titled “Methods for county-level estimation of pre-exposure prophylaxis coverage and application to the U.S. ending the HIV epidemic jurisdictions.”

The unrounded number of weighted PrEP users per county were then summed to obtain state-, regional-, and national-level estimates.

Finally, data suppression rules were applied to protect persons using PrEP from any potential disclosure of identity by geographic and personal characteristics. If the number of persons using PrEP in a group was less than 3, or the population denominator was less than 100, the data was suppressed.

Please see the Data Methods page for additional information.

What types of PrEP use data are available on AIDSVu?

In addition to interactive maps and profiles, AIDSVu provides downloadable PrEP use maps and datasets at the county-and state-level and PrEP use datasets at the regional and national-level for researchers and health departments to utilize in their own analyses.

Alongside state-level PrEP use data and maps by race/ethnicity, AIDSVu has additional data and maps on PrEP use at the county- and state-level.

• Single year, county-level PrEP users and rates from 2012-2021, stratified by age and sex
• Single year, county-level PrEP-to-Need Ratio from 2012-2021, stratified by age and sex
• Single year, state-level PrEP users and rates from 2012-2021, stratified by age, sex, and race/ethnicity
• Single year, state-level PrEP-to-Need Ratio from 2012-2021, stratified by age, sex, and race/ethnicity
• Profiles with statistics on PrEP use data at the national, regional, state, and county levels

Additional PrEP resources on AIDSVu include a Deeper Look: PrEP page providing further insights on AIDSVu’s PrEP use and PNR data, downloadable infographics and data sets, and blogs by HIV experts. AIDSVu also features a PrEP Locator, a national directory of public and private practice providers of PrEP across the U.S. AIDSVu users can find local PrEP providers near them with this tool or overlay service locations on top of AIDSVu’s PrEP use maps.

What are the limitations of the PrEP use data?

The U.S. healthcare system is very fragmented, and that fragmentation carries over to the way that data is collected and shared across the system. There are a large number of public and private healthcare data collection systems in the U.S.; however, data do not flow among these entities in a cohesive or standardized way. Due to this fact, there is currently no single entity or data source that collects data on all users of PrEP across the U.S. As a result, the exact number of PrEP users is unknown.

The PrEP use data on AIDSVu represent a reliable and consistent estimate of the number of PrEP users at the county- and state-level in the U.S. by year, but the actual number of PrEP users may be higher.

AIDSVu’s PrEP use dataset is derived from a single data source, IQVIA, and they do not directly collect data on every prescription in the U.S. IQVIA uses national estimates of prescription fills to estimate PrEP prescriptions for the small percentage of U.S. prescriptions they do not track but this is an estimation.  Additionally, AIDSVu’s PrEP use dataset excludes TDF/FTC and TAF/FTC prescriptions that do not have sufficient medical procedure or diagnosis codes to confirm that the prescription was for PrEP and not for any other use, such as HIV treatment, chronic Hepatitis B treatment, or post-exposure prophylaxis – referred to here as “unclassified prescriptions.” However, only a small minority (6%) of these unclassified prescriptions can be assumed to have been prescribed for purposes other than PrEP. To correct for the underestimation of PrEP use due to unclassified prescriptions, the raw data has been adjusted with state-specific weights of unclassified TDF/FTC and TAF/FTC prescriptions. This calculation method provides a reliable and consistent metric for PrEP users at the county- and state-level.

The PrEP use data by race/ethnicity should be interpreted with caution. Race/ethnicity data is available for about a third of individuals with PrEP prescriptions. The race/ethnicity categories include Black, Hispanic, and White. To estimate total PrEP users by race/ethnicity, AIDSVu assumed that the racial/ethnicity distribution was the same in PrEP users with missing race/ethnicity data as in those with reported race data.  Additionally, <1% of PrEP users categorized as Black or white may be one or more other races besides Black or white because of Experian Consumer Database decision rules implemented before AIDSVu received the data.

What do the PrEP use data reveal?

