Meeting national targets could prevent 185,000 new HIV infections by 2020
BOSTON — A new modeling study showed that reaching the National HIV/AIDS Strategy targets for HIV testing and treatment and expanding the delivery of pre-exposure prophylaxis to high-risk groups would prevent approximately 185,000 new HIV infections in the United States by 2020. This translates to a 70% reduction in HIV transmission in the country.
“If we expand the use of our current prevention strategies today, we can significantly reduce new HIV infections tomorrow,” Jonathan Mermin, MD, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a press release. “This study confirms that we have the right tools to dramatically reduce new HIV infections, but we have a long way to go in order to make those reductions a reality.”
In the next 5 years, the National HIV/AIDS Strategy (NHAS) aims to increase the proportion of people living with HIV (PLWH) who are diagnosed with the disease to 90%, linkage to care to 85%, and the proportion of PLWH who are diagnosed and achieve viral suppression to 80%. CDC researchers developed a forecasting model of HIV transmission to predict the impact of these goals.
The researchers estimated that in 2015, 87% of PLWH were diagnosed, 80% were linked to care and 36% of those with a diagnosis were virally suppressed.
Achieving the NHAS goal of increasing the proportion of those who are both diagnosed and virally suppressed to 80% alone would prevent more than 168,000 new infections by 2020, the researchers said. In that same scenario, increasing the use of PrEP among high-risk groups would spare almost 17,000 additional people from HIV in the next 5 years.
According to the researchers, even if testing and treatment rates remained at current levels, the expansion of PrEP could potentially reduce HIV incidence by 18% — or more than 48,000 cases — by 2020. In a scenario in which PrEP was not expanded, and the rate of virally suppressed PLWH reached just 60% while the other two NHAS goals were successfully met, the incidence of disease would still be reduced by 34%, resulting in almost 90,000 fewer cases.
These findings suggest that increasing diagnoses, linkage to care and treatment would substantially reduce HIV incidence by 2020, and that even with high levels of viral suppression in the U.S., PrEP would continue to reduce new infections, according to the researchers.
“We urgently need to close gaps in HIV care and treatment for people living with HIV,” Eugene McCray, MD, director of the CDC’s Division of HIV/AIDS Prevention, said in the release. “At the same time, in the short term, we need to rapidly expand access to PrEP and other lifesaving prevention tools.” – by John Schoen
Yaylali E, et al. Abstract 1051. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 22-25, 2016; Boston.
Disclosures: The researchers, Mermin and McCray report no relevant financial disclosures.