Dr. Anthony Fauci

Immunology

A Plan for Ending the HIV Epidemic in America

By Dr. Anthony Fauci, Director of the National Institutes of Health's (NIH) National Institute of Allergy and Infectious Diseases (NIAID), as addressed at the 2019 Conference on Retroviruses and Opportunistic Infections (CROI)

The plan is to decrease the number of new HIV infections by 75% in 5 years and by 90% in 10,  acheived by the effors of the NIAID and the leaders of the Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), Indian Health Service (IHS), and Office of the Assistant Secretary of Health (OASH) which have collaborated on a strategy to make best use of the highly effective tools that are now available – specifically, HIV treatment and pre-exposure prophylaxis (PrEP).

There are The 19 NIH-supported Centers for HIV Research and six additional AIDS Research Centers supported by the National Institute of Mental Health, which will focus on implementation science and NIH also will continue to advance it's HIV research agenda across a range of topics, including new and improved forms of HIV prevention and treatment, a vaccine, and research toward an HIV cure.

“We still have a significant problem with HIV in the United States,” said Dr. Fauci, with 1.1 million Americans living with HIV, 38,000 new HIV infections each year, and significant demographic and geographic disparities in new infections concentrated mostly among men who have sex with men and racial/ethnic minorities.

Another discussion during the 2019 Conference on Retroviruses and Opportunistic Infections (CROI) was from Dr. Carl W. Dieffenbach, Ph.D., the Director of the Division of AIDS at NIH’s National Institute of Allergy and Infectious Diseases (NIAID), where he discussed the promising findings from a large study evaluating a “universal test and treat” strategy, as well as other results showing improved viral suppression and retention in care when point-of-care viral load testing is offered. The clinical trial called “Population Effects of Antiretroviral Therapy to Reduce HIV Transmission” (PopART), or HPTN 071, was presented at the Conference, sponsored by NIAID and funded primarily by the President’s Emergency Plan for AIDS Relief (PEPFAR).

PopART, or HPTN 071, was presented at the Conference and sponsored by NIAID. Primarily funded by the President’s Emergency Plan for AIDS Relief (PEPFAR), PopART found that that conducting population-wide, home-based HIV testing and offering treatment to those diagnosed with HIV—a strategy often referred to as “universal test and treat”—resulted in high rates (70%) of viral suppression and a 30% reduction in new HIV infections. The researchers concluded that such a strategy could help control the epidemic in certain settings.

The study showed Point-of-Care Viral Load Testing significantly improved HIV viral suppression and retention in care in South Africa, partly by ensuring rapid receipt of viral load results to patients and their providers. The researchers, led by Dr. Paul Drain of the University of Washington, concluded that increasing access to point-of-care viral load testing could help to achieve goals for increasing the proportion of people living with HIV who are virally suppressed in many areas in southern Africa where less than 50% of people with HIV have achieved viral load suppression.

Source: hiv.gov

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