(PrEP use data is from 2021, and new diagnoses data is from 2020, unless otherwise noted. Due to the COVID-19 pandemic, all data from 2020 should be interpreted with caution)

PrEP Use by Race/Ethnicity

• Black people represented 14% of PrEP users, but 42% of new HIV diagnoses.
• Hispanic/Latinx people represented 17% of PrEP users and 27% of new HIV diagnoses
• White people represented 65% of PrEP users and 26% of new HIV diagnoses.
• Regionally, Black people made up 52% of new HIV diagnoses in the South, but only 21% of PrEP users in the South; in the Midwest, Black people made up 48% of new HIV diagnoses, but only 12% of PrEP users.
• Of the 7 states with the greatest unmet need for PrEP among Black people, three were in the South (Arkansas, Mississippi, and Alabama) and three were in the Midwest (North Dakota, South Dakota, and Iowa). These states have a PrEP-to-Need Ratio (PNR) of less than 2 (i.e., fewer than 2 PrEP users for every new HIV diagnosis) *.
• In the West, Hispanic/Latinx people represented 43% of new HIV diagnoses but only represented 22% of all PrEP users.

Overall PrEP Use

• The number of PrEP users in the U.S. increased by 23% from 2020 to 2021, continuing a trend of consistent growth in PrEP use since 2012.
• Although PrEP use has increased steadily every year since 2012, there was a much lower rate of increase in 2020 of only 11% from 2019. This lower pace of growth occurred during the COVID-19 pandemic.
• The South accounted for 52% of HIV diagnoses but only accounted for 39% of PrEP users.
• In 2021, states that had expanded their Medicaid programs had rates of PrEP use that were 1.5X higher than states that did not expand Medicaid.
• Among all PrEP users in the U.S., 92% were male and only 8% were female, despite the fact that women comprised 18% of new HIV diagnoses.
• Teenagers and young adults (aged 13-24 years) had the greatest unmet need for PrEP among all age groups, with a PNR of 6*accounting for 20% of new HIV diagnoses but only 13% of PrEP users.

* PrEP-to-Need Ratio (PNR) is the ratio of the number of PrEP users in 2021 to the number of people newly diagnosed with HIV in 2019. It is a measurement of whether PrEP use appropriately reflects the need for HIV prevention. A lower PNR indicates more unmet need.

Why were these data released on AIDSVu, and why does data on PrEP use matter?

It is said that things that are not measured do not change. AIDSVu’s mission is to make HIV-related data widely available, easily accessible, and locally relevant to inform public health decision-making.

Increasing the use of PrEP is one of four key focus areas in the national initiative, Ending the HIV Epidemic: A Plan for America and a is a core component of Getting to Zero campaigns in cities and states across the U.S. AIDSVu’s county- and state-level PrEP use data help health departments, elected officials, medical professionals, and community leaders better understand and visualize trends in PrEP use over time, so they can develop programs and policies to increase PrEP awareness and access where it is needed most.

In 2018, AIDSVu released the first-ever state-level data and interactive maps of PrEP users across the U.S. In 2020, AIDSVu released the first-ever county-level data and interactive maps of PrEP users nationwide. In 2022, AIDSVu released the first-ever publicly available state-level PrEP use data by race/ethnicity. By continuing to add new PrEP use data, AIDSVu continues its commitment to provide public health officials, policymakers, healthcare professionals, researchers, and community leaders with a more comprehensive view of the HIV epidemic at the local, state, and national levels.

What can the PrEP use data on AIDSVu be used for?

The PrEP use datasets on AIDSVu provide reliable, consistent, comparable, and replicable numbers of annual PrEP users by county and state. Limitations of the data are described in the FAQs and Data Methods. These data are well suited for public health research and planning purposes. For example, these data can be used to:

• Monitor progress, trends, and disparities in PrEP use at the county- and state-level and among specific age groups, racial/ethnic groups, or sexes;
• Compare relative levels of PrEP use among counties, states, and regions;
• Support research to investigate questions related to PrEP awareness, access, and use; and
• Inform public health planning and policies.

How else can the PrEP use data be utilized on AIDSVu, and what other PrEP-related resources does AIDSVu have?

County- and state-level PrEP use data on AIDSVu can be viewed alongside social determinants of health and other HIV data, such as new diagnoses, prevalence, and mortality. Additionally, AIDSVu provides downloadable PrEP use datasets at the county-, state-, regional- and national-level for researchers and health departments to utilize in their own analyses. Check the AIDSVu blog for recent examples of PrEP use data utilization.

In addition to the PrEP use data and maps, AIDSVu also features a Deeper Look: PrEP page, which is dedicated to promoting public awareness about PrEP, visualizing key facts about PrEP, and advancing education around PrEP. The page features insights from the data, infographics, and blogs by HIV experts and is updated on an ongoing basis.

