AIDS and Behavior

, Volume 20, Issue 7, pp 1383–1389 | Cite as

Evaluating the Impact of the US National HIV/AIDS Strategy, 2010–2015

Original Paper

Abstract

The 2010 US National HIV/AIDS Strategy (NHAS) set key targets for the reduction of HIV incidence (25 %) and the transmission rate (30 %) by 2015. We utilized published CDC data on HIV prevalence and mortality for 2007–2012, and literature-based incidence estimates for 2008–2012, along with mathematical modeling to evaluate whether the original NHAS incidence and transmission rate goals were achieved. From 2010 to 2015, a decrease was estimated from about 37,366 to 33,218 (11.1 % net decrease) for HIV incidence, and from 3.16 to 2.61 (17.4 % net decrease) for the HIV transmission rate. Over the same period, estimated all-cause mortality decreased from 17,866 to 16,085, while HIV prevalence increased from 1,181,300 to 1,270,755 persons living with HIV. At the conclusion of the original NHAS time period, important incremental but ultimately insufficient progress was made in attempting to reach key incidence and transmission rate targets for the NHAS. HIV prevention efforts must be reinvigorated in the NHAS’s second era.

Keywords

HIV AIDS Policy analysis Surveillance Mathematical modeling United States 

Resumen

La Estrategia Nacional contra el VIH/SIDA (ENVS) de 2010 estableció propósitos claves para la reducción de la incidencia del VIH (25 %) y la tasa de transmisión (30 %) antes de que terminara el año 2015. Utilizamos datos de la prevalencia y la mortalidad del VIH publicados por los Centros para el Control y la Prevención de Enfermedades desde el año 2007 al año 2012, y estimaciones de la incidencia del VIH basada de la literatura desde el año 2008 al año 2012. Entonces usamos modelos matemáticos para evaluar si la ENVS original logró las metas para la incidencia y la tasa de transmisión del VIH. Desde el año 2010 al año 2015, observamos una reducción de aproximadamente 37,366 a 33,218 (11.1 % reducción neta) por la incidencia del VIH y de 3.16 a 2.61 (17.4 % reducción neta) por la tasa de transmisión. En el mismo periodo, la mortalidad bajó de aproximadamente 17,866 a 16,085, mientras que la prevalencia del VIH subió de 1,181,300 a 1,270,755 personas viviendo con el VIH. Al final de la época de la ENVS original, se logró progreso incremental, pero fue últimamente insuficiente para cumplir con las metas claves de la ENVS. Tenemos que fortalecer los esfuerzos de prevención contra el VIH en la segunda era de la ENVS.

