A new study conducted by a team of researchers from Johns Hopkins Bloomberg School of Public Health and Brigham and Women’s Hospital, describes an aspiring, but very feasible path in the direction of what may have appeared too difficult to achieve a decade ago – an end to AIDS as an epidemic in the United States. The research team utilized prevention surveillance data from the Centers for Disease Control and Prevention (CDC) to replicate rates of HIV prevalence, mortality and incidence and set targets to reduce new infections to 21,000 by the year 2020 and 12,000 by 2025.
The researchers utilized CDC surveillance data for 2010 to 2013 to model various key indicators, including prevalence and incidence rates, death rates and transmission rates and others through 2025. The researchers took into account the goals set by the U.S. National HIV/AIDS Strategy (NHAS) and were able to estimate the probable trajectory of the HIV/AIDS epidemic, if those standards in care were actually met. The NHAS set goals for the year 2020, including 90 percent of people with HIV would receive quality care, 90 percent would know their status and 90 percent of people partaking in antiretroviral therapy would finally achieve viral suppression (90/90/90 targets). Extending to 2025, the agency was able to evaluate an achievement of those particular goals at 95 percent levels (95/95/95 targets).
With this scheme in place, the researchers assessed whether decreasing new HIV infections to 12,000 by the year 2025 would be attainable. With mathematical modeling, the researchers discovered that the United States could attain a 46 percent decrease in HIV incidence by the year 2020 and an almost 70 percent decrease in HIV incidence by the year 2025, on condition that the United States puts into effect a “90/90/90” HIV plan by 2020 and a “95/95/95” plan by the year 2025. The HIV transmission rate, a measure of how quickly the HIV epidemic is spreading, would decline from a rate of 3.53 in 2013 to a rate of 0.98 in 2025. In 2013, 16,500 HIB-related deaths were reported in the United States, but if the plan were successful that rate would drop to 12,522 by 2025. The number of people living with HIV infection in the United States would rise from 1,104,600 in 2013 to 1,220,615 by 2025.
The researchers note that in order to achieve these goals throughout the United States, all communities, especially those that have inordinately been affected by the HIV epidemic, including young people, gay men, Hispanic Americans, transgender persons and African-Americans, along with those living in the southern states, tracking progress in real time would be a requirement.
The study was published in The American Journal of Preventive Medicine on May 15, 2017.