New HIV cases in Iowa see first sustained drop since 1998

Report shows new cases reduced 30 percent since spike in 2016

The Centers for Disease Control and Prevention passed a recommendation that every adult in the United States be screened
The Centers for Disease Control and Prevention passed a recommendation that every adult in the United States be screened for HIV at least once in his or her lifetime. (Penchan Pumila/Dreamstime/TNS)

The number of Iowans diagnosed with HIV dropped for the third year in a row, the first sustained reduction in diagnoses in more than two decades, state public health officials announced Thursday.

According to the Iowa Department of Public Health’s annual end-of-year HIV Surveillance Report, 98 people were diagnosed with HIV in 2019, down 16 percent from the previous year.

The 98 diagnoses last year is the lowest number of new HIV cases in Iowa since 2015, the report states.

It’s also a 30 percent decrease from 2016, when 137 new cases were reported, which was the most HIV diagnoses ever recorded in a single year in Iowa, public health officials say.

According to the report, the drop in diagnoses between 2016 and 2019 is “the first sustained reduction in HIV diagnoses since HIV reporting began in 1998.”

“This report and the three-year trend demonstrate the value of early testing, access to good health care, and strong support to help people living with HIV make the most of that health care,” said a statement from Randy Mayer, chief of the Bureau of HIV, STD and Hepatitis at the Public Health Department. “Clearly, our most impactful services include comprehensive health care that includes testing, client-centered case management, transportation assistance and housing.”

The reason for the sharp spike in new HIV diagnoses in 2016 wasn’t wholly clear to officials at the time, but according to previous Gazette reporting, some officials believed the Affordable Care Act could be a factor. The ACA, which was fully implemented in 2014, led to increased access to health care providers, and therefore increased testing.


HIV, or human immunodeficiency virus, is a virus that interferes with the body’s ability to fight infections. It is a lifelong condition, and without treatment an HIV-positive individual can develop AIDS, or acquired immunodeficiency syndrome.

Since 2016, white Iowans saw a 35 percent drop in HIV diagnoses. The rate of new cases among that population has dropped 46 percent since 2007.

Men who have sex with men also saw a 43 percent drop in diagnoses since 2016.

HIV diagnoses dropped 33 percent among black Iowans within that three-year period. This is significant, according to public health officials, because black Iowans were more than 14 times more likely to be diagnosed than their white counterparts in 2019.

However, the surveillance report notes that not all populations experienced a decrease in diagnoses in 2019.

The decrease between 2018 and 2019 was felt most by U.S.-born individuals, which saw a 24 percent decline among its population. Diagnoses among foreign-born individuals living in Iowa, on the other hand, increased 23 percent from 2018. Among black immigrants, diagnoses increased 31 percent from the previous year.

Public health officials note in the report that increased diagnoses among non-white people diagnosed with HIV are exasperated by racial disparities such as poverty, lack of economic opportunity, unequal treatment in the health care system and disproportionate incarceration rates.

“These social circumstances may limit a person’s access to health care and the opportunity to engage in a healthy lifestyle,” the report states.

State public health officials credit a high rate of viral suppression among HIV-positive Iowans for falling transmission rates. In fact, studies show viral suppression, achieved through medication, may reduce the likelihood of transmitting HIV by 96 percent, according to the Centers for Disease Control and Prevention.


Of the 2,839 diagnosed Iowans, 95 percent were virally suppressed and 86 percent had ongoing and regular engagement with medical care providers.

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