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Look Back Recap: CROI and Ending the HIV Epidemic

Tuesday, April 2, 2019


It's well worth spending 20 minutes to watch this recap of what is driving the Ending the HIV Epidemic Plan for the United States and the crucial role of HRSA and other federal agencies in pursuing its four pillars of diagnose, treat, prevent, and respond. 

NIH's Anthony Fauci presented and Ending the Epidemic overview in his CROI 2019 plenary last month, in March, highlighting "implementation gaps," what is already being done to address them, and how those insights can be applied nationally. 

Watch the video and read the blog

Implementation Gaps

  • Nationally, viral load suppression rates are around 60%, which is not good enough. In contrast, HRSA's Ryan White HIV/AIDS Program (RWHAP) has achieved an 85.9% rate.
  • A fairly small proportion of those at high risk of HIV infection are on PrEP—around 269,000 of the one million plus who are high risk.
  • The number of new HIV diagnoses each year is no longer falling and appears to be stuck at a little less than 40,000.

Viral Suppression Rate in the U.S. Overall and the Ryan White HIV/AIDS Program

Inspiration for the National Plan 

Fauci highlighted what is being done in San Francisco, New York State, and the District of Columbia and how their work inspired the Ending the Epidemic plan. In San Francisco, "Treat All" and "RAPID" have driven new HIV diagnoses down dramatically from 2007 to 2017. The same results have been achieved in New York City and D.C., said Fauci.

These targeted efforts are the impetus for the Ending the Epidemic's focus on the 48 counties in the United States (along with D.C. and Puerto Rico) that account for over 50% of new infections (out of the nation's 3007 counties). The plan also is targeting seven southern states that have a disproportionate number of HIV cases in rural areas.

Cross-Agency Work to End the Epidemic

Fauci highlighted the cross-HHS agency work behind Ending the Epidemic, with HRSA's role being to "accelerate RWHAP treatment and care for those with HIV and provide PrEP for those at risk through the HRSA Health Centers Program." That focus is because of the above-cited viral load success achieved in the RWHAP. Simultaneously is expanding the provision of PrEP through HRSA Health Centers as the RWHAP cannot directly fund PrEP.

HHS Agencies Work to End the HIV Epidemic
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