AIDSVu also features a PrEP Locator, a national directory of public and private practice providers of PrEP across the U.S. AIDSVu users can find local PrEP providers near them with this valuable tool. The PrEP Locator project was originally developed by Emory University’s Rollins School of Public Health with support from M•A•C AIDS Fund. The PrEP Locator is now managed by CDC’s National Prevention Information Network (NPIN). PrEP provider locations can be overlaid on top of AIDSVu’s PrEP use maps.

How has AIDSVu’s PrEP use data evolved?

AIDSVu continually strives to increase the granularity and usefulness of its publicly available data to inform local public health decision making. Over time, new data methods and data sources for PrEP have surfaced and AIDSVu has improved its PrEP use data as a result.

Prior to 2020, AIDSVu obtained PrEP use data from Symphony Health and did not have race/ethnicity data.

AIDSVu now obtains PrEP use data from IQVIA and includes state-level race/ethnicity data. Please see “What types of PrEP use data are available on AIDSVu?” above for additional information.

Which PrEP medications are included in AIDSVu’s PrEP use data?

The U.S. Food and Drug Administration (FDA) approved the HIV medicine tenofovir disoproxil fumarate [TDF] in combination with emtricitabine [FTC] (TDF/FTC) for daily use as PrEP in 2012, as well as tenofovir alafenamide [TAF] in combination with emtricitabine [FTC] (TAF/FTC) for daily use as PrEP in 2019. In December of 2021, the FDA approved cabotegravir extended-release injectable suspension for use in at-risk adults and adolescents weighing at least 35 kilograms (77 pounds) for PrEP to reduce the risk of sexually acquired HIV. AIDSVu currently displays PrEP utilization data through 2021 and includes prescriptions of TDF/FTC and TAF/FTC for PrEP, after their approvals in 2012 and 2019, respectively. However, AIDSVu’s dataset does not yet include prescriptions of cabotegravir since it was approved on December 20, 2021.  Future PrEP use data updates on AIDSVu will include prescriptions of cabotegravir for PrEP.

You can sign up on the AIDSVu website to receive email notifications when new features or data are added to the site.

Does AIDSVu’s PrEP use data include donations of PrEP medications made by Gilead Sciences to the Ready, Set, PrEP program as part of the Ending the HIV Epidemic: A Plan for America initiative?

AIDSVu currently displays PrEP use data through 2021. The Ready, Set, PrEP program was launched in December 2019; therefore, the current PrEP use data on AIDSVu includes any PrEP medication prescriptions provided through the Ready, Set, PrEP program after its launch. For more information about Ready, Set, PrEP, visit www.getyourprep.com.

You can sign up on the AIDSVu website to receive email notifications when new features or data are added to the site.

How are these data different from other data on PrEP that have been shared publicly?

AIDSVu’s PrEP use data are not intended to be compared to any other publicly available data on PrEP use due to the significant differences in data sources and methodologies. Data displayed on AIDSVu represent the estimated number of unique persons, by county and state, who were prescribed TDF/FTC or TAF/FTC for PrEP. On AIDSVu, these individuals are referred to as “PrEP users.”

The PrEP use data on AIDSVu represent a reliable and consistent estimate of the number of PrEP users at the county- and state-level in the U.S. by year. The data are subject to the limitations of the dataset as described above and on the Data Methods page.

There is currently no single data source that includes data on all unique users of PrEP across the U.S. Other publicly shared data on PrEP use have derived estimates from different data sources, the same data source with different inclusion/exclusion criteria and assumptions, or from multiple data sources. Additionally, data has also been shared publicly on the cumulative number of unique persons who have initiated TDF/FTC for PrEP since 2012, also referred to as “PrEP starts.”

Why does the most current year PrEP rate not always use the respective year of population data for calculation?

Rates of PrEP use are calculated per 100,000 population to allow for data standardization and comparison. American Community Survey (ACS) one-year population estimates are used for the denominator for yearly state-level data. ACS combined five-year population estimates are used for the denominator for yearly county-level data. However, due to timing of surveillance population data reporting, the denominators (state and county population), will typically lag one year behind the numerator (number of PrEP users). As more current population data becomes available, the 2021 PrEP rates will be updated with future data launches.

How is the PrEP-to-Need Ratio calculated?

