CDC: More Urgency Needed to Reach HIV Infection Goals

We seem to have hit a wall when it comes to slowing the rate of new HIV infections, according to the US Centers for Disease Control and Prevention (CDC). “Since 2013, progress in reducing the number of new human immunodeficiency virus (HIV) infections has stalled at approximately 38,000 new infections occurring each year,” CDC investigators say in a study out this week in the agency’s Morbidity and Mortality Weekly Report. Using data from theNational HIV Surveillance System (NHSS), the CDC measured rates of new HIV infections from 2013 to 2017.

The CDC wants to practically eliminate the occurrence new HIV infections by 2030. “Accelerated efforts to diagnose, treat, and prevent HIV infection are needed to achieve the US goal of at least 90% reduction in the number of new HIV infections by 2030,” the study states. 

Reaching this goal will mean getting at least 95% of people with HIV diagnosed, getting 95% of those diagnosed to viral suppression, and getting 50% of those at increased risk for acquiring HIV on pre-exposure prophylaxis (PrEP), the daily pill that prevents HIV. 

Jonathan Mermin, MD, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, and STD Prevention, said in a statement that “the number of people who acquire HIV each year is unacceptably high. Ending this epidemic would be one of the greatest public health triumphs in our nation’s history.”

In 2017, about 154,000 people with HIV (14%) did not know that they had it and so couldn’t take advantage of HIV treatment. The CDC says that people ages 13 to 24 are less likely to know their HIV status than people 25 years or older. About two-thirds (63%) of those who knew that they had HIV were receiving effective treatment for it. 

In 2018, according to CDC data, 219,700 of the 1.2 million people who could benefit from PrEP had gotten a prescription from a retail pharmacy for the medication. PrEP coverage was likely higher than that, however, because CDC’s data did not include prescriptions from the military or managed care organizations. “Coverage was especially low among young people, African Americans, and Latinos who could benefit from PrEP,” the CDC states. 

In addition to looking at the number of new infections from 2013 to 2017, the CDC used 2017 data to determine the percentage of people with diagnosed HIV infection with viral load suppression. The agency also looked at surveillance and pharmacy data to estimate PrEP coverage-the number of people prescribed PrEP divided by number of people who should be taking it.  

The CDC has recommended since 2012 that prompt treatment with antiretroviral therapy be initiated for people diagnosed with HIV, yet only 61.5% of people diagnosed in 2017 had a suppressed viral load 6 months after diagnosis.