CHICAGO — The number of Chicagoans newly diagnosed with HIV and AIDS in 2020 was at the lowest level in four decades, according to a comprehensive new HIV and STI (sexually transmitted infections) report from the Chicago Department of Public Health (CDPH) released today. The reportwhich presents the first COVID-era picture of HIV and STIs among Chicagoansalso notes increases in the number of Chicagoans living with HIV who have achieved viral suppression, a key factor in living a high-quality life and reducing the likelihood that HIV will be passed to others. People achieve viral suppression by consistently taking prescribed HIV medications.
CDPH's HIV/STI Data Report presents official HIV and STI surveillance data for 2020, including new and prevalent cases of HIV, and new diagnoses of chlamydia, gonorrhea, syphilis, and congenital syphilis. The report also highlights how HIV is impacting transgender persons. The report contains a detailed summary of trends in HIV and STIs and a geographic analysis calculating disease incidence in community areas across the city.
"I'm proud of the work that CDPH's Syndemic Infections Bureau did to produce this extensive report," said CDPH Commissioner Allison Arwady, M.D. "I'm even more proud of the excellent progress that Chicago continues to make in the fight against HIV/AIDS. It's not just that HIV diagnoses are down, it's that they are down for Black Chicagoans, White Chicagoans, and Latinx Chicagoans of all ages. But we must remain focused on addressing disparities, knowing that more than half of new HIV diagnoses still occur in Black Chicagoans and that other STIs are on the rise, especially among younger people."
A total of 627 new HIV diagnoses were reported in 2020 in Chicagothe lowest number since 1987. This represents a 29 percent decrease when compared to 2016 (when there were 886 new diagnoses). Declines in new diagnoses between 2016 and 2020 were seen in all genders, in all age groups, and Chicago's Black, Latinx, and White populations. In 2020, 269 Chicagoans were diagnosed with AIDS, which is the most advanced stage of HIV infection, when the immune system has been badly damaged by the HIV virus. This is the fewest new AIDS diagnoses since 1985, with an AIDS case rate of 8.4 per 100,000 population.
The biggest percent decrease in new HIV cases between 2016 and 2020 was among heterosexual Chicagoans (down 76%), while the biggest drop in absolute numbers of new cases was among gay and bisexual men (550 to 337).
Caution should be taken however, when comparing 2020 data to previous years. The COVID-19 pandemic may have affected trends in HIV reporting during 2020 potentially resulting in underreporting of new HIV diagnoses.
As in previous years, individuals aged 20-29 years were the most likely age group to be diagnosed with chlamydia, gonorrhea and primary and secondary syphilis. A plurality of the STI diagnoses also continue to be experienced by non-Hispanic Black Chicagoans: 50.6 percent of all reported chlamydia cases, 60.7 percent of gonorrhea cases, and 50 percent of syphilis cases.
In 2020, the number of reported primary and secondary syphilis cases among Chicago women increased by 56 percent (from 88 to 137). Mirroring this trend, congenital syphilis cases in newborns increased by 137 percent (from 8 to 19 cases). If a syphilis infection is left untreated in a pregnant woman, it can lead to infection of the fetus and increase the risk for stillbirth or death of the newborn.
According to the Report, 85 percent of persons newly diagnosed with HIV in Chicago were linked to medical care within 1 month of diagnosis - meeting the National HIV/AIDS Strategy (NHAS) goal. Furthermore, 95 percent of newly diagnosed individuals were linked to medical care within 12 months, an increase from the previous year. Among those living with HIV, 61 percent achieved viral suppression in 2020, an 11 percent increase from 2019. Racial disparities were seen in levels of viral suppression: 55 percent of non-Hispanic Black Chicagoans living with HIV were virally suppressed in 2020, compared to 71 percent of non-Hispanic White Chicagoans living with HIV.
CDPH HIV SERVICES PORTFOLIO
Since 2019, CDPH, through its status-neutral HIV Services Portfolio, has invested more than $41 million annually in community-driven investments aligned with the Getting to Zero Illinois plan. Status-neutral means that both people living with HIV and people vulnerable to HIV can access services and health care, including the medications that prevent HIV (known as PrEP) and the medications that treat HIV and lead to viral suppression. Viral suppression with medication is a key goal in the Getting to Zero plan, which lays out an ambitious roadmap to end the HIV epidemic in Illinois by 2030.
