Recent increases in new HIV diagnoses among cisgender women in King, Los Angeles and San Francisco Counties, 2015-2024
Jennifer E Balkus, Kathleen Poortinga, Apri Terzian, Amy Bennett, Priya Patel, Julia Janssen, Anna Berzkalns, Zhijuan Sheng, Jason S Melo, Erin Antunez, Nia Deot, Stephanie E Cohen, Matthew GoldenAbstract
Background
Syphilis cases among cisgender (cis) women have been rising in jurisdictions across the United States, raising concerns about potential increases in HIV. Using public health data, we summarized trends in HIV diagnoses among cis women in three west coast jurisdictions.
Methods
We analyzed data from the National HIV Surveillance System and local partner services databases for King County, Washington; Los Angeles (LA) County, California; and San Francisco (SF) County, California from 2015-2024. Individuals were included if sex was “female”, current gender was “woman”, and HIV diagnosis was classified as new.
Results
From 2015-2020, all three jurisdictions reported decreases in HIV rates among cis women. Rates began increasing in 2021, and in 2024, were 38%, 14% and 63% higher for King, LA and SF counties, respectively, compared to 2019 (pre-COVID). In 2024, for all three counties, the proportion of cis women who were unhoused at diagnosis was higher than the proportion for the overall population of newly diagnosed individuals (King: 29% vs 20%; LA: 32% vs 14%; SF: 39% vs 16%). There were significant and persistent racial/ethnic disparities, which varied by county.
Conclusions
Across three urban jurisdictions, HIV diagnoses among cis women increased from 2022-2024, with over a quarter of women newly diagnosed in 2024 reporting being unhoused at diagnosis. While 2024 HIV rates were similar to pre-COVID-19, the recent increases are concerning as they follow years of declining rates of new HIV diagnoses. Improved access to stigma-free HIV screening, prevention and treatment for cis women are important to reverse this trend.