The PrEP-to-Need Ratio (PNR) data compare the ratio of the number of PrEP users in a given year to the number of people newly diagnosed with HIV in the corresponding year. The numerator is number of PrEP users, by year, and the denominator is new HIV diagnoses cases, by year.

Why does the most current year PrEP-to-Need Ratio not always use the respective year new HIV diagnoses for calculation?

Due to the timing of HIV surveillance data reporting, the denominator (HIV New Diagnoses) will typically lag one year behind the numerator (number of PrEP users). The latest HIV new diagnoses data available will be used as the denominator when calculating PNR. For example, since 2019 new diagnoses is the latest year available on AIDSVu, it is used to calculate 2020 and 2021 PNR. As more current HIV diagnoses data becomes available, the 2020 and 2021 PNR will be updated with future data launches.

How often will new PrEP use data be released?

AIDSVu continually strives to increase the granularity of its publicly-available data to support more-informed local public health decision making. To that end, AIDSVu plans to release updated PrEP maps and data on an annual basis.

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What is Powered By AIDSVu?

Powered By AIDSVu projects use the existing AIDSVu infrastructure to expand to other projects that visualize complex information to inform public health decision-making. Powered By AIDSVu projects incorporate collaborative content and programs from additional data sources and partners. The inaugural Powered By AIDSVu project, HIVContinuum.org, was released in February 2015 as a proof of concept and maps the continuum of care across the five stages of the HIV treatment cascade. Now AIDSVu has expanded on this model and maps more than 40 states, Washington, DC, and over 35 cities at ZIP Code-level across the U.S. A new Powered By AIDSVu project, HepVu.org, was released in April 2017 and visualizes the first standardized state-level estimates of people with Hepatitis C infection across the United States.

For more information about AIDSVu’s HIV care continuum maps and data, visit the HIV Care Continuum tab.

What does HIVContinuum.org show?

HIVContinuum.org displays data and maps illustrating the HIV care continuum in eight large cities in the U.S. – Atlanta, Chicago, Dallas, New Orleans, New York, Philadelphia, San Francisco, and Washington, D.C and two states – Illinois and Texas. The site includes data for persons newly diagnosed with HIV between 2010 and 2014 and visualizes new HIV diagnosis, late HIV diagnosis, linkage to HIV care, engagement in HIV care, and suppressed HIV Virus (engaged and diagnosed).

These data and maps began as a proof of concept with the inaugural Powered By AIDSVu project HIVContinuum.org in February 2015, and now AIDSVu has expanded on this model to more than 40 states, Washington, DC, and 35 cities at ZIP Code-level across the U.S. For more information about AIDSVu’s HIV care continuum maps and data, visit the HIV Care Continuum tab.

What does HepVu show?

HepVu maps state-level Hepatitis C prevalence estimates obtained from the Emory University Coalition for Applied Modeling for Prevention (CAMP) project, including researchers from the University of Albany. This was a collaborative effort with researchers from the Centers for Disease Control and Prevention (CDC), and findings were published in the peer-reviewed Journal of the American Medical Association (JAMA) Network Open.

HepVu also maps state-level Hepatitis C-related mortality data (2017) and three opioid-related indicators that, together with HepVu’s Hepatitis C data, help illustrate the relationship between the opioid crisis and viral hepatitis in the U.S. The opioid-related data on HepVu include:

• Opioid prescription rate (2019)
• Overdose mortality rate (2018-2019)
• Pain reliever misuse prevalence (2019)

HepVu data at the county level includes:

• Hepatitis C-related mortality data (2017)
• Opioid prescription rate (2018)
• Overdose mortality rate (2018)

HepVu’s Hepatitis C data can be visualized by rates and cases, and alongside data comparison maps, including opioid-related indicators and social determinants of health – such as poverty, high school education, median household income, income inequality, and people without health insurance.

Why was AIDSVu developed?

AIDSVu was developed with the goal of making HIV data widely available, easily accessible, and locally relevant to inform public health decision making. AIDSVu’s state-, county-, and city- level data can help increase disease awareness and inform planning and decisions about the best use of HIV prevention, testing, and treatment resources. These data also underscore the importance of all individuals aged 13 to 64 being tested for HIV at least once in their lifetime, as recommended by the U.S. Centers for Disease Control and Prevention (CDC).

Who is AIDSVu intended for?

