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Data Sources
- Who provided the data for AIDSVu?
- Why does the map differ between the rate and number of cases?
- How does AIDSVu differ from maps provided by the CDC?
- How does AIDSVu differ from other maps produced from some states?
- How do the numbers on AIDSVu compare to national statistics?
- How did AIDSVu select the cities displaying ZIP Code?
- How does AIDSVu address the Ending the HIV Epidemic: A Plan for America?
- How did AIDSVu select the counties displaying profile data?
- Can you provide a ranked list of counties with the highest HIV rates in the U.S.?
- Is AIDSVu based on where people lived at the time of HIV diagnosis or where they live now?
- How often do you intend to update AIDSVu? Are you planning to add new features to AIDSVu?
- Where does AIDSVu get the statistics and findings released on infographics and awareness day pages?
Who provided the data for AIDSVu?
State- and county-level AIDSVu data are obtained from CDC’s national HIV surveillance programs and mortality data are obtained from CDC’s Division of HIV/AIDS Prevention (DHAP). Data are released to AIDSVu in accordance with each state’s HIV/AIDS data re-release agreement and are compiled by researchers at the Rollins School of Public Health at Emory University.
ZIP Code level data are obtained directly from state and local health departments. All data received by Emory are anonymous, meaning that no names or other personally identifying information are provided. Strict rules are applied to the mapping process to protect the privacy of those living with HIV.
Most social determinants of health data are obtained from the American Community Survey. See the Data Methods page for more information on sources.
Please see the PrEP Data FAQ for further details on its data source.
The information, definitions, and data on our Deeper Look pages is taken from a variety of sources, including the Kaiser Family Foundation, CDC, HIV.gov, and Gilead. We thank them for their excellent and informative content.
Why does the map differ between the rate and number of cases?
The scales in the legends for rates and number of cases for individual states, counties, and city-level data differ because the rate (usually expressed as the number of cases per 100,000 people in the population) is an expression of the relative concentration of people in an area (state, county, ZIP Code, community area, ward, or census tract) living with an HIV diagnosis. This differs from the number of cases, which is the actual number of people living with an HIV diagnosis. The rate can be useful for comparing the severity of the HIV epidemic in areas with different population sizes – for example, in a densely populated area and in a more sparsely populated one. The number of cases can identify areas where the greatest or fewest number of individuals living with an HIV diagnosis reside.
For example, in a county with fewer people but with a relatively large number of people living with an HIV diagnosis, the county may be shaded a dark red when viewing the prevalence rate. However, the same county may not appear dark red when viewing the map by the total number of cases because the county has a smaller number of cases compared with other counties.
How does AIDSVu differ from maps provided by the CDC?
Both AIDSVu and the CDC maps are built using the same data from CDC surveillance programs. However, AIDSVu also displays city-level data on HIV prevalence, new diagnoses, and care continuum, which the CDC does not currently publish. CDC maps also offer some content that AIDSVu does not, including data on other infections, such as acute viral hepatitis and other sexually transmitted infections.
How does AIDSVu differ from other maps produced from some states?
All state- and county-level HIV surveillance data for AIDSVu were obtained from CDC’s national HIV surveillance database housed in the Division of HIV/AIDS Prevention’s HIV Incidence and Case Surveillance Branch. Data released from CDC may differ from data released by individual states because the data were analyzed differently, or because they are from different time periods. These differences can produce slightly different numbers that are released at the national vs. state or local levels.
How do the numbers on AIDSVu compare to national statistics?
CDC estimates that 1.2 million people in the U.S. are living with HIV. These national statistics count both people who have been diagnosed with HIV (i.e., who have had a positive test for HIV) and an estimate of other people who are living with HIV but who have not been diagnosed. CDC estimates that one in seven people in the United States who are living with HIV don’t know it. The state- and county-level data on AIDSVu only include people who have been diagnosed with HIV. Nationally, CDC estimates that nearly one fifth of all HIV infections are diagnosed late, meaning individuals were diagnosed after the disease had already progressed to Stage 3 HIV (AIDS). People with late HIV diagnoses miss opportunities to start treatment earlier, which can lead to better health outcomes.
Each individual city, county, state, regional, and national profile on AIDSVu provides additional information, such as racial disparity in HIV diagnoses, new and late HIV diagnoses, mode of HIV transmission, federal grant funding for HIV/AIDS, and other sexually transmitted disease rates.
How did AIDSVu select the cities displaying ZIP Code?
