US HIV Infections Drop, But Fail to Meet Reduction Goals

A recent study has demonstrated that, although annual HIV infection and transmission rates declined in the United States over the last 5 years, they fell short of the goals outlined in the US National HIV/AIDS Strategy (NHAS).

Robert A. Bonacci, MPH, from the Perelman School of Medicine at the University of Pennsylvania and David R. Holtgrave, PhD, from Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, published the results of their study in AIDS and Behavior.

“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,” the authors write. “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.”

The first comprehensive NHAS was released by President Obama's administration in 2010, to help guide the national response to the domestic HIV epidemic. It outlined key priorities and steps with clear and measurable targets to be achieved by 2015.

In order to provide the first estimates of progress toward the 2015 goals, the researchers conducted a mathematical modeling study. They evaluated surveillance data published by the US Centers for Disease Control and Prevention (CDC) on HIV prevalence and mortality for 2007 to 2012, as well as their own previously published data on estimates of HIV incidence for 2008 to 2012.

The analysis estimated that, from 2010 to 2015, the number of new HIV infections dropped by 11.1% (from 37,366 to 33,218) and the rate of HIV transmissions dropped by 17.3% (from 3.16 to 2.61). During this 5-year period, the number of people living with HIV rose from 1,181,300 to 1,270,755. And the number of deaths (from all causes) of people with HIV dropped from 17,866 to 16,085.

In a press release from the University of Pennsylvania, the study’s lead author, Dr. Holtgrave, noted that researchers had previously warned that the 2015 goals would not be achieved without an increase in services for diagnostics, prevention, and care.

Indeed, according to Bonacci, the investments were not made to improve HIV diagnostic and prevention programs to the levels needed. And except for increased funding for HIV treatment, funding for HIV programs in the US has remained relatively unchanged since the release of the 2010 NHAS. Connecting patients with HIV to appropriate care and keeping them on treatment also continues to be a challenge.

“HIV prevention efforts must be reinvigorated in the NHAS’s second era,” the authors conclude.

Dr. Parry graduated from the University of Liverpool, England in 1997 and is a board-certified veterinary pathologist. After 13 years working in academia, she founded Midwest Veterinary Pathology, LLC where she now works as a private consultant. She is passionate about veterinary education and serves on the Indiana Veterinary Medical Association’s Continuing Education Committee. She regularly writes continuing education articles for veterinary organizations and journals, and has also served on the American College of Veterinary Pathologists’ Examination Committee and Education Committee.