References

  1. 1.
    CDC. Estimated HIV Incidence in the United States, 2007–2010. HIV Surveillance Supplemental Report. 2012;17 (No. 4). http://www.cdc.gov/hiv/library/reports/surveillance/index.html. Accessed 2 April 2016.
  2. 2.
    The White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States. 2010. https://www.whitehouse.gov/administration/eop/onap/nhas. Accessed 2 April 2016.
  3. 3.
    President Barack Obama: Remarks by the President on the National HIV/AIDS Strategy. http://www.whitehouse.gov/the-press-office/remarks-president-national-hivaids-strategy (2013). Accessed 30 Mar 2016.
  4. 4.
    Holtgrave DR. On the epidemiologic and economic importance of the National AIDS Strategy for the United States. J Acquir Immune Defic Syndr. 2010;55(2):139–42.CrossRefPubMedGoogle Scholar
  5. 5.
    Holtgrave DR, Hall HI, Wehrmeyer L, Maulsby C. Costs, consequences and feasibility of strategies for achieving the goals of the National HIV/AIDS strategy in the United States: a closing window for success? AIDS Behav. 2012;16(6):1365–72.CrossRefPubMedGoogle Scholar
  6. 6.
    Bonacci RA, Holtgrave DR. Unmet HIV service needs among hispanic men who have sex with men in the United States. AIDS Behav. 2016.Google Scholar
  7. 7.
    Holtgrave DR, Kim JJ, Adkins C, Maulsby C, Lindsey KD, Johnson KM, et al. Unmet HIV service needs among Black men who have sex with men in the United States. AIDS Behav. 2014;18(1):36–40.CrossRefPubMedGoogle Scholar
  8. 8.
    Holtgrave DR. Achieving and advancing the goals of the National HIV/AIDS strategy for the United States. AIDS Behav. 2015;19(2):211–3.CrossRefPubMedGoogle Scholar
  9. 9.
    Holtgrave DR. Development of year 2020 goals for the National HIV/AIDS Strategy for the United States. AIDS Behav. 2014;18(4):638–43.CrossRefPubMedGoogle Scholar
  10. 10.
    CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas—2013. HIV Surveillance Supplemental Report. 2015; 20 (No. 2). http://www.cdc.gov/hiv/library/reports/surveillance/index.html. Accessed 2 April 2016.
  11. 11.
    Baeten JM, Donnell D, Ndase P, Mugo NR, Campbell JD, Wangisi J, et al. Antiretroviral prophylaxis for HIV prevention in heterosexual men and women. NEJM. 2012;367(5):399–410.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. NEJM. 2011;365(6):493–505.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Grant RM, Lama JR, Anderson PL, McMahan V, Liu AY, Vargas L, et al. Preexposure chemoprophylaxis for HIV prevention in men who have sex with men. NEJM. 2010;363(27):2587–99.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Thigpen MC, Kebaabetswe PM, Paxton LA, Smith DK, Rose CE, Segolodi TM, et al. Antiretroviral preexposure prophylaxis for heterosexual HIV transmission in Botswana. NEJM. 2012;367(5):423–34.CrossRefPubMedGoogle Scholar
  15. 15.
    The White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States: Updated to 2020. 2015. https://www.aids.gov/federal-resources/national-hiv-aids-strategy/overview/. Accessed 2 April 2016.
  16. 16.
    CDC. Diagnoses of HIV Infection in the United States and Dependent Areas, 2014. HIV Surveillance Report. 2015; 26. http://www.cdc.gov/hiv/library/reports/surveillance/index.html. Accessed 2 April 2016.
  17. 17.
    CDC. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 Dependent Areas—2012. HIV Surveilance Supplemental Report. 2014;19 (No. 3). http://www.cdc.gov/hiv/library/reports/surveillance/index.html. Accessed 2 April 2016.
  18. 18.
    Bonacci RA, Holtgrave DR. Simplified estimates of HIV incidence and transmission rates for the USA, 2008–2012. AIDS. 2016;30(2):332–3.CrossRefPubMedGoogle Scholar
  19. 19.
    May RM, Anderson RM. The transmission dynamics of human immunodeficiency virus (HIV). Philos Trans R Soc Lond B Biol Sci. 1988;321(1207):565–607.CrossRefPubMedGoogle Scholar
  20. 20.
    May RM, Anderson RM. Transmission dynamics of HIV infection. Nature. 1987;326(6109):137–42.CrossRefPubMedGoogle Scholar
  21. 21.
    Holtgrave DR. Is the elimination of HIV infection within reach in the United States? Lessons from an epidemiologic transmission model. Public Health Rep. 2010;125(3):372–6.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Siddiqi AE, Hall HI, Hu X, Song R. Population-Based Estimates of Life Expectancy After HIV Diagnosis. United States 2008–2011. J Acquir Immune Defic Syndr. 2016.Google Scholar
  23. 23.
    Kaiser Family Foundation. U.S. Federal Funding for HIV/AIDS: The President’s FY 2016 Budget Request. (2015). http://kff.org/global-health-policy/fact-sheet/u-s-federal-funding-for-hivaids-the-presidents-fy-2016-budget-request/. Accessed 2 April 2016.
  24. 24.
    Bradley H, Hall HI, Wolitski RJ, Van Handel MM, Stone AE, LaFlam M, et al. Vital signs: HIV diagnosis, care, and treatment among persons living with HIV—United States, 2011. MMWR. 2014;63(47):1113–7.PubMedGoogle Scholar
  25. 25.
    Hall HI, Holtgrave DR, Tang T, Rhodes P. HIV transmission in the United States: considerations of viral load, risk behavior, and health disparities. AIDS Behav. 2013;17(5):1632–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Skarbinski J, Rosenberg E, Paz-Bailey G, Hall HI, Rose CE, Viall AH, et al. Human immunodeficiency virus transmission at each step of the care continuum in the United States. JAMA Intern Med. 2015;175(4):588–96.CrossRefPubMedGoogle Scholar
  27. 27.
    McAllaster C, Fang J. One size does not fit all: what does high impact prevention funding mean for community-based organizations in the deep south? Southern HIV/AIDS Strategy Initiative; 2015.Google Scholar
  28. 28.
    Song R, Green T. An improved approach to accounting for reporting delay in case surveillance systems. JP J Biostat. 2012;7(1):1–14.Google Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Perelman School of MedicineUniversity of Pennsylvania Jordan Medical Education CenterPhiladelphiaUSA
  2. 2.Department of Health, Behavior, and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA

Personalised recommendations