In the initial days of AIDSVu, our focus was to collaborate with health departments for cities with the highest rates of new HIV diagnoses in the US. We at AIDSVu work to continuously expand the data we display at the zip code level. We currently invite cities to participate in AIDSVu that could benefit from increased disease awareness and also to increase representation across the US. Unfortunately, at this time, AIDSVu is unable to map all U.S. cities because of the possibility of low case counts or small population sizes, leading to data suppression issues.
How does AIDSVu address the Ending the HIV Epidemic: A Plan for America?
Specifically surrounding the Ending the HIV Epidemic: A Plan for America initiative, AIDSVu has gathered data and resources for public health officials, researchers, policymakers, and community members to help inform their ending the epidemic efforts. These additional resources include:
- A Deeper Look: Ending the Epidemic page, which provides an overview of the national plan, its goals and focus, as well as insights on areas targeted by the plan.
- County-level profiles for the 48 counties with the highest burden of new HIV diagnoses that are being targeted by the initiative.
- City-level profiles, including the cities targeted by the plan: Washington, DC, and San Juan, PR.
- State-level profiles, including the seven states with a substantial rural HIV burden being targeted by the initiative.
- Regional-level profiles for the four U.S. regions as defined by the U.S. Census Bureau, including the South which is home to 48% of the counties targeted by the initiative.
- A national profile outlining the HIV burden across the nation.
- A section of the EHE jurisdiction profiles that outlines non-federal HIV-related philanthropic funding.
- Additional infographics on the national plan’s key strategies and other state and local jurisdictional plans to end the HIV epidemic.
How did AIDSVu select the counties displaying profile data?
AIDSVu chose to collect and visualize data for the 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, a ten-year initiative to end the HIV epidemic in the U.S.
Can you provide a ranked list of counties with the highest HIV rates in the U.S.?
Because the data for several counties are suppressed or not available, AIDSVu is unable to provide a ranking of U.S. counties. To determine counties with the highest rates or case counts, it is possible to sort the county-level downloadable data set from highest to lowest.
Is AIDSVu based on where people lived at the time of HIV diagnosis or where they live now?
Prevalence data is based on most recent known address and new diagnoses data is based on residence at time of diagnosis.
How often do you intend to update AIDSVu? Are you planning to add new features to AIDSVu?
AIDSVu is updated on an ongoing basis with new data and additional information as it becomes available. For details about how often different data elements will be updated, see the Data Methods page. You can also sign up on the AIDSVu website to receive email notifications when new features or data are added to the site.
Where does AIDSVu get the statistics and findings released on infographics and awareness day pages?
Unless otherwise noted, AIDSVu receives all statistics and findings from CDC. This information is carefully reviewed and confirmed by the AIDSVu team prior to their release, and in the event of any discrepancies, AIDSVu contacts CDC to confirm the data source and methodology.
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Data Limitations
- Why are the data not from this year?
- Why aren’t some data shown?
- Why do the maps look different compared to last year?
- What is the difference between data not shown, data not released to AIDSVu, and no cases reported?
- How does AIDSVu account for prison and jail data and what do the correctional disclaimers on the map mean?
- How are transgender cases defined on AIDSVu?
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.
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.
Areas appear gray 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 are updated annually. Sometimes states request changes in the data suppression thresholds in their data re-release agreements, which is why the maps and the data may look different from last year.
What is the difference between data not shown, data not released to AIDSVu, and no cases reported?
The gray 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 white 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. The data provided are the estimated number of people living with diagnosed HIV and had a reported difference between birth sex and current gender.
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Continuum Data
- What is the HIV care continuum and why is it important?
- What is viral suppression and why is viral suppression important?
- What HIV care continuum indicators does AIDSVu map?
- What inspired AIDSVu to add HIV care continuum data and maps?
- What is the source of AIDSVu’s HIV care continuum data?
- Why do AIDSVu’s HIV care continuum indicators differ from others like CDC?
- Why does AIDSVu map the HIV care continuum?
- What Ending the HIV Epidemic: A Plan for America initiative goals are linked to HIV care continuum indicators?
- How else can the HIV care continuum data on AIDSVu be utilized, and what continuum resources does AIDSVu have?
- Why are HIV care continuum data not available for all AIDSVu cities?
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 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 2022.
- Late HIV Diagnoses – Individuals diagnosed with stage 3 HIV (AIDS) within 3 months of an initial HIV diagnosis in 2022.
- Linkage to HIV Care – Individuals who visited an HIV health care provider within 1 month of being diagnosed with HIV in 2022.
- Receipt of HIV Care – Individuals living with diagnosed HIV who received medical care for HIV in 2022.
- Viral Suppression – Individuals living with diagnosed HIV who had a low or undetectable viral load (the amount of HIV in the blood) in 2022.
