Patterns in New HIV Diagnoses and Prevalence Trends in Texas
Discover patterns and prevalence trends in new HIV diagnoses from 1981 to 2021 in Texas. Explore rates of new diagnoses by demographics and years, emphasizing priority populations like MSM and transgender individuals.
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Patterns in New HIV Diagnoses and HIV Prevalence, Texas 2021 HIV/STD/HCV Epidemiology and Surveillance Unit Source: DSHS surveillance data, August 2022
Big Picture Prevalence increases each year because more people living with HIV are living longer lives. Based on patterns in HIV morbidity in Texas, the priority populations are: White men who have sex with men (MSM) Black MSM Hispanic MSM Black women whose mode of HIV transmission was sex with a male People who are Transgender
Acronyms HIV = Human Immunodeficiency Virus PLWH = People Living With HIV EMA = Eligible Metropolitan Area TGA = Transitional Grant Area MSM = Men Who Have Sex With Men IDU = Injection Drug Use ICE = Immigration and Customs Enforcement TDCJ = Texas Department of Criminal Justice
New HIV Diagnoses, Persons Living with HIV, and Deaths in Texas (1981-2021) 6,000 120,000 5,000 100,000 PERSONS LIVING WITH HIV NEW DIAGNOSES/DEATHS 4,000 80,000 3,000 60,000 2,000 40,000 1,000 20,000 0 0 1981 1985 1989 1993 1997 2001 2005 2009 2013 2017 2021 Year New HIV Diagnoses Deaths in Persons Living with HIV Persons Living with HIV
New HIV Diagnoses Rates of new HIV diagnoses have slightly decreased from 16.8/100,000 in 2012 to 14.8/100,000 in 2021. In 2021, rates of new HIV diagnoses are highest among males (24.6/100,000), Blacks (41.7/100,000), and those between 25 and 29 years of age (44.3/100,000). Between 2012 and 2021, the proportion of new HIV diagnoses increased for Hispanic MSM, from 39.2% to 42.8% and among Black MSM, from 26.1% to 28.6%. Within the last ten years, among those newly diagnosed with HIV, the proportion of those with a late diagnoses (3 months between HIV diagnosis and AIDS) has declined from 27.8% in 2012 to 21.4% in 2021.
New HIV Diagnoses and Rates by Year of Diagnosis, 2012-2021 5,000 18 4,500 16 4,000 14 3,500 RATE PER 100,000 12 NEW DIAGNOSIS 3,000 10 2,500 8 2,000 6 1,500 4 1,000 2 500 0 0 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 Number Rate per 100,000 4,377 4,391 4,471 4,566 4,575 4,382 4,441 4,358 3,595 4,377 16.8 16.6 16.6 16.6 16.4 15.5 15.5 15 12.3 14.8 NUMBER RATE PER 100,000
New HIV Diagnosis Rates by Sex at Birth and Year of Diagnosis, 2012-2021 30 25 RATE PER 100,000 20 15 10 5 0 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 (F) Female rate 6.4 6.2 6.1 6.1 5.7 5.3 5.5 5.4 4.1 5.1 (M) Male rate 27.4 27.1 27.2 27.3 27.2 25.8 25.7 24.8 20.6 24.6 Year (F) FEMALE RATE (M) MALE RATE 10
New HIV Diagnosis Rates by Race/Ethnicity and Year of Diagnosis, 2012-2021 80 70 RATE PER 100,000 60 50 40 30 20 10 0 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 White 7.4 7.5 7.3 7.3 7.3 6.4 7.1 6.7 5.7 6.7 Black 50.8 50 50.3 48.8 47.3 46.5 44.5 43.5 35.8 41.7 Year Hispanic 17.1 16.6 16.9 17.4 17 16.5 16.2 15.4 12.7 15.8 Asian 4.9 6.3 5.7 6 4.9 4.2 5.7 4.4 3.2 4.1 Native Hawaiian/Pacific Islander 25.5 0 0 9 4.3 8.4 0 11.6 11.3 14.6 American Indian/Alaskan Native 1.2 1.2 1.1 4.5 4.4 2.2 0 3.2 1 3.1 Multi-race 68.4 61.9 56.8 51.3 54.7 36.4 34.8 42.5 25.2 27.5 11
