Objective Status

  • 6 Baseline only
  • 0 Developmental
  • 0 Research

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About the Workgroup

Approach and Rationale

HIV (human immunodeficiency virus) remains a significant public health issue in the United States. Approximately 38,000 new HIV infections happen in the United States each year. In 2017, about 86 percent of an estimated 1.2 million people with HIV were aware of their HIV status, meaning they could get HIV treatment to stay healthy, control the virus, and prevent passing HIV to others. Only 63 percent of people who knew they had HIV were virally suppressed or had the virus under control through effective treatment.1 In addition, only about 18 percent of the estimated 1.2 million people who could benefit from PrEP (pre-exposure prophylaxis)2 got a prescription for it.

Core objectives selected by the HIV Workgroup are aligned with the current U.S. National HIV/AIDS Strategy (NHAS),3 the nation’s roadmap in the fight against HIV. The current plan expires in 2020, and development of the next iteration of NHAS is under way.4 The updated plan will be grounded in the latest science and will guide stakeholders from all sectors in collaborative efforts focused on key strategies to achieve national HIV goals. Ending the HIV Epidemic: A Plan for America (EHE)5,6 is an initiative announced in February 2019 that seeks to reduce new HIV infections by 90 percent by 2030 using 4 science-based strategies (diagnose, treat, prevent, and respond). National indicators of HIV prevention are selected for national plans through a process led by the HHS Office of Infectious Disease and HIV/AIDS Policy. The Healthy People 2030 HIV objectives and targets are aligned with indicators in the new EHE initiative. 

Understanding HIV

The annual number of new HIV infections has remained relatively stable from 2013 to 2017.1 However, certain populations continue to bear a disproportionate burden of the disease. Young people ages 13 to 24 years were less likely to know their HIV status than those age 25 and older.1 Compared to other age and racial/ethnic groups, linkage to HIV medical care was lowest among young people and African Americans. Young people and African Americans were also less likely to be virally suppressed. PrEP coverage was especially low among young people, African Americans, and Latinos who could benefit from PrEP. To end the U.S. HIV epidemic, it’s critical to scale up implementation of the 4 science-based strategies (diagnose, treat, prevent, and respond) while addressing disparities.  

Emerging Issues in HIV

Collective efforts over the years at the local, state, and federal level have successfully increased the proportion of people living with HIV who know their status, are linked to medical care, and achieve viral suppression. However, progress has stalled. Using the strategies from the proposed EHE initiative can help achieve the goal of reducing HIV in the United States by 2030.

Citations

1.

Centers for Disease Control and Prevention. (Dec. 2019). Vital Signs: Status of Human Immunodeficiency Virus Testing, Viral Suppression, and HIV Preexposure Prophylaxis — United States, 2013–2018. Morbidity and Mortality Weekly Report, 68(48), 1117–1123. http://dx.doi.org/10.15585/mmwr.mm6848e1

2.

U.S. Preventive Services Task Force. (2019). Preexposure Prophylaxis for the Prevention of HIV Infection: US Preventive Services Task Force Recommendation Statement. JAMA, 321(22), 2203–2213. https://doi.org/10.1001/jama.2019.6390

3.

U.S. Department of Health and Human Services. (2017). National HIV/AIDS Strategy: Updated to 2020. Retrieved from https://www.hiv.gov/federal-response/national-hiv-aids-strategy/nhas-update

4.

U.S. Department of Health and Human Services. (April 2019). Developing the Next National HIV/AIDS Strategy. Retrieved from https://www.hiv.gov/federal-response/national-hiv-aids-strategy/developing-the-next-nhas

5.

U.S. Department of Health and Human Services. What is ‘Ending the Epidemic: A Plan for America’? Retrieved from https://www.hiv.gov/federal-response/ending-the-hiv-epidemic/overview

6.

Fauci, A.S., Redfield, R.R., Sigounas, G., Weahkee, M.D., & Giroir, B.P. (March 2019) Ending the HIV Epidemic: A Plan for the United States. JAMA 321(9), 844-845.