As of July 1, 2015, the United States Census Bureau estimates that the Commonwealth of Massachusetts is home to 6,794,422 individuals. Among those reporting only one race, over three-quarters (82.1%) of Massachusetts residents are white, 8.4% of residents are Black/African American, 0.5% are American Indian or Alaska Native; 6.6% are Asian, and 2.3% are two or more races. Persons of Hispanic/Latino origin comprise 11.2% of the total population. Fifteen percent (15.3%) of the population is foreign born, and 22.2% speak a language other than English at home. According to the 2015 American Community Survey (ACS) one-year estimates, 11.5% of the population lives under the poverty level.
As of July 1, 2017, there are 21,117 persons living with HIV infection (PLWH) in Massachusetts, and a cumulative total of 35,180 individuals who were ever diagnosed with HIV infection and reported to the Massachusetts surveillance system, with or without an AIDS diagnosis. Due to improved survival, there are more individuals living with HIV in state than ever before, and the population of persons living with HIV continues to grow by approximately 3% every year. Health outcomes among PLWH continue to improve; the most recent HIV care continuum demonstrates viral suppression rates approaching 90% for individuals who are engaged and retained in care.
There has been a 41% decrease in the number of new HIV diagnoses reported each year, from nearly 1,200 HIV diagnoses in the year 2000 to between 600 and 650 in recent years (624 in 2015), and a corresponding 41% decline in the number of annual deaths among persons with HIV infection. Our success in preventing new infections relies on high rates of insurance coverage made possible by state and federal health care reforms, a robust health care infrastructure including 50 community health centers, and a combination of state-directed public health interventions, and a contracted system of community-based prevention and care services.
Massachusetts will utilize a combination of timely HIV surveillance data, MDPH-deployed field epidemiologists (formerly, Disease Intervention Specialists or DIS), and HIV testing and linkage services delivered by community-based contracted organizations to identify HIV-infected persons who are undiagnosed or out of care, link HIV+ individuals to care and treatment, increase the number of HIV+ individuals who achieve and sustain viral suppression, and reduce transmission of HIV.
Prevention services will be delivered in cities and in regions with the highest incidence and prevalence of HIV infection, while sustaining a capacity to respond to all new HIV diagnoses and out of care individuals, statewide. Prevention efforts will prioritize the populations most affected by HIV in Massachusetts, with an emphasis on reaching gay and bisexual men and other MSM, in particular MSM under 30 and those who are Black or Hispanic/Latino. Massachusetts also requests support for a demonstration project to implement a novel prevention intervention in populations of persons who inject drugs (PWID) that will promptly detect emerging clusters of HIV infection attributed to injection drug use (IDU), rapidly deploy an intensive set of interventions, and interrupt transmission chains to prevent an outbreak.
All prevention and surveillance activities are designed, implemented, and monitored to accomplish the long-term outcomes identified by CDC: reducing new HIV infections among persons at risk for HIV infection; increasing access to care for persons living with diagnosed HIV infection, including maintaining viral suppression, achieving a reduction in HIV-related health disparities, and reducing the death rate among persons living with diagnosed HIV infection. We will accomplish these goals through programs and policies that are high-impact, science-based, geographically targeted, and tailored to meet the needs of individuals disproportionately impacted by HIV.