The U.S. has quite a long way to go in a short period of time if it wants to reach the goals defined in its “Ending the HIV Epidemic” (EtE) plan, newly published data indicate.
The EtE plan, which was unveiled earlier this year, calls for a 90% reduction in HIV incidence by 2030. It also aims to ensure that, among people living with HIV (PLWH), 95% have been diagnosed and 95% of those diagnosed are virally suppressed. The plan further sets a PrEP prescription target of 50% of all Americans who meet indications for biomedical HIV prevention.
At the moment, U.S. numbers fall well short of these targets, the new data show. In 2017, 86% of PLWH were diagnosed, 63% of those diagnosed were virally suppressed, and 18% of those eligible for PrEP had been prescribed the medication in 2018, researchers with the U.S. Centers for Disease Control and Prevention (CDC) estimated in Morbidity and Mortality Weekly Report.
Further, recent trend lines are not encouraging. The rate of new seroconversions changed little between 2013 and 2017, dropping from 38,500 to 37,500, the CDC researchers reported. Racial and ethnic disparities persist throughout the HIV care cascade as well: For example, while 89% of white people living with HIV had been diagnosed in 2017, only 80% of Native Americans had. Similarly, PrEP coverage varied widely, with 42% of whites eligible for this medication getting it compared to 6% of African Americans.
“Accelerated efforts to diagnose, treat, and provide PrEP while addressing disparities, are urgently needed to reach the targets for the Ending the HIV Epidemic: A Plan for America initiative,” study authors concluded. Such efforts must include addressing social and economic barriers to care, such as health insurance, housing, and prison or jail, they added.