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Injection Drug Use HIV/AIDS Prevalence among People Who Inject Drugs Minnesota has a relatively low rate of infection among people who inject drugs (IDU). However, it is important to note that injection drug use may be under reported due to social stigma. People who inject drugs (including people with a joint risk of MSM and IDU) account for approximately 10% of all living HIV cases in Minnesota. As of December 31st 2014, there were 429 people who inject drugs and 405 men who have sex with men and inject drugs (MSM/IDU) living with HIV/AIDS in Minnesota. HIV Diagnoses among IDU The number of new diagnoses attributable to injection drug use has remained low from year to year over the past decade. However there are differences by racial/ethnic group as well as by gender. Gender and Race/Ethnicity IDU is the second most common known mode of transmission among women after heterosexual contact with someone with or at risk for HIV, and accounted for 3% of cases among women in 2014. IDU was estimated as a risk for 14% of cases among white women, 25% among American Indian women, 8% among Hispanic women, and 3% among African American women during 2012-2014. No cases were attributed to IDU among African-born or Asian women during this same time period. It is important to note the number of American Indian females diagnosed during this time period was small and is difficult to make generalizations about risk. Among men, IDU and MSM/IDU accounted for 6% of new cases in 2014, however percentages varied by racial/ethnic group. IDU and MSM/IDU was estimated as a risk for 9% of cases among white men, 2% among African American men, 3% among Hispanic men, 9% among Asian men, and 45% among American Indian men during 2012-2014. It is important to note the number of American Indian and Asian males diagnosed during this time period was small and is difficult to make generalizations about risk. No cases were attributed to IDU or MSM/IDU among Africanborn males during this same time period. Minnesota HIV/AIDS Epidemiologic Profile—Injection Drug Use December 2015 Treatment Cascade for IDU and MSM/IDU in Minnesota There were 423 HIV positive persons with IDU as their identified risk and 396 with MSM/IDU as their risk included in the treatment cascade analyses. Compared to the overall HIV treatment cascade in Minnesota, people who have an identified HIV risk of IDU have lower percentages of retention in care as well as viral suppression. Persons with a HIV risk of MSM/IDU have higher percentages of retention in care and viral suppression compared to the overall cascade for the state. The MSM/IDU risk group had high levels of linkage to HIV care within three months of HIV diagnosis, while IDU had low percentage of linkage to HIV care but the number of cases in 2013 among IDU and MSM IDU were small and should be interpreted with caution. Percentage of IDU and MSM/IDU diagnosed with HIV engaged in selected stages of the continuum of care, by mode of exposure, 2014– Minnesota 100% 100% 100% 90% 90% 80% 80% 76% 66% 70% 60% 64% 54% 50% 40% 30% 20% 10% 0% IDU PLWH Linkage to Care n=423 MSM/IDU Retention in Care Viral Suppression n=396 MSM=Men who have sex with men IDU=Injection drug use Minnesota HIV/AIDS Epidemiologic Profile—Injection Drug Use December 2015