Daily antiretroviral therapy (ART) that suppresses HIV to levels undetectable by standard blood tests is lifesaving for individuals living with HIV and prevents sexual transmission of the virus to others. The public health community must use targeted interventions, however, to do a better job of reaching populations with low levels of viral suppression, according to experts from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
If HIV treatment as prevention is to help us reach the goal of ending the HIV epidemic in the United States, it is critical to understand, address and bridge gaps in achieving viral suppression, NIAID director Anthony S. Fauci, MD, and colleagues write in an editorial commenting on an NIH-funded study published in Annals of Internal Medicine.
The study found that rates of viral suppression among 31,930 adults receiving HIV care at eight clinical sites across the United States improved from 32 percent in 1997 to 86 percent in 2015. However, these gains were not equally distributed across different demographic and clinical populations.
As HIV treatment guidelines changed to promote early ART initiation, and as ART regimens improved, overall rates of viral suppression rose. Yet certain demographic groups, such as black people living with HIV, remained less likely to be virally suppressed. Additionally, improvements in viral suppression among heterosexual individuals and people who inject drugs plateaued from 2013 to 2015.
According to the NIAID experts, the new study brings us closer to understanding viral suppression gaps brought on by social and economic barriers to care. Fauci and colleagues call for additional research to follow up on these findings and to identify ways to address and resolve these disparities. They also note that bringing all people living with HIV into care remains a key challenge to the success of treatment as prevention efforts for which more effective strategies are needed.
As the public health community strives to end the HIV epidemic in the United States, targeted treatment interventions for populations with low levels of viral suppression, paired with tailored prevention packages, will be essential, Fauci and colleagues conclude.
The related study was supported by NIAID, the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, all components of NIH.
References:
HD Marston, CW Dieffenbach, AS Fauci. Ending the HIV epidemic in the United States: closing the implementation gaps. Annals of Internal Medicine DOI: 10.7326/M18-1944 (2018).
RM Nance, JAC Delaney, JM Simoni et al. HIV viral suppression trends over time among HIV-infected patients in care in the United States, 1997-2015. Annals of Internal Medicine DOI: 10.7326/M17-2242 (2018).
Source: NIH
Product Locator: Spring and Early Mother's Day Gift Guide for Infection Prevention Personnel
March 27th 2024Whether it's a spring holiday, birthdays, or no reason at all, infection prevention personnel love to give and receive gifts that help at the end of a stressful day. Infection Control Today® offers some gift ideas for infection prevention personnel and their families.
Catching Up With Vangie Dennis, AORN 2022-2023 President at AORN 2024
March 26th 2024Infection Control Today (ICT) had the privilege of catching up with Vangie Dennis, MSN, RN, CNOR, CMLSO, at the Association of periOperative Registered Nurses' (AORN’s) International Surgical Conference & Expo 2024. As the former president of AORN and an esteemed figure in perioperative services, Vangie Dennis shared insights into her recent endeavors and the exciting new chapter she's embarked upon.
How To Optimize Your Time Management Strategies for the Busy Infection Preventionist
March 25th 2024Is your calendar resembling a chaotic masterpiece of overlapping tasks? Join the club of infection preventionists striving to balance responsibilities. Dive into proven strategies from a fellow infection preventionist to reclaim control of your time, streamline tasks, and boost productivity effectively. This is an IP Lifeline article.
CenTrak Unveils Revolutