The State of the HIV Epidemic

Following years of apparent stagnation in the U.S. fight against HIV, recent reports suggest that things are looking up. What’s the full story?

This summer will mark 35 years since the first reports of AIDS. Additionally, two decades have now passed since combination antiretroviral treatment began to transform a health crisis into a more manageable public health concern.

Anniversaries are time to take stock: to reflect on the lessons of the past, assess the status quo and make projections for the future. For many years now, the American HIV epidemic has appeared trapped in a protracted stagnation, paralyzed by the systemic flaws of the U.S. health care system, fueled by increases in sexual risk-taking among men who have sex with men (MSM) while new infections drop among other risk groups, and stymied by increased public apathy.

Good news for gays

The prevention advances to which McCray refers are grounded in the increasing scientific understanding of the power of antiretrovirals to prevent transmission. First there is so-called treatment as prevention (TasP) among people living with HIV. In addition, Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) is available for HIV-negative people. Approved in 2012, PrEP is estimated to reduce the risk of acquiring the virus by more than 99 percent when taken daily.

The CDC recently estimated that 1.2 million Americans could benefit from PrEP, including 492,000 MSM, 115,000 injection drug users, and 624,000 heterosexuals.

A precise picture of how widespread PrEP use has become is hard to come by. But the combination of anecdotal evidence as well as data from Gilead Sciences, Truvada’s manufacturer, suggests that the pill is becoming an increasingly popular form of HIV prevention. After prescriptions apparently tripled between 2014 and 2015, a very rough estimate of 22,000 Americans, primarily MSM, were on PrEP as of about a year ago.

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During the Canada Post strike announced September 25, 2025, the following measures will be undertaken to minimize service disruption to BC-CfE clients and providers.

  • The BC-CfE Laboratory has transitioned to private courier for delivery of outgoing reports and documents. Results required urgently can be faxed upon request. (Lab Contact Information: Phone 604-806-8775; FAX 604-806-9463)
  • The BC-CfE Drug Treatment Program (DTP) will fax outgoing forms and documents to the provider’s office. (DTP Contact Information: Phone 604-806-8515; FAX 604-806-9044)
  • St. Paul’s Hospital Ambulatory Pharmacy has transitioned to private courier for delivery of medications. We recommend requesting medication at least 2 weeks in advance in case of delivery delays, particularly to rural/remote parts of BC. (Contact Information: Phone 1-800-547-3622; FAX 604-806-8675)

During the Canada Post strike, we recommend that documents be faxed or couriered to our sites, versus utilization of regular mail service

The BC-CfE Laboratory is streamlining reporting processes for certain tests in order to simplify distribution and record-keeping, and to ensure completeness of results. Beginning September 2, 2025, results for the ‘Resistance Analysis of HIV-1 Protease and Reverse Transcriptase’ (Protease-RT) and ‘HIV-1 Integrase Resistance Genotype’ tests will be combined into a single ‘HIV-1 Resistance Genotype Report’.
For more details and example reports, please click on the button below