New HIV Diagnosis Rates Among Ages 15-39, 2012-2021 60 50 RATE PER 100,000 40 30 20 10 0 2012 13.1 2013 11.3 2014 11.4 2015 12.1 2016 11.4 2017 11.9 2018 11.6 2019 12.6 2020 9.5 2021 10.4 15-19 20-24 42.5 42.6 46.7 44.8 42 38.2 39.8 39 32.5 35.6 25-29 39.2 42.2 44.2 43.5 48.1 43.9 45 42.4 34.1 44.3 30-34 34.1 33.4 30.8 34.2 34.9 34.9 32.3 31.4 30.2 34.7 35-39 26.3 25.5 26.9 27.1 24.4 24.1 25.4 23.7 17.2 23.7 15-19 20-24 25-29 30-34 35-39 12
New HIV Diagnosis Rates by Age at Diagnosis, 2021 50 45 40 35 RATE PER 100,000 30 25 20 15 10 5 0 0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ 0.1 0 10.4 35.6 44.3 34.7 23.7 20.2 14.1 12.8 10.5 5.9 2.1 13
New HIV Diagnoses by Mode of Transmission*, 2012-2021 2021 2020 2019 2018 2017 YEAR 2016 2015 2014 2013 2012 0 500 1,000 1,500 2,000 2,500 3,000 3,500 4,000 4,500 5,000 2012 4,377 2013 4,391 2014 4,471 2015 4,566 2016 4,575 2017 4,382 2018 4,441 2019 4,358 2020 3,595 2021 4,377 Total Pediatric 24 17 18 17 10 11 11 8 12 8 Heterosexual 952 986 951 944 880 856 911 869 655 755 MSM/IDU 167 179 173 207 175 198 175 215 140 164 IDU 263 220 233 249 271 233 255 241 218 288 MSM 2,971 2,989 3,096 3,148 3,239 3,084 3,088 3,025 2,570 3,162 NEW DIAGNOSES * Mode of transmission is imputed for individual patients when risk information is missing
New HIV Diagnoses by Mode of Transmission and Sex at Birth, 2021 FEMALES MALES 4 4 160 164 149 138 596 3,162 IDU Heterosexual Pediatric MSM IDU MSM/IDU Heterosexual Pediatric
New HIV Diagnoses by Priority Group, 2012 vs. 2021 New HIV Diagnoses, 2012 New HIV Diagnoses, 2021 558 644 1,038 1,178 955 834 98 N=4,377 N=4,377 56 298 411 1,255 1,430 White MSM Black MSM Hispanic MSM White MSM Black MSM Hispanic MSM Black Het Female Transgender Other Population Black Het Female Transgender Other Population 3/5/2025 16
New HIV Diagnoses by Mode of Transmission and EMA/TGA*, 2021 1000 900 800 700 600 500 400 300 200 100 0 Fort Worth TGA Houston EMA San Antonio TGA U.S.-Mexico Border All Other Texas Area Austin TGA Dallas EMA East Texas ICE FED PRISON TDCJ MSM 216.4 743.7 233.2 940.1 263.1 184.3 254.4 253.8 25 6.7 41.6 IDU 16.2 73.2 21.1 81 19.8 18.8 11.7 26.8 1.9 1 16 MSM/IDU 17.7 32.4 14 37.2 13.5 5.4 13.4 21.1 1.3 0.5 7.3 Heterosexual 31.7 187.7 64.7 250.7 52.6 62.5 41.5 52.3 4.8 1.8 5.1 Pediatric 0 2 2 1 0 1 0 2 0 0 0 3/5/2025 *Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs) are Metropolitan areas consisting of several counties designated by the Ryan White Program for funding purposes
Late Diagnoses* as Percentage of Total HIV Diagnoses, 2012-2021 1,400 30 1,200 25 NUMBER OF LATE DIAGNOSES PERCENT OF LATE DIAGNOSES 1,000 20 800 15 600 10 400 5 200 0 0 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 N 1,217 27.8 1,154 26.3 979 21.9 1,002 21.9 984 21.5 882 20.1 885 19.9 860 19.7 756 21.0 937 21.4 % Late Dx * Stage 3 (AIDS) diagnosis within 3 months of HIV diagnosis 3/5/2025 19
Late Diagnoses* as Percentage of Total HIV Diagnoses by EMA/TGA**, 2021 1,400 30.0% 1,200 25.0% 1,000 20.0% % LATE DIAGNOSIS TOTAL DIAGNOSES 800 15.0% 600 10.0% 400 5.0% 200 0 0.0% Area Fort Worth TGA Houston EMA San Antonio TGA U.S.-Mexico Border All Other Texas Austin TGA Dallas EMA East Texas ICE FED PRISON TDCJ N 282 1,039 335 1,310 349 272 321 356 33 10 70 % Late DX 19.9% 20.2% 19.4% 22.4% 18.3% 24.6% 24.0% 25.0% 15.2% 20.0% 11.4% * Stage 3 (AIDS) diagnosis within 3 months of HIV diagnosis **Eligible Metropolitan Areas (EMAs) and Transitional Grant Areas (TGAs) are Metropolitan areas consisting of several counties designated by the Ryan White Program for funding purposes 3/5/2025
