Iowa Leads Nation in HIV Viral Suppression and Preventive Coverage

December 19, 2019

Human immunodeficiency virus (HIV) was first observed in the United States in 1981. Its incredible ability to spread has required swift and sweeping action to increase screening and treatment for those living with HIV and preventive services for those who may be at risk. A recent Centers for Disease Control and Prevention (CDC) Vital Signs report ranked Iowa as first in the nation for HIV viral suppression (79.6% of people diagnosed) and fourth in the nation for the proportion of those with PrEP coverage (pre-exposure prophylaxis, a preventive medication for those with a higher-than-average risk of contracting HIV) in 2017.

Once contracted, HIV spreads throughout the body as it encounters uninfected T-cells. As these newly infected T-cells meet other T-cells, the infection spreads faster. Newly developed antiretroviral therapies (ART) lower the amount of HIV in the body, rendering the disease almost completely non-contagious and preserving the health of the patient. Some community health centers in Iowa also participate in the Ryan White HIV/AIDS program to provide medical care and case management services for persons living with HIV and those with identified risk factors that may increase opportunities for HIV transmission. In recent years, significant clinical evidence has confirmed the HIV Undetectable = Untransmittable (U=U) concept as scientifically sound. The idea contends that people with HIV who achieve and maintain an undetectable viral load--the amount of HIV in the blood--by taking ART daily as prescribed cannot sexually transmit the virus to others. So, treatment for HIV has become a powerful tool for HIV prevention, and one that Iowa providers have excelled in using.

Iowa also earned accolades for its high prevalence of PrEP coverage. PrEP is a daily oral pill that has been almost 99% effective in preventing the acquisition of HIV. Since its introduction in 2012, the various drugs used in PrEP have kept an immeasurable number of individuals from contracting HIV all over the world. Iowa’s community health centers are vital in this work. Ryan White programming within health centers provides immediate linkage to care and case management for patients newly diagnosed with HIV or those who may currently be out of care. Their pharmacy services help patients across the state receive the prescriptions they need to stay HIV-free, and the centers’ accessibility and coordinated care model ensure that a patient’s other medical needs won’t conflict with their PrEP treatment.

Iowa is the only low-morbidity area to be in the CDC’s Vital Signs top five. This tells us that our relatively low number of patients living with HIV are receiving high-quality, personalized care depending on their needs. Our health centers are a vital part of linkage to care and access to services by offering screening, diagnosis, referrals to care, and access to PrEP across Iowa, regardless of the patient's circumstances and ability to pay for services.

You can read the Vital Signs report here.