AIDSVu maps the following steps of the HIV care continuum at the county-level:
- New HIV Diagnoses – Individuals who received a new HIV diagnosis in 2022.
- Linkage to HIV Care – Individuals who visited an HIV health care provider within 1 month of being diagnosed with HIV in 2022.
- Receipt of HIV Care – Individuals living with diagnosed HIV who received medical care for HIV in 2022.
- Viral Suppression – Individuals living with diagnosed HIV who had a low or undetectable viral load (the amount of HIV in the blood) in 2022.
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 2017 and 2021.
- Late HIV Diagnoses– Individuals diagnosed with stage 3 HIV (AIDS) within 3 months of an initial HIV diagnoses between 2017 and 2021.
- Linkage to HIV Care– Individuals who visited an HIV health care provider within 1 month of being diagnosed with HIV between 2017-2021.
- Receipt of HIV Care– Individuals living with diagnosed HIV who received medical care for HIV in 2021.
- Viral Suppression– Individuals living with diagnosed HIV who had a low or undetectable viral load (the amount of HIV in the blood) in 2021.
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- and county-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-, county-, 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.
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PrEP Use Data
- What is Pre-Exposure Prophylaxis (PrEP)?
- What data do the AIDSVu PrEP maps visualize?
- What is the source of the PrEP use data?
- What is IQVIA?
- How was the number of PrEP users by county and state calculated?
- What types of PrEP use data are available on AIDSVu?
- What are the limitations of the PrEP use data?
- What do the PrEP use data reveal?
- Why were these data released on AIDSVu, and why does data on PrEP use matter?
- What can the PrEP use data on AIDSVu be used for?
- How else can the PrEP use data be utilized on AIDSVu, and what other PrEP-related resources does AIDSVu have?
- How has AIDSVu’s PrEP use data evolved?
- Which PrEP medications are included in AIDSVu’s PrEP use data?
- 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?
- How are these data different from other data on PrEP that have been shared publicly?
- Why does the most current year PrEP rate not always use the respective year of population data for calculation?
- How is the PrEP-to-Need Ratio calculated?
- Why does the most current year PrEP-to-Need Ratio not always use the respective year new HIV diagnoses for calculation?
- How often will new PrEP use data be released?
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 2023 and includes prescriptions of TDF/FTC and TAF/FTC for PrEP, after their approvals in 2012 and 2019, respectively. The AIDSVu dataset also includes prescriptions of cabotegravir after its approval in December 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, TAF/FTC after its approval in 2019, or cabotegravir after its approval in 2021 for PrEP in a calendar year from 2012 to 2023, excluding prescriptions for TDF/FTC, TAF/FTC, and cabotegravir 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) 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 was 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, FTC/TAF after its approval in 2019, or cabotegravir after its approval in 2021. For AIDSVu, the analyses determined total PrEP usage with FTC/TDF, FTC/TAF, and cabotegravir and not individually for each product. IQVIA excluded prescriptions for TDF/FTC, TAF/FTC, and cabotegravir 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, FTC/TAF, or cabotegravir 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 2023), 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 and Technical Notes pages 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, research 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 greater than zero but less than three, 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 2012-2023, stratified by age and sex
- Single year, county-level PrEP-to-Need Ratio from 2012-2023, stratified by age and sex
- Single year, state-level PrEP users and rates from 2012-2023, stratified by age, sex, and race/ethnicity
- Single year, state-level PrEP-to-Need Ratio from 2012-2023, stratified by age, sex, and race/ethnicity
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 is likely 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, TAF/FTC, and cabotegravir 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, TAF/FTC, and cabotegravir 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 data 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 2023, and new HIV diagnoses data is from 2022, unless otherwise noted.)
Overall PrEP Use:
- The number of PrEP users in the U.S. increased by 17% from 2022 to 2023, continuing a trend of consistent growth in PrEP use since 2012.
- Nationally, there are 13 PrEP users for every new HIV diagnosis. The PrEP-to-Need Ratio (PnR) has steadily increased from 10 in 2021, to 12 in 2022, to 13 in 2023.
- The South accounted for 53% of HIV diagnoses but only accounted for 39% of PrEP users. The South has the greatest unmet need for PrEP of all regions.
PrEP Use by Race/Ethnicity:
- Black people represent 39% of all new HIV diagnoses, but only accounted for 14% of PrEP users.
- Hispanic/Latinx people represent 31% of all new HIV diagnoses, but only accounted for 18% of PrEP users.
- White people represent 24% of all new HIV diagnoses but accounted for 64% of PrEP users.