HIV Prevalence, 2021 102,800 Texans living with HIV at the end of 2021. 348.1 per 100,000 Texans 1 in every 288 people in Texas is living with HIV Over half (63%) of people living with HIV (PLWH) acquired the virus through male-male sexual contact. By 2021, over half of PLWH were 45 years of age or older. Between 2012 and 2021, the total number of PLWH increased by 28% and proportion of PLWH within priority populations increased by 5.5%. A majority of people living with HIV live in urban areas of Texas. The counties with the largest numbers of PLWH were Harris and Dallas, followed by Bexar, Tarrant, and Travis counties. 22
Sex at Birth of PLWH, 2021 90,000 1,000.0 900.0 80,000 800.0 70,000 700.0 60,000 RATE PER 100,000 600.0 PERSONS 50,000 500.0 40,000 400.0 30,000 300.0 20,000 200.0 10,000 100.0 0 0.0 (F)Female (M)Male Persons 21,218 81,582 Rate per 100,000 143.4 553.6
Race/Ethnicity of PLWH, 2021 40,000 1,200.0 35,000 1,000.0 30,000 800.0 25,000 RATE PER 100,000 PERSONS 20,000 600.0 15,000 400.0 10,000 200.0 5,000 0 0.0 Native American Indian/Alaskan Native White Black Hispanic Asian Hawaiian/Pacific Islander Multi-race Persons 23,098 37,578 36,381 1,179 33 49 4,482 Rate per 100,000 194.3 1,035.0 306.8 75.7 120.7 50.5 946.6 Persons Rate per 100,000
Age Distribution of PLWH, 2021 14,000 900.0 800.0 12,000 700.0 10,000 600.0 RATE PER 100,000 8,000 500.0 PERSONS 400.0 6,000 300.0 4,000 200.0 2,000 100.0 0 0.0 0-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Persons 60 105 430 3,212 8,190 12,397 11,737 11,695 11,213 12,570 13,032 9,241 8,918 Rate per 100,000 1.5 4.8 20.3 158.2 389.2 575.6 551.7 586.9 608.4 704.5 762.3 573.6 230.1
PLWH by Mode of Transmission*, 2021 907 0% 89 1% 22,921 22% 6% 5,618 64,778 63% 8% 8,488 MSM IDU MSM/IDU Heterosexual Pediatric Adult Other * Mode of transmission is imputed for individual patients when risk information is missing ** Adult Other includes received clotting factor, transfusion/transplant, other and unknown
HIV Prevalence by Priority Group, 2012 vs. 2021 People Living with HIV, 2012 People Living with HIV, 2021 16,716 14,453 31,655 26,904 18,409 10,675 1,302 9,659 666 7,066 14,508 25,059 White MSM Black MSM Hispanic MSM White MSM Black MSM Hispanic MSM Black Het Female Transgender Other Population Black Het Female Transgender Other Population
Number of New HIV Diagnoses by Texas County, 2021 TOTAL NEW HIV DIAGNOSES: 4,264 Data source: DSHS Surveillance Data, March2023 Map Source: ArcGIS Enterprise
Rate of New HIV Diagnoses by Texas County per 100,000, 2021 Data source: DSHS Surveillance Data, March2023 Map Source: ArcGIS Enterprise
Number of People Living With HIV (PLWH) by Texas County, 2021 TOTAL NUMBER OF PLWH: 98,854 Number of Cases Data source: DSHS Surveillance Data, March2023 Map Source: ArcGIS Enterprise
HIV Prevalence Rate by Texas County per 100,000, 2021 Rates per 100,000 Data source: DSHS Surveillance Data, March2023 Map Source: ArcGIS Enterprise
Texas HIV Treatment Cascade, 2021 120,000 120% 100% 100,000 100% PERSONS LIVING WITH HIV 77% 80,000 80% 71% PERCENT 62% 59% 60,000 60% 102,800 40,000 40% 79,168 72,514 63,429 60,983 20,000 20% 0 0% Diagnosed PLWH In HIV-Related Medical Care Retained in care across the year On ART (est) HIV viral supression as of the end of the year 33
