Robert A Bonacci1, David R Holtgrave2. 1. Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts. Electronic address: rbonacci@bwh.harvard.edu. 2. Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Abstract
INTRODUCTION: The recently updated U.S. National HIV/AIDS Strategy sets key HIV prevention and care targets for 2020, but the trajectory of the epidemic remains unclear. Authors modeled HIV incidence, prevalence, and mortality for the U.S. over 10 years to determine whether an ambitious trajectory toward "ending AIDS" by 2025 would be achievable. METHODS: Authors utilized recently published 2010-2013 Centers for Disease Control and Prevention surveillance data to model HIV incidence, prevalence, and mortality. Authors applied a 90/90/90 framework (90% awareness of serostatus, 90% of diagnosed individuals in care, and 90% of individuals on antiretroviral therapy virally suppressed) by 2020 and 95/95/95 by 2025 to assess the feasibility of meeting epidemiologic targets. Analyses were conducted in 2016. RESULTS: With a goal of reducing infections to 21,000 new HIV infections in 2020, authors project a transmission rate of 1.74, 12,571 deaths, and a total of 1,205,515 people living with HIV. By 2025, with a target of 12,000 new HIV infections (a 69% decrease in HIV incidence), authors project a transmission rate of 0.98, 12,522 deaths, and a total of 1,220,615 people living with HIV. With a 90/90/90 framework by 2020 and a 95/95/95 framework by 2025, these epidemiologic targets would be feasible. CONCLUSIONS: Key programmatic milestones provide an ambitious, but important, pathway to reduce U.S. HIV incidence below 12,000 new infections by 2025. HIV incidence would decrease below mortality in 2025, marking a transition toward ending the HIV/AIDS epidemic. Such goals will require a sustained and intensified national commitment over the next decade.
INTRODUCTION: The recently updated U.S. National HIV/AIDS Strategy sets key HIV prevention and care targets for 2020, but the trajectory of the epidemic remains unclear. Authors modeled HIV incidence, prevalence, and mortality for the U.S. over 10 years to determine whether an ambitious trajectory toward "ending AIDS" by 2025 would be achievable. METHODS: Authors utilized recently published 2010-2013 Centers for Disease Control and Prevention surveillance data to model HIV incidence, prevalence, and mortality. Authors applied a 90/90/90 framework (90% awareness of serostatus, 90% of diagnosed individuals in care, and 90% of individuals on antiretroviral therapy virally suppressed) by 2020 and 95/95/95 by 2025 to assess the feasibility of meeting epidemiologic targets. Analyses were conducted in 2016. RESULTS: With a goal of reducing infections to 21,000 new HIV infections in 2020, authors project a transmission rate of 1.74, 12,571 deaths, and a total of 1,205,515 people living with HIV. By 2025, with a target of 12,000 new HIV infections (a 69% decrease in HIV incidence), authors project a transmission rate of 0.98, 12,522 deaths, and a total of 1,220,615 people living with HIV. With a 90/90/90 framework by 2020 and a 95/95/95 framework by 2025, these epidemiologic targets would be feasible. CONCLUSIONS: Key programmatic milestones provide an ambitious, but important, pathway to reduce U.S. HIV incidence below 12,000 new infections by 2025. HIV incidence would decrease below mortality in 2025, marking a transition toward ending the HIV/AIDS epidemic. Such goals will require a sustained and intensified national commitment over the next decade.
Authors: Kate M Mitchell; Brooke Hoots; Dobromir Dimitrov; Danielle German; Colin Flynn; Jason E Farley; Marcy Gelman; James P Hughes; Deborah Donnell; Adeola Adeyeye; Robert H Remien; Chris Beyrer; Gabriela Paz-Bailey; Marie-Claude Boily Journal: J Int AIDS Soc Date: 2019-03 Impact factor: 5.396
Authors: Steven P Masiano; Erika G Martin; Rose S Bono; Bassam Dahman; Lindsay M Sabik; Faye Z Belgrave; Adaora A Adimora; April D Kimmel Journal: J Int AIDS Soc Date: 2019-05 Impact factor: 5.396
Authors: Aditya Subhash Khanna; Mert Edali; Jonathan Ozik; Nicholson Collier; Anna Hotton; Abigail Skwara; Babak Mahdavi Ardestani; Russell Brewer; Kayo Fujimoto; Nina Harawa; John A Schneider Journal: Math Biosci Eng Date: 2021-05-06 Impact factor: 2.080