BALTIMORE, Md. — Researchers say “ambitious” goals to create a turning point for the epidemic are well within reach, with the start of a decline in the total number of people living with HIV in the U.S. starting by 2025.
The path is set to see an annual reduction in new U.S. infections to 21,000 by 2020 and 12,000 by 2025, a new study conducted by researchers at Johns Hopkins Bloomberg School of Public Health and Brigham and Women’s Hospital. Should these initially lofty goals be met, 2025 would be turning the corner in a reduction of HIV’s prevalence.
“While these targets are ambitious, they could be achieved with an intensified and sustained national commitment over the next decade,” says study co-author David Holtgrave, PhD, chair of the Department of Health, Behavior and Society at the Bloomberg Public Health School in a press release. “It’s critical to note that the key to ending the HIV epidemic domestically lies in our collective willingness as a country to invest the necessary resources in HIV diagnostic, prevention and treatment programs.”
The Centers for Disease Control and Prevention estimates that roughly 1.2 million people in the United States are living with HIV, and nearly one in eight of those individuals aren’t aware that they are infected. The annual number of U.S. HIV infections has been reduced by more than two-thirds since its height in the mid-1980s. In 1985, there were roughly 130,000 new infections compared to 50,000 in 2010.
The researchers used data collected by the CDC from 2010 to 2013 that projects yearly estimates for key statistics such as the number of new nationwide infections each year, the number of people living with the virus in the U.S., and the estimated mortality rate moving forward through 2025.
This data was put up against former President Barack Obama’s 2010 and 2015 benchmarks that were released by the National HIV/AIDS Strategy (NHAS) as goals for 2020. The “90/90/90” goal aims for 90 precent of people living with the virus to be aware of their status, 90 percent of people diagnosed to receive sustained care and 90 percent of people on antiretroviral therapy (ART) to achieve a minute level of the virus in their blood. The researchers say an updated “95/95/95” goal by 2025 can be achieved.
Should the “95” goal be achieved, new infections would drop from the 39,000 recorded in 2013 to around 20,000 in 2020 — a 46 percent decrease. By 2025, their would be a nearly 70 percent reduction to 12,000. The number of deaths among individuals living with HIV is estimated to decrease to around 12,522 in 2025, or a nearly one-quarter (24 percent) decrease from 2013 statistics.
Researchers also project a nearly one-third decrease (31 percent) in the mortality rate to 1,025 per 100,000 living with HIV compared to 1,494 deaths per 100,000 recorded in 2013.
“If the United States were to reduce the number of new HIV infections to 12,000 by 2025, this would mark an important inflection point in the HIV epidemic in this country,” says study leader Robert Bonacci, MD, MPH, a resident physician in the Department of Medicine at Brigham and Women’s Hospital. “It would be the first year that the number of new infections drops below the simultaneously decreasing number of deaths among people living with HIV. This is critical, because if new infections decline faster than the number of deaths, the total number of people living with HIV in the United States would begin to decrease, meaning the United States would be on course to end the epidemic.”
The researchers note that gay men, young people, transgender people, black and Hispanic Americans and people living in Southern states continue to be disproportionately affected by HIV. These findings were published in “U.S. HIV Incidence and Transmission Goals, 2020 and 2025” by Robert A. Bonacci, MD; and David R. Holtgrave, PhD.