Progress in the HIV epidemic: Identifying goals and measuring success

• Type of Material: Article
• Authors: Jeb Jones, Emory University; James W Curran, Emory University; Patrick S Sullivan, Emory University
• Language: English
• Date: 2019-01-01
• Publisher: Public Library of Science
• Publication Version: Final Published Version
• Copyright Statement: © 2019 Jones et al.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1371/journal.pmed.1002729
• Title of Journal or Parent Work: PLoS Medicine
• ISSN: 1549-1277
• Volume: 16
• Issue: 1
• Start Page: e1002729
• End Page: e1002729
• Grant/Funding Information: An earlier version of this paper was commissioned by UNAIDS for a meeting convened in October 2017.; JJ received compensation for producing the earlier version of the paper. UNAIDS reviewed and provided feedback on earlier drafts of the paper; however, final editorial decisions were made by coauthors.
• Keywords: Medicine, General & Internal; PREVENTION; MEN; Life Sciences & Biomedicine; PROPHYLAXIS; Science & Technology; General & Internal Medicine
• Research Categories: Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Substantial progress has been made towards the goal of ending the HIV/AIDS epidemic due to advancements in both prevention and treatment of HIV. However, major challenges still remain. We describe basic principles of epidemic control in the context of HIV and identify a number of attainable goals in terms of control and elimination of HIV in specific populations and risk groups, given currently available HIV prevention and treatment methods. Currently available HIV prevention methods make it a feasible goal to eliminate HIV transmission attributable to mother-to-child transmission and blood transfusions. Reductions in transmission attributable to sexual behavior and injection drug use are feasible, but elimination of these modes of transmission will require further advancements in behavioral and biomedical HIV prevention. With regard to HIV-related mortality, we argue that elimination of death due to HIV-related causes is a feasible goal. HIV-related deaths should be treated as sentinel events triggering epidemiological investigation into the breakdowns in the HIV care continuum that led to them. We briefly discuss additional considerations that will affect the success of HIV prevention programs.