Quantifying the impact of the National HIV/AIDS strategy targets for improved HIV care engagement in the US: a modelling study

Details

• Alternative Title:
  Lancet HIV
• Personal Author:
  Shah, Maunank ; Perry, Allison ; Risher, Kathryn ; Kapoor, Sunaina ; Grey, Jeremy ; Sharma, Akshay ; Rosenberg, Eli S ; Del Rio, Carlos ; Sullivan, Patrick ; Dowdy, David W.
• Description:
  Background
  
  The recently updated White House National HIV/AIDS Strategy (NHAS) includes specific progress indicators for improving the HIV care continuum, but the economic and epidemiological impact of achieving those indicators remains unclear.
  
  Methods
  
  We constructed a dynamic transmission model of HIV progression and care engagement to project HIV incidence, prevalence, mortality, and costs among adults in the United States over ten years. We specifically considered achievement of the 2020 targets set forth in NHAS progress indicator 1 (90% awareness of serostatus), indicator 4 (85% linkage within one month), and indicator 5 (90% of diagnosed individuals in care).
  
  Finding
  
  At current rates of engagement in the HIV care continuum, we project 524,000 (95% Uncertainty Range 442,000 – 712,000) new HIV infections and 375,000 deaths (364,000 – 578,000) between 2016 and 2025. Achieving NHAS progress indicators 1 and 4 has modest epidemiologic impact (new infections reduced by 2·0% and 3·9%, respectively). By contrast, increasing the proportion of diagnosed individuals in care (indicator 5) averts 52% (47-56%) of new infections. Achieving all NHAS targets resulted in a 58% reduction (52%-61%) in new infections and 128,000 lives saved (106,000-223,000) at an incremental health system cost of $105 billion dollars.
  
  Interpretation
  
  Achievement of NHAS progress indicators for screening, linkage, and particularly improving retention in care, can substantially reduce the burden of HIV in the United States.
  
  
• Subjects:
  Adult Article Delivery Of Health Care Federal Government Forecasting Health Care Costs Health Planning Health Policy HIV Infections Humans Incidence Models, Economic

  More +
• Source:
  Lancet HIV. 3(3):e140-e146.
• Pubmed ID:
  26939737
• Pubmed Central ID:
  PMC4787987
• Document Type:
  Journal Article
• Funding:
  P30 AI050409/AI/NIAID NIH HHS/United States ; 5U38PS004646/PS/NCHHSTP CDC HHS/United States ; K23AI089259/AI/NIAID NIH HHS/United States ; T32AI102623/AI/NIAID NIH HHS/United States ; K23 AI089259/AI/NIAID NIH HHS/United States ; U38 PS004646/PS/NCHHSTP CDC HHS/United States ; T32 AI102623/AI/NIAID NIH HHS/United States
• Place as Subject:
  United States
• Volume:
  3
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:10f5ed6548e1dd210b29e315ff1a971f060d03371e45e56065a200e3a1b97aaf
• Download URL:
  https://stacks.cdc.gov/view/cdc/40278/cdc_40278_DS1.pdf
• File Type:
  [PDF - 315.20 KB ]