Number of HIV Infections in US Falling, Missed Reduction Goals

The number of new HIV infections occurring annually in the United States decreased by an estimated 11% from 2010 to 2015, and the HIV transmission rate decreased by an estimated 17% during the same time period, a new study finds. However, researchers with Johns Hopkins Bloomberg School of Public Health and the University of Pennsylvania said that while this is progress on key indicators, the nation fell short of the goals set by the Obama administration’s National HIV/AIDS Strategy (NHAS) released in 2010. The NHAS called for a 25% reduction in HIV incidence and a 30% reduction in the rate of transmission by 2015.

David Holtgrave, PhD, chair of the Department of Health, Behavior and Society at the Bloomberg School, and senior author of the study, published online in Aids and Behavior, said the good news is that we appear to have made important strides in preventing HIV and reducing its transmission in the United States, but we are only about halfway to the 2015 goal set by NHAS. Using published data from the US Centers for Disease Control (CDC) on HIV prevalence and mortality for 2007-2012, literature-based incidence estimates for 2009-2012, and mathematical modeling to evaluate whether the original NHAS incidence and transmission rate goals were achieved.

Holtgrave said that his group’s analysis concludes that we have failed to expand diagnostic, prevention, and care services to the needed levels, and that is why we have, as a nation, failed to meet our goals with respect to HIV. We have not strategically allocated federal and local resources, which Holtgrave acknowledges are limited, to 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.

The analysis shows that in 2015 there were approximately 33,218 new HIV infections in the United States, a fall from an estimated 37,366 in 2010 (the 11.1% reduction). The HIV transmission rate was estimated to be 2.61 in 2015, a decline of 17.3% from the 2010 rate of 3.16.

Study leader Robert Bonacci, MPH, of the Perelman School of Medicine at the University of Pennsylvania, said the nation’s incremental progress in reducing new HIV infections was not enough to achieve the NHAS targets for 2015 and we must take a critical look at the last 5 years and apply the lessons learned to maximize the impact on our communities most affected by HIV. Partial gains made overall have not been evenly experienced across all communities, especially gay and other men who have sex with men, for whom the epidemic may be worsening.