The Centers for Disease Control and Prevention (CDC) recently released new data from the 2021 cycle of the Medical Monitoring Project (MMP), an annual representative survey of adults with diagnosed HIV in the United States. While some indicators improved—including a decrease in the proportion of HIV-positive people who were homeless or unstably housed—less than two thirds maintained viral suppression over the past year.

An estimated 1,072,051 people were living with HIVin the United States at the end of 2020, and the number of new HIV diagnoses that year was 30,692. For the latest MMP survey, which covered June 2021 through May 2022, a total of 9,700 people from 16 states were selected, and 3,995 of them opted to participate.

About three quarters were cisgender men, 23% were cisgender women and 2% were transgender. More than half (55%) were ages 50 or older, 20% were ages 40 to 49, 18% were 30 to 39 and 7% were 18 to 29. About 41% identified as Black or African American, 24% as Hispanic or Latino, 28% as white, 5% as multiracial and 1% or less as Asian, American Indian or Alaska Native.

CDC

MMP reports information critical for achieving national goals, including data used to monitor five National HIV/AIDS Strategy (NHAS) quality-of-life indicators:

  • The percentage of people with HIV who reported good or better health—meaning they rated their health as good, very good or excellent as opposed to poor or fair—was 69% in 2021, down from 72% in 2018 (2025 NHAS goal: 95%).
  • The percentage who had an unmet need for mental health services was 28% in 2021, up from 24% in 2017 (2025 NHAS goal: 12%).
  • The percentage who reported unstable housing or homelessness fell to 17% in 2021, down from 21% in 2018 (2025 NHAS goal: 11%).
  • The percentage who reported being unemployed remained stable at 15% (2025 NHAS goal: 8%).
  • The percentage who reported hunger or food insecurity was 16% in 2021, down from 21% in 2017 (2025 NHAS goal: 11%).

While 38% of respondents had household incomes below the federal poverty level, almost everyone (99%) had some type of health insurance or coverage for care or medications, including 42% with private insurance, 43% with Medicaid, 29% with Medicare and 47% with coverage through the Ryan White HIV/AIDS Program.

CDC

Most people (95%) received some HIV care, and 80% were prescribed antiretroviral therapy, but the proportion who remained engaged in care was lower, at 71%. The percentage with viral suppression (less than 200 copies) on their last viral load test was 66%, but just 62% had sustained suppression during the past year. The survey included only people with diagnosed HIV, so the rate of viral suppression for the total population living with HIV (diagnosed or not) would be lower.

CDC

Nearly 90% of participants reported that they used at least one strategy to prevent sexual transmission of HIV, including maintaining an undetectable viral load, using condoms or having sex with partners who were taking pre-exposure prophylaxis (PrEP) or were also HIV positive.

HIV stigma was measured with a score ranging from 0 (no stigma) to 100 (high stigma). The median HIV stigma score was 29 in 2021, down from 31 in 2018 (2025 NHAS goal: 16).

CDC

Overall, these findings show some promising improvements over the past half decade, with a notable drop in unstable housing and food insecurity. But the increased need for mental health services and the lower proportion of people reporting good health show a need for further progress. None of the five NHAS quality-of-life metrics met the 2025 targets.

The CDC is collaborating with partners to improve the reach of HIV prevention education, reduce barriers to services and fund and support health departments and community-based organizations to implement programs that address overall quality of life and stigma among people living with HIV.

Click here to see the full 2021 Medical Monitoring Project report.