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In the United States, about 40% of new HIV infections occur in about 40% of people who do not know they are infected or who do not receive HIV care, according to a report released today by the US. Center for Disease Control and Prevention (CDC). ).
The remaining 20% of new infections occur among people who receive care for HIV infection but have not been virally suppressed.
"These new vital signs data show the tremendous impact we can have in helping all Americans living with HIV to know their diagnosis, to start treatment and to stay in treatment to stay healthy," he said. said CDC director Robert R. Redfield in a press release.
Zihao Li, PhD and colleagues at the CDC used surveillance data to create a mathematical model to estimate HIV transmission rates in 2016 along the continuum of care, from infection to treatment and viral suppression.
The estimated overall HIV transmission rate in 2016 was 3.5 new infections per 100 person-years. The authors report that rates of transmission decreased with progression in the HIV care continuum.
Seriously infected individuals who are unaware of their infection have the highest transmission rate (16.1 per 100 person-years), followed by uninfected and non-conscious individuals (8.4 per 100 person-years). ). The model shows that these two groups account for 15% of people living with HIV and about 38% of new HIV transmissions.
The transmission rate among people who are aware of their HIV infection but who are not receiving care is 6.6 per 100,000 person-years. This group represents 23% of people living with HIV and represents 43% of new transmissions. People who receive HIV care but are not suppressed by viruses (11%, transmission rate 6.1) account for 20% of new HIV infections.
According to the researchers, in particular, the rate of transmission was nil in 51% of HIV-infected people who were receiving antiretroviral therapy and were virally suppressed.
"Bold but achievable"
The report was published online March 18 in the newspaper Weekly report on morbidity and mortality coinciding with the opening of the CDC's National Conference on HIV Prevention in 2019 in Atlanta, Georgia.
Ensuring that more people are screened and receiving HIV care is the foundation of the recently announced federal initiative, Ending the HIV Epidemic – A Plan for HIV / AIDS. 39, America, said Admiral Brett P Giroir, Assistant Secretary for Health and Social Services for Health. journalists.
The ambitious plan, announced last month, aims to reduce HIV infections by 75% in the United States by 5 years and by 90% by 10 years.
"HIV has cost America too much for too long," said Giroir. He pointed out that 700,000 Americans have died of AIDS since 1981 and another 400,000 are at risk of contracting HIV this decade, "if we accept the status quo".
The plan to end the HIV epidemic in America is "bold but quite achievable," he said, "because we have the right tools, the right data, and the right leadership."
"Diagnose, treat, protect and respond: these are the key strategies of our historic initiative to end the HIV epidemic in America by engaging all people at risk in comprehensive prevention strategies," said Redfield. in his press release.
The CDC recommends that providers screen at least once for HIV infection in patients aged 13 to 64, and test some patients more frequently (annually for high-risk individuals, every 3 to 6 months for badually active homobadual and bibadual men); quickly link, engage or re-engage patients in comprehensive HIV care; and encourage patients to maintain viral suppression for their own health and because of the benefits of prevention.
"We now have the tools needed to end the HIV epidemic," said Jonathan Mermin, director of the CDC's National Center on HIV / AIDS, Viral Hepatitis, STDs. and tuberculosis. "But a tool is only useful if it's in the hands of someone.That's why it's essential to introduce the screening test and treatment of all of them." HIV-positive people – and give them the power to control their lives and change the course of the epidemic. "
MMWR Morb Mortal Wkly Rep. Posted online 18 March 2019. Full text
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