Data-Driven Goals for Curbing the U.S. HIV Epidemic by 2030
Progress in reducing HIV infections has been suboptimal despite availability of effective prevention and treatment interventions and national strategies to bring them to scale. As part of a community-driven process, we expanded previous epidemiologic models using updated surveillance data from the Centers for Disease Control and Prevention to estimate quantitative parameters for ambitious but attainable national HIV prevention goals. We estimated new HIV infections could be reduced by up to 67% and prevalence could begin to decline by 2030 if 95% targets for diagnosis, care retention, and viral suppression are met by 2025 and an additional 20% of transmissions are averted through targeted interventions such as pre-exposure prophylaxis. Notably, this would require the percentage of diagnosed persons retained in HIV care to increase by more than 35 percentage points, which would necessitate innovative models and a substantial expansion of supportive services. Although the HIV incidence reduction goal of 90% as unveiled in the 2019 State of the Union Address is likely unachievable with the current intervention toolkit, it is possible to begin to substantially reduce HIV prevalence in the next decade with sufficient investments and innovation.
KeywordsSurveillance HIV care continuum HIV incidence HIV prevalence
- 1.Centers for Disease Control and Prevention. HIV Surveill. Report. 2017;2018:29.Google Scholar
- 4.Centers for Disease Control and Prevention and Association of Public Health Laboratories. Laboratory Testing for the Diagnosis of HIV Infection: Updated Recommendations 2014.Google Scholar
- 16.White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States 2010.Google Scholar
- 17.White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States: updated to 2020 2015.Google Scholar
- 18.Joint United Nations Programme on HIV/AIDS (UNAIDS). Fast-track: ending the AIDS epidemic by 2030. Geneva, Switzerland 2014.Google Scholar
- 19.National Alliance of State and Territorial AIDS Directors (NASTAD). Ending the HIV epidemic: jurisdictional plans. 2019; https://www.nastad.org/maps/ending-hiv-epidemic-jurisdictional-plans. Accessed February 10, 2019.
- 21.Centers for Disease Control and Prevention. Estimated HIV incidence and prevalence in the United States, 2010–2015. 2018.Google Scholar
- 30.Centers for Disease Control and Prevention. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data: United States and 6 dependent areas, 2016. HIV Surveill Suppl Rep. 2018;23(4):1065–72.Google Scholar
- 32.Centers for Disease Control and Prevention. Compendium of evidence-based interventions and best practices for HIV prevention: linkage to, retention in, and re-engagement in HIV Care (LRC) Chapter. 2019; https://www.cdc.gov/hiv/research/interventionresearch/compendium/lrc/index.html. Accessed February 11, 2019.
- 34.Higa DH, Crepaz N, Mullins MM, Prevention Research Synthesis Project. Identifying best practices for increasing linkage to, retention, and re-engagement in HIV medical care: findings from a systematic review, 1996–2014. AIDS Behav. 2015;24:951–66.Google Scholar
- 35.Mizuno Y, Higa DH, Leighton CA, Roland KB, Deluca JB, Koenig LJ. Is HIV patient navigation associated with HIV care continuum outcomes? AIDS. 2018;32(17):2557–71.Google Scholar
- 41.AIDS United. Ending the HIV epidemic in the United States: a roadmap for federal action 2018.Google Scholar