In 2017, more than 16,000 people with H.I.V. died, and about 5,500 of those deaths were from H.I.V.-related causes, positioning the virus among the 10 leading causes of death in certain groups.
“There’s still work to be done,” said Karin Bosh, the C.D.C. epidemiologist who led the study.
The earlier the diagnosis, the sooner people can get sustained care and treatment and suppress the virus in their body, Dr. Bosh said. For instance, the proportion of younger people dying from H.I.V. is higher than older people because younger people are less likely to have continuing access to care, either because they lack of health insurance, or because they don’t seek care regularly.
“This is concerning, because H.I.V. deaths are preventable,” Dr. Bosh said.
The lack of improvement in deaths from other causes is particularly worrying for women and substance users, other experts said.
“It really speaks to the things that we think work in public health — mobilization and community engagement,” said Dr. Eileen Scully, an infectious diseases physician at Johns Hopkins University. “And that is not how the epidemic has been among women in the United States.”
Unlike gay men, women with H.I.V. “come from many different walks of life” and are often disconnected from networks of support, she said. “We still have a lot of work to do, both to build trust and to bring in particular, minority women into the health care system in ways that they feel safe and supported.”
Race also played an outsized role in H.I.V. deaths, with the highest rates among Black people or those of multiple races.
Dr. Marrazzo compared the high numbers in the American South to the “Global South” — resource-poor countries in sub-Saharan Africa and elsewhere that also cope with issues of stigma and opaque sexual networks, particularly among gay Black men.