U.S. HIV Infections Decline, But Progress Falls Short of NHAS Goals

By Eric Brus

During the period from 2010 to 2015, the annual number of new HIV infections in the U.S. declined by about 11 percent, and the HIV transmission rate dropped about 17 percent, according to a new study from researchers at the University of Pennsylvania and the Johns Hopkins Bloomberg School of Public Health.

However, despite this progress, the U.S. fell short of important goals set forth in the White House's 2010 National HIV/AIDS Strategy (NHAS). The 2010 NHAS called for a 25 percent reduction in HIV incidence and a 30 percent reduction in the rate of transmission by the year 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 U.S.; unfortunately, these key gains only got us roughly halfway to the 2015 goal line," noted Johns Hopkins's David Holtgrave, one of the study's coauthors. "After the release of the first NHAS, 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."

The researchers used mathematical models to estimate HIV incidence and the rate of HIV transmission for 2015, and then used their estimates to calculate the change in these measures since 2010. This analysis indicated that the number of new HIV infections fell 11.1 percent from an estimated 37,366 in 2010 to an estimated 33,218 in 2010.

During the same period, the HIV transmission rate -- defined as the average annual number of HIV transmissions per 100 people living with the virus -- declined 17.3 percent from 3.16 in 2010 to 2.61 in 2015.

In addition, the estimated annual number of deaths (from all causes) among persons living with HIV in the U.S. decreased from 17,866 to 16,085 over the same period. However, because the number of new HIV infections continued to exceed the number of deaths, the total number of people living with HIV in the U.S. rose from about 1,181,300 in 2010 to 1,270,755 in 2015.

"Our models indicate that the country's incremental progress in reducing new HIV infections was not enough to achieve the NHAS targets for 2015," according to the study's other coauthor, Robert Bonacci of 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."

Eric Brus is the Director of Health Information at AIDS Action Committee. This report is produced by the Health Library of the AIDS Action Committee in collaboration with the New England AIDS Education and Training Center Minority AIDS Initiative Project. The full version is available here.