HIV Epidemic May Come to an End by 2025, Predicts Study

In eight years, the HIV epidemic in the U.S. could come to a halt, with declines in infections of the deadly virus outpacing new cases.

A new statistical analysis of current and projected HIV trends from researchers at Johns Hopkins Bloomberg School of Public Health and Brigham and Women’s Hospital found that “the achievement of critical milestones” between today and 2025 could severely curtail HIV transmission.
They report that current goals in place that seek to reduce new yearly infections to 12,000 cases by 2025 are already showing signs of success, according to a new study published in the American Journal of Preventive Medicine.

“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,” noted study author Dr. Robert Bonacci, a resident physician in the Department of Medicine at Brigham and Women’s Hospital.

That forecast, which the researchers based on goals set forth under President Obama as part of the National HIV/AIDS Strategy (NHAS), would reflect a significant turning point in the history of the virus in the U.S., which currently infects about 39,000 people per year, according to estimates from 2013.

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Should the 2025 goals be met, “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,” said Bonacci. “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.”

Meeting Key Goals

The NHAS initiative set several longitudinal targets for disease incidence, including a “90/90/90” paradigm by 2020. Under that goal, the medical community seeks to have 90 percent of people with HIV aware of their disease status; 90 percent with HIV on “sustained, quality” care; and 90 percent on antiretroviral therapy that results in “an undetectable level of virus in the blood.”

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By 2025, the initiative targets a “95/95/95” threshold for those key factors, which would lead to about a 70 percent disease reduction between 2013 and 2025 and a steep drop in mortality rates.
By reducing levels of HIV virus in the blood, antiretroviral therapy can turn AIDS into “a management chronic disease.” Yet the researchers note that the therapy, while highly effective, is often off limits to some sectors of the population.

“Providing HIV services to our most disproportionately affected communities is fundamental to future success,” said study author Dr. David Holtgrave of the Johns Hopkins Bloomberg School of Public Health.

The researchers note that many of the more than 1 million people currently living with HIV lack access to effective treatment, which could be a leading hurdle to overcome to meet the program’s goals.

“While these targets are ambitious, they could be achieved with an intensified and sustained national commitment over the next decade,” says Holtgrave. “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.”

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