In order for a substantial decrease of HIV infections in the United States, there needs to be a rapid expansion of prevention and treatment for individuals at risk.
HIV infections in the United States could be potentially reduced by approximately 67% by 2030 if goals in treatment and care are met and targeted prevention interventions for individuals at risk are rapidly expanded, according to a study by Georgia State University and the University at Albany-SUNY.
During the 2019 State of the Union address, the federal administration announced its new goal to reduce new HIV infections by 90% in the next 10 years. According to the study, the outcome is unlikely to be achieved. The authors, however, speculated that new innovative models in care and prevention, along with investments to achieve these goals may make it possible to substantially decrease new HIV infections.
In order to determine this likelihood, investigators analyzed the latest HIV surveillance data from the CDC. They then estimated how many new HIV infections could be potentially averted through national HIV prevention goals.
Their findings, posted in the journal AIDS and Behavior, conclude that these goals could be attained only by meeting internationally accepted targets for HIV diagnosis and care by 2025 and by preventing an additional 20% of transmissions through targeted interventions, such as pre-exposure prophylaxis (PrEP) for those with HIV risk. If these goals are met, they could potentially decrease infections in the United States by 67%.
To achieve this goal, the current percentage of people diagnosed with HIV who are receiving care must increase from under 70% to 95% in 6 years and 40% PrEP coverage among those at risk for HIV. These are levels that are unprecedented in the US epidemic.
"It is important to set HIV prevention goals that are ambitious, but realistic," said Dr Heather Bradley, lead author of the study, in a prepared statement. "We know that treating people living with HIV greatly improves health and also prevents transmission of HIV infection to others. However, treating enough people to meaningfully reduce new HIV infections will require us to confront issues like poverty, unstable housing and mental health conditions that keep people living with HIV from accessing care."
According to the press release, progress to reduce HIV infections in the United States, particularly among key minority and risk groups, has been relatively stagnant and a new national HIV strategy with achievable targets is critically needed.
"Greatly increasing the number of people living with HIV who are receiving care and treatment combined with targeted prevention strategies for people at risk for HIV infection could result in substantial reductions in new HIV infections in the next decade. Our study estimates how much improvement is possible and can help quantify what it would take to get there," Bradley said.