One of the many CDPH-led strategic investments is in Population Centered Health Homes (PCHH). PCHH provide cohesive, comprehensive, and integrated clinical and essential supportive services for both persons living with and vulnerable to HIV. Services include HIV screening; access to anti-retroviral medications to treat HIV and to pre-exposure prophylaxis (PrEP) medications to prevent HIV; primary medical care, and supportive services. The 2022 report spotlights PCHH data, including efforts to increase the number of individuals that are prescribed anti-retroviral medications and that are virally suppressed.
CDPH funds twelve agencies to implement PCHH in the Chicago Metropolitan Area, across Chicago, suburban Cook County, and eight collar counties.
In 2020, these PCHH served a total of 14,611 people living with HIV. In 2020, 70 percent of clients served through PCHH were between the ages of 30 and 59 years; 56 percent were non-Hispanic Black individuals; 75 percent were males; and 48 percent were gay, bisexual, or other men who have sex with men. While 61% of all Chicagoans living with HIV are virally suppressed, more than 90% of people connected to a PCHH are virally suppressed.
As CDPH prepares for its next round of funding, the department is working closely with community partners to further mitigate racial disparities in the number of new cases in communities of color.
FACT SHEET: HIV TRENDS in 2020, CHICAGO
627 new HIV diagnoses in 2020 in Chicago, a decrease of 5% from 2019 and a decrease of 32% from 2015
By age group, the largest number of new HIV diagnoses in 20—29-year-old Chicagoans (44% of new diagnoses)
By race/ethnicity, the largest number of new HIV diagnoses in Non-Hispanic (NH) Black Chicagoans (55% percent of new diagnoses)
NH-Blacks also represented 57% of AIDS diagnoses, and 48% of late HIV diagnoses
By geography of the community area, the largest number of new HIV infection diagnoses in Uptown residents. Corrected for population size, the highest rate of new HIV infection diagnoses in Pullman residents (102.7 per 100,000)
People Living with HIV and Viral Suppression
19,340 individuals who had been diagnosed with HIV through 2019 were living with HIV in 2020 in Chicago, corresponding to a rate of 717.9 per 100,000 population.
People 40 years and older accounted for 67 percent of Chicagoans living with HIV in 2020
Among all people in Chicago living with HIV in 2020, 71% had accessed care and 61% had achieved viral suppression
Among the 14,611 people living with HIV serviced by the 12 CDPH-funded agencies that implement Population Centered Health Homes, 90.1% were virally suppressed
STI TRENDS IN 2020, CHICAGO
Gay and bisexual men continue to account for the majority (59.2%) of primary and secondary syphilis cases.
Since 2016, the highest proportion of reported STIs has been among non-Hispanic Blacks, with:
50.6% of reported chlamydia cases,
60.7% of reported gonorrhea cases, and
49.9% of reported P&S syphilis cases in 2020.
Between 2016—2020, reported syphilis cases increased among non-Hispanic Blacks by 56 percent, decreased among non-Hispanic Whites by 22 percent, and decreased among Hispanics by 2 percent.
Chicagoans aged 20-29 years were the most frequently diagnosed age group for chlamydia (54.2%), gonorrhea (50.5%), and primary and secondary syphilis (35.8%)
19 reported cases of congenital syphilis in Chicago in 2020a 138% increase from the previous year.
GEOGRAPHY OF HIV IN CHICAGO
In 2020, the top three community areas with the highest new HIV infection diagnosis rates (corrected for population size of community area) were:
Pullman (102.7 per 100,000),
Washington Park (96.9 per 100,000), and
Uptown (65.0 per 100,000)
The top three community areas with the highest number of new HIV infection diagnoses were:
Austin (n=30), and
South Shore (n=26)
In 2020, the top three community areas with the highest HIV prevalence rates (people living with HIV) were:
Edgewater (2,150.1 per 100,000),
Uptown (2,095.0 per 100,000), and
Rogers Park (1,649.3 100,000)