Human immunodeficiency virus (HIV) is a virus that attacks the body’s immune system and, without treatment, can lead to acquired immunodeficiency syndrome (AIDS). People at risk for HIV can take pre-exposure prophylaxis (PrEP) to prevent getting HIV from sex or injection drug use. In December, the Centers for Disease Control and Prevention (CDC) published updates to its PrEP guidelines and now recommends doctors talk to all sexually active people in the general population about HIV prevention, and prescribe PrEP to any patient who asks for it. Previously, PrEP was recommended as a preventative option only for adults at high risk of HIV acquisition, such as sexually active men who have sex with men and injection drug users. GlobalData epidemiologists expect that if these new recommendations are adopted by physicians, the total population on PrEP will continue to increase, and new cases of HIV will likely be prevented.

The CDC hopes these changes will help end the stigma surrounding HIV and HIV prevention, and make it as commonplace to talk about as other health interventions, such as discussing smoking and alcohol use. HIV PrEP is primarily marketed to men who have sex with men, but heterosexual sex accounted for 23% of new HIV diagnoses in the US in 2019. Furthermore, a study published in the CDC’s Morbidity and Mortality Weekly Report at the end of November showed that awareness and use of PrEP among heterosexually active adults is low. Only 32% of the study participants, who lived in cities with a high prevalence of HIV, were aware of PrEP, while usage was less than 1%.

In the US, GlobalData epidemiologists expect diagnosed incident cases of HIV in men and women and the total population on PrEP to reach 43,700 and 451,000, respectively, by 2029 (as shown in Figure 1). However, if awareness and use of HIV PrEP increase as a result of the CDC’s revised guidelines, new cases of HIV will likely be prevented, and diagnosed incident cases may decrease below those currently forecast. Additionally, the total population on PrEP will likely surpass the current forecast estimates. GlobalData epidemiologists recommend continued monitoring of trends in HIV incidence and PrEP use, including among groups typically underrepresented in HIV prevention research.

Figure 1: US, Diagnosed Incident Cases of HIV and Total Population on PrEP, All Ages, Men and Women, 2019–2029 (N). Source: GlobalData