"This report describes data from 11,437 PWID who participated in NHBS in 2018, of whom 69% identified as male, 30% female, and 1% transgender; 39% were white, 33% were black, and 21% were Hispanic or Latino; 36% were aged ≥50 years (Table 1). Among all participants, 26% had no health insurance, 21% had not visited a health care provider, and the household income of 75% of participants was at or below the federal poverty level.

"In 2018, 6% of participants with a valid NHBS HIV test result tested positive for HIV (Table 2). By gender, HIV prevalence was as follows: 6% among males, 6% among females, and 28% among transgender. By race and ethnicity, HIV prevalence was as follows: 9% among blacks, 8% among Hispanics or Latinos, and 4% among whites.

"CDC recommends that persons at increased risk of HIV infection, including PWID, undergo HIV testing at least annually [10]. Among participants who did not report a previous HIV-positive test result or who had received their first HIV-positive test result less than 12 months before the interview, 55% reported that they had been tested for HIV in the 12 months before the interview, and 90% reported that they had ever been tested (Table 3).

"Among participants who reported being tested for HIV in the 12 months before the interview, 66% reported their most recent test was performed in a clinical setting while 29% reported being tested in a nonclinical setting, such as an HIV counseling and testing site, an HIV street outreach program or mobile unit, a SSP, or at home (Table 4)."