Based on population risk group and the cumulative amount of time spent in each age group and care-continuum step, the model estimated the number of infections each subgroup generated. For persons in the model with viral suppression, the reduction in transmission rate was 100% † ( 2– 5). Model inputs included behavioral data from National HIV Behavioral Surveillance and epidemiologic and clinical data from the National HIV Surveillance System. Persons newly infected with HIV were incorporated into the model. Transmissions were tracked weekly in the acute stage (up to 3 months after HIV infection) and monthly thereafter. Persons formed main and casual sexual partnerships as well as injection partnerships, with chances of transmission determined by sexual behaviors, injection risk behaviors, partnership preference, and viral load suppression status. PATH 2.0 tracked persons with HIV infection and their stage of disease (as measured by viral load and CD4 counts) as they moved along the HIV care continuum. Mutually exclusive population risk groups included 1) men who have sex with men (MSM), 2) persons who inject drugs (men and women), 3) MSM who inject drugs, and 4) heterosexual men and women. transmission rates by step along the HIV care continuum, population risk group, and age group ( 9). To focus national and local prevention efforts to eliminate HIV, CDC used a model to estimate the number of persons and HIV transmissions at each step along the continuum of care.ĬDC updated the Progression and Transmission of HIV (PATH 2.0) model to estimate 2016 U.S. Lack of effective treatment results in worse outcomes for persons with HIV infection and higher rates of HIV transmission and was associated with 38,700 new HIV infections in 2016 ( 8). In addition, sexual and injection-drug–associated risk behaviors varied with knowledge of HIV infection status and access to care ( 9, 10). In 2015, among all persons with HIV infection, 14.5% did not have a diagnosis, 37.2% were not in care, * and 48.9% were not virally suppressed ( 7). Department of Health and Human Services (HHS) to end the HIV epidemic in the United States within 10 years ( 6).ĭespite the availability of effective treatment, many of the 1.1 million persons with HIV infection in the United States are not effectively treated ( 7, 8). These findings also provide an important scientific underpinning to the new federal initiative headed by the U.S. Today’s treatment regimens are simpler than those prescribed in the past, sometimes requiring only single-tablet formulations, with fewer side effects most persons with HIV infection can achieve viral suppression within 6 months of initiating treatment. These findings indicate that HIV transmission can become a rare event if persons with infection can obtain treatment and achieve and maintain viral suppression. Together, these prospective studies found no HIV transmissions attributable to sex between HIV-discordant couples when the partner with HIV infection was on treatment and maintained viral suppression, despite documenting tens of thousands of acts of condomless sex in which the HIV-negative partner was not using preexposure prophylaxis. Four recent studies found that viral suppression prevented sexual transmission of HIV ( 2– 5). The benefits of treatment are maximized with suppression of the virus (<200 copies of HIV/mL of blood on the most recent viral load test), which benefits health and decreases rates of transmission. Medical treatment has substantially improved the health, quality of life, and life expectancy of persons with HIV infection ( 1).
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