- There is a greater unmet need for PrEP in Black and Hispanic/Latinx communities than White communities in all regions of the U.S.
- Regionally, Black people made up 48% of new HIV diagnoses in the South in 2022, but only 22% of PrEP users in the South in 2023; in the Midwest, Black people made up 42% of new HIV diagnoses in 2022, but only 13% of PrEP users in 2023.
- In the South, there were 25 white PrEP users for every new HIV diagnosis among white people. In comparison, there were only 5 Black PrEP users for every new HIV diagnosis among Black people.
- In the West, Hispanic/Latinx people represented 50% of new HIV diagnoses but only represented 24% of all PrEP users.
PrEP Use by Age:
- 64% of all PrEP users in 2023 were between ages 25 and 44 years old.
- Teenagers and young adults (aged 13-24 years) had the greatest unmet need for PrEP among all age groups, with a PrEP-to-Need Ratio (PnR) of 9. That means that for every person in that age group diagnosed with HIV, there were only 9 people using PrEP. People aged 35 to 44 had the highest PnR of 16.
PrEP Use by Sex:
- Among all PrEP users in the U.S., 92% were male and only 8% were female, despite the fact that women comprised 19% of new HIV diagnoses.
PrEP Use and Medicaid Expansion:
- In 2023, states that had expanded Medicaid had an average PrEP use rate that was 1.3 times higher compared with states that had not expand Medicaid.
- In 2023, states that had expanded Medicaid had an average PrEP-to-Need Ratio (PnR) that was 2 times as high compared to states that had not expanded Medicaid.
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- Note: 41 of the 51 US states + DC had adopted and implemented Medicaid expansion as of December 2023.
*Note: The PrEP-to-Need Ratio (PnR)—the ratio of the number of PrEP users to the number of people newly diagnosed with HIV—serves as a measurement for whether PrEP use appropriately reflects the need for HIV prevention in a geographic region or demographic subgroup. A lower PnR indicates more unmet need for PrEP.
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 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 2023 and includes prescriptions of TDF/FTC, TAF/FTC, and cabotegravir for PrEP, after their approvals in 2012, 2019, and 2021 respectively.
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 2023. 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.
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. Vintage county population estimates from the U.S. Census Bureau (2012 to 2022) were used for the denominators for yearly state-level data and 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). Vintage 2022 population estimates were used to calculate 2023 PrEP rates as they were the most current available. As more current population data becomes available, the 2023 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. A lower PnR indicates more unmet need for PrEP.
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 more information on PnR calculations, please see the data methods.
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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Powered By AIDSVu
- What is Powered By AIDSVu?
- What does HIVContinuum.org show?
- What does HepVu show?
- What is PrEPVu.org?
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 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
- Overdose mortality rate
- Pain reliever misuse prevalence
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.
What is PrEPVu.org?
PrEPVu.org is a Powered By AIDSVu project that aims to serve as a one-stop shop for information on PrEP use in the United States. It houses infographics, relevant Q&As, and is the home of the PrEPVu Monthly newsletter. It was launched in June of 2024 and will be updated regularly as new data and content is added to parent site, AIDSVu.
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About AIDSVu
- Why was AIDSVu developed?
- Who is AIDSVu intended for?
- Who created AIDSVu?
- Who helps to advise the AIDSVu project?
- What does AIDSVu’s interactive map show?
- What does AIDSVu demonstrate about HIV/AIDS in America?
- How can I get AIDSVu maps and resources for my work?
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., and in multiple cities. The state and county maps also show new HIV diagnoses data – the rates and cases of new HIV diagnoses. The new HIV diagnoses in the cities show a cumulative 5-year case count and risk.
AIDSVu also visualizes steps of the HIV care continuum at the state, county, and city-level for all 50 states, Washington, DC, and over 40 cities. At the state-level, the platform maps late HIV diagnoses, linkage to HIV care, receipt of HIV care, and viral HIV suppression. At the county-level, the platform maps late HIV diagnoses, linkage to HIV care, receipt of HIV care, and viral HIV suppression. At the ZIP Code-level, AIDSVu maps late HIV diagnoses, linkage to HIV care , receipt of HIV care, and viral HIV suppression.
The HIV mortality data – the rates and numbers of persons with HIV who died – are shown at the state-level. HIV Testing data – percent of people ever tested for HIV – are shown at the state-level. 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 to the number of people newly diagnosed with HIV. PnR serves as a measurement of how PrEP use compares to the need for PrEP in a population – in states and counties.
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.
AIDSVu also has local data pages with profiles for over 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.