AIDSVu can be used by everyone. The site is intended to be a resource for public health officials, health care providers, researchers, policymakers, advocates, and the general public. The detailed, yet easily accessible, information on AIDSVu can help communities plan where HIV prevention, testing, and treatment services are needed most; provide important data and visuals for grants, policy reports, and advocacy efforts; and give health care providers and the general public a tool for better understanding how HIV impacts their communities.

Who created AIDSVu?

AIDSVu was developed by Emory University’s Rollins School of Public Health in partnership with Gilead Sciences, Inc. It is led by Dr. Patrick Sullivan, Professor of Epidemiology at Emory University.

Who helps to advise the AIDSVu project?

AIDSVu receives ongoing support and guidance from three groups consisting of key stakeholders and experts: the AIDSVu Advisory Committee, the AIDSVu Technical Advisory Group, and the AIDSVu Prevention and Treatment Advisory Committee. The individuals who participate in these groups are representatives of organizations such as the U.S. Department of Health and Human Services, the U.S. Centers for Disease Control and Prevention, the U.S. National Institutes of Health, the Kaiser Family Foundation, the National Association of State and Territorial AIDS Directors, national patient and community advocates, representatives from state and local health departments, and private industry.

What does AIDSVu’s interactive map show?

AIDSVu visualizes HIV prevalence data – the rates and numbers of persons living with an HIV diagnosis – in states and counties across the U.S. in 2019, and in multiple cities in 2019. The state and county maps also show new HIV diagnoses data – the rates and cases of new HIV diagnoses – from 2008 to 2019. The new HIV diagnoses in the cities show a cumulative 5-year case count and risk from 2016 to 2020. 

AIDSVu also visualizes steps of the HIV care continuum at the state- and city-level for all 50 states, Washington, DC, and over 35 cities. At the state-level, the platform maps late HIV diagnoses (2019), linkage to HIV care (2019), receipt of HIV care (2019), and viral HIV suppression (2019). At the ZIP Code-level, AIDSVu maps late HIV diagnoses (cumulative 2015 to 2019), linkage to HIV care (cumulative 2015 to 2019), receipt of HIV care (2019), and viral HIV suppression (2019).

The HIV mortality data – the rates and numbers of persons with HIV who died – are shown at the state-level for 2019. AIDSVu also shows PrEP utilization – the rates and numbers of persons using PrEP, or pre-exposure prophylaxis –, as well as  PrEP-to-Need Ratio (PnR) – the ratio of the number of PrEP users in 2021 to the number of people newly diagnosed with HIV in 2019 to serves as a measurement of how PrEP use compares to the need for PrEP in a population –  in states and counties, by year from 2012 to 2021. HIV Testing data – percent of people ever tested for HIV – are shown at the state-level for 2019.

Prevalence and new HIV diagnosis data are available at finer geographic levels, including community area- and census tract- levels for Chicago, census tract-level for Philadelphia, and ward- and census tract-levels for Washington, D.C.

AIDSVu data can be visualized by race/ethnicity, sex, age, and transmission category. HIV data can also be viewed alongside various social determinants of health and related infectious diseases – such as poverty, high school education, median household income, income inequality, people without health insurance, unemployment, housing, food insecurity, Medicaid expansion, as well as Hepatitis C prevalence and primary and secondary syphilis. AIDSVu allows users to locate a place for HIV prevention, testing and care, and also includes NIH-funded HIV prevention, vaccine, and treatment trial locations.

AIDSVu also has local data pages with profiles for nearly 50 U.S. cities, 48 counties with the highest burden of new HIV diagnoses that are prioritized for Phase 1 of Ending the HIV Epidemic: A Plan for America initiative, 50 states, DC, Puerto Rico, 4 regions, and the nation, offering easy-to-understand, printable snapshots that summarize the impact of HIV and other sexually transmitted diseases.

What does AIDSVu demonstrate about HIV/AIDS in America?

AIDSVu provides a visualization of the HIV epidemic across the United States. The interactive maps illustrate geographic variations in the HIV epidemic and reveal how the epidemic affects communities differently. This information is important for individuals to understand how HIV impacts their communities, and for health officials and policymakers to see where HIV prevention, testing, and care services are needed most.

How can I get AIDSVu maps and resources for my work?

AIDSVu has a map print functionality, allowing users to download and print custom views from the interactive map for use in grant proposals, presentations, manuscripts, and other materials. Additionally, the local statistics section allows users to download and print state- and city-specific data and fact sheets using a custom export function at the top right-hand side of the page.