Sonia Singh, PhD, on Addressing Racial Disparities to Help End the HIV Epidemic

In this podcast, Sonia Singh, PhD, talks about HIV testing before HIV diagnosis in the Black population in the United States from 2013 to 2018, including ways to help make routine HIV testing more accessible and ways to help address disparities to help end the HIV epidemic. 

Additional Resource:

Sonia Singh, PhD, is an epidemiologist at the Division of HIV Prevention at the Centers for Disease Control and Prevention. 



Jessica Bard: Hello, everyone. Welcome to another installment of "Podcasts360," your go‑to resource for medical news and clinical updates. I'm your moderator Jessica Bard with Consultant360 Specialty Network.

According to the CDC, Black and African American people account for a higher proportion of people with HIV compared to other races and ethnicities. Dr Sonia Singh is here to speak with us about addressing disparities to help end the HIV epidemic. Dr Singh is an epidemiologist at the Division of HIV Prevention at the CDC.

Dr Singh, you presented your research, decreased HIV testing before HIV diagnosis among Black and African American people in the United States from 2013 to 2018, at CROI 2021. Can you please give us an overview of your session?

Dr Sonia Singh: In 2018, Blacks/African Americans accounted for 42 percent of HIV diagnoses but only 13 percent of the US population. CDC recommends that everyone between the ages of 13 and 64 years old get testing for HIV at least once as part of routine health care.

For those at higher risk, CDC recommends getting tested at least once a year. Ensuring high levels of HIV testing is essential for reducing disparities and timely HIV diagnoses and decreasing the rate of HIV infection among Blacks/African Americans.

In the session, we presented results from a CDC study assessing trends and HIV testing patterns among Blacks/African Americans aged 13 years and older with HIV infection diagnosed from 2013 to 2018. We assessed testing trends by age, sex, and transmission category.

Jessica: Tell us more about the data you used for your study. What trends did you find?

Dr Singh: We used data from the National HIV Surveillance System. The states, the District of Columbia, and the US territories report cases of HIV infection and associated demographic and clinical information to the National HIV Surveillance System.

These data are the nation's source of timely information on the burden of HIV infection. HIV surveillance data are used by CDC's public health partners and other federal agencies, health departments, nonprofit organizations, and academic institutions to help target HIV prevention efforts, plans for services, and develop policy.

For our study, we saw that among Blacks/African Americans with HIV, who had information on HIV testing prior to diagnosis, there was decreased testing overall.

For the subgroups, there was decreased HIV testing among those aged 13 to 44 years, males with infection attributed to male‑to‑male sexual contact, and males and females with infection attributed to heterosexual contact.

We found that the percentage of participants with a negative test up to 12 months before HIV diagnosis remained stable for all groups.

Jessica: What were the conclusions of your study? How can this information be used to improve and make more accessible routine HIV testing and to address disparities to help end the HIV epidemic?

Dr Singh: We assess the HIV testing trends by age, sex, and transmission category to understand which subgroups among Blacks/African Americans might benefit from increased testing. These data are critical to help identify and close the gaps in HIV treatment to achieve better health outcomes and reduce transmission.

The CDC is conducting further analyses to identify the barriers to HIV testing within Black/African American subgroups. CDC is also using and expanding innovative testing strategies, such as rapid and mail‑in HIV self‑testing and conducting routine HIV testing outside primary care settings to increase access to testing.

Our take‑home messages from our session were annual HIV testing should be promoted among Black/African Americans at higher risk of infection to increase early detection of HIV infection. It is also important to increase linkage to care to improve HIV care outcomes and reduce risk for transmission.

Jessica: What's next for research on HIV testing before HIV diagnosis?

Dr Singh: Further research is needed to assess trends and uptake of HIV testing and prevention strategies among Black/African Americans and the general population to provide context for this analysis. We also need to look at factors that may affect uptake in HIV testing, such as challenges associated with accessing care and HIV‑related stigma.

Jessica: Dr. Singh, thank you so much for your time. Is there anything else that you'd like to add that you think that we missed?

Dr Singh: I think we covered it all.

Jessica: Thank you so much for your time. We appreciate you being here with us today.

Dr Singh: Thank you.

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