Number of HIV infections falling in United States, but fails to meet reduction goals

May 3, 2016
HIV (yellow) infecting a human immune cell. Credit: Seth Pincus, Elizabeth Fischer and Austin Athman, National Institute of Allergy and Infectious Diseases, National Institutes of Health

The number of new HIV infections occurring annually in the United States decreased by an estimated 11 percent from 2010 to 2015, while the HIV transmission rate decreased by an estimated 17 percent during the same time period, according to new research from the Johns Hopkins Bloomberg School of Public Health and the University of Pennsylvania.

But despite making important progress on these key indicators, the researchers say the U.S. fell short of the goals outlined in the first comprehensive National HIV/AIDS Strategy (NHAS) released by President Obama's administration in 2010. The 2010 NHAS called for a 25-percent reduction in HIV incidence—the number of new infections in a given time period—and a 30-percent reduction in the rate of transmission by the year 2015. Their report, published online in the journal AIDS and Behavior, used mathematical modeling to provide the first estimates of the nation's progress toward the NHAS targets for HIV incidence and transmission rates by 2015.

"The good news is that we appear to have made important strides in the prevention of HIV and the reduction of HIV transmission rates in the United States; unfortunately, these key gains only got us roughly halfway to the 2015 goal line," says the study's senior author, David Holtgrave, PhD, chair of the Department of Health, Behavior and Society at the Bloomberg School. "After the release of the first National HIV/AIDS strategy, researchers cautioned that failure to expand diagnostic, prevention and care services to necessary levels would result in underachievement on the NHAS goals for 2015. Our analysis suggests that is just what happened."

Holtgrave says that while he understands that federal and local resources are limited, efforts must be made to ensure they are allocated strategically, including through an intensified focus on reaching the communities most disproportionately affected by HIV, particularly gay men, young people, transgender people, African American and Hispanic communities, and those who live in southern states.

To evaluate whether the United States achieved the NHAS goals for reducing the number of new HIV infections, the researchers used mathematical models to estimate HIV incidence and rate of transmission for 2015, and these estimates were used to calculate the net percent change from 2010 to 2015. Their calculations were based on surveillance data published by the Centers for Disease Control and Prevention (CDC) on HIV prevalence and mortality for 2007 to 2012, as well as their own previously published estimates of HIV incidence for 2008 to 2012. Changes seen from 2010 through 2012 were extrapolated for the time period 2013 through 2015.

According to the analysis, in 2015 there were approximately 33,218 new HIV infections in the United States, down from an estimated 37,366 in 2010—a reduction of 11.1 percent. The HIV transmission rate—defined as the average annual number of disease transmissions per 100 people living with HIV—was estimated to be 2.61 in 2015, a reduction of 17.3 percent from the 2010 rate of 3.16.

"Our models indicate that the country's incremental progress in reducing new HIV infections was not enough to achieve the NHAS targets for 2015," says study leader Robert Bonacci, MPH, a medical student at the Perelman School of Medicine at the University of Pennsylvania. "Going forward, as we implement the recently released updated NHAS for 2020, we must take a critical look at the past five years and apply the lessons learned to maximize the impact on our communities most affected by HIV."

Advancements in antiretroviral therapy (ART) mean that HIV can now be a manageable chronic disease. And in the U.S., the average life expectancy for people living with HIV continues to increase toward that of the general population. Yet certain populations—particularly gay men, young people, transgender people, black and Hispanic Americans and those who live in southern states—continue to be disproportionately affected, and the partial gains made overall have not been spread evenly across all communities. For some, especially gay and other men who have sex with men, the epidemic may be worsening. Additionally, of the 1.2 million people living with HIV in the U.S., many lack access to ART, the lifesaving drugs that reduce HIV transmission by lowering the level of virus in the blood.

Explore further: New study tests the effectiveness of at-home HIV testing for male couples

More information: "Evaluating the Impact of the U.S. National HIV/AIDS Strategy, 2010-2015" was written by Robert A. Bonacci, MPH, and David R. Holtgrave, PhD.

Related Stories

New study tests the effectiveness of at-home HIV testing for male couples

April 20, 2016
Relationships bring with them lots of issues: Who will do the laundry? The cooking? Pay the bills?

CDC: One in two gay black men in US will be diagnosed with HIV

February 23, 2016
About half of gay and bisexual black men will be diagnosed with the AIDS virus in their lifetime, according to new government estimates.

Study compares tests to detect acute HIV infection

February 16, 2016
In a study appearing in the February 16 issue of JAMA, Philip J. Peters, M.D., of the Centers for Disease Control and Prevention, Atlanta, and colleagues evaluated the performance of an HIV antigen/antibody (Ag/Ab) combination ...

HIV transmission at each step of the care continuum in the United States

February 23, 2015
Individuals infected but undiagnosed with the human immunodeficiency virus (HIV) and those individuals diagnosed with HIV but not yet in medical care accounted for more than 90 percent of the estimated 45,000 HIV transmissions ...

CDC: fewer blacks consistently retained in HIV care

February 8, 2016
(HealthDay)—Fewer blacks are consistently retained in HIV care compared with other racial/ethnic groups, according to research published in the Feb. 5 issue of the U.S. Centers for Disease Control and Prevention's Morbidity ...

Growth in maternal and child health funding outpaces spending on HIV, TB, and malaria

April 14, 2016
Funding earmarked for improving maternal and child health in low- and middle-income countries has grown faster since 2010 than funding for HIV, TB, and malaria.

Recommended for you

Study suggests a way to stop HIV in its tracks

December 1, 2017
When HIV-1 infects an immune cell, the virus travels to the nucleus so quickly there's not enough time to set off the cell's alarm system.

Discovery puts the brakes on HIV's ability to infect

November 30, 2017
Viewed with a microscope, the virus faintly resembles a pineapple—the universal symbol of welcome. But HIV, the virus that causes AIDS, is anything but that. It has claimed the lives of more than 35 million people so far.

Rising levels of HIV drug resistance

November 30, 2017
HIV drug resistance is approaching and exceeding 10% in people living with HIV who are about to initiate or reinitiate first-line antiretroviral therapy, according to the largest meta-analysis to date on HIV drug resistance, ...

Male circumcision and antiviral drugs appear to sharply reduce HIV infection rate

November 29, 2017
A steep drop in the local incidence of new HIV infections accompanied the rollout of a U.S.-funded anti-HIV program in a large East-African population, according to a study led by researchers at Johns Hopkins Bloomberg School ...

Combination HIV prevention reduces new infections by 42 percent in Ugandan district

November 29, 2017
A study published today in the New England Journal of Medicine provides real-world evidence that implementing a combination of proven HIV prevention measures across communities can substantially reduce new HIV infections ...

Research on HIV viral load urges updates to WHO therapy guidelines

November 24, 2017
A large cohort study in South Africa has revealed that that low-level viraemia (LLV) in HIV-positive patients who are receiving antiretroviral treatment (ART) is an important risk factor for treatment failure.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.