# Social Determinants and Prevention Strategies in the HIV Epidemic: The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Database Analysis

## TL;DR

This study examines how social factors and prevention efforts influence the HIV epidemic in the U.S. using national data from 2018 to 2022.

## Contribution

The study provides a comprehensive analysis of HIV trends and social determinants during the COVID-19 pandemic using NCHHSTP data.

## Key findings

- New HIV infections decreased, while prevalence increased, indicating better diagnosis and treatment.
- Viral suppression rates improved despite a spike in HIV-related deaths during the pandemic.
- Persistent issues like HIV stigma and unstable housing continue to hinder health outcomes.

## Abstract

Background: The human immunodeficiency virus (HIV) epidemic remains a significant public health challenge, with social determinants and prevention strategies playing a crucial role in disease outcomes. While advancements in treatment and prevention have led to improvements in viral suppression and healthcare access, disparities in healthcare remain, particularly among vulnerable populations.

Aim: This study analyzes HIV epidemiological trends, healthcare access, and social determinants influencing the HIV epidemic in the United States from 2018 to 2022, using data from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) database.

Method: A retrospective analysis of national surveillance data was conducted to assess trends in HIV-related mortality, viral suppression, incidence, prevalence, and healthcare access. Key indicators such as knowledge of HIV status, PrEP coverage, linkage to care, HIV stigma, and unstable housing were evaluated. Data were analyzed for temporal trends, with a focus on the impact of the COVID-19 pandemic on HIV outcomes.

Results: The findings indicate a reduction in new HIV infections and an increase in HIV prevalence, suggesting improvements in diagnosis and treatment. Although AIDS-related and HIV-related deaths spiked during the COVID-19 pandemic, viral suppression rates steadily improved. Healthcare access remained stable, with increased PrEP coverage and linkage to care. However, persistent barriers such as HIV stigma and unstable housing continued to affect health outcomes.

Conclusion: The study highlights significant progress in HIV prevention and care but underscores the need for targeted interventions addressing social determinants. Continued investment in equitable healthcare access, stigma reduction, and housing stability is essential for sustaining control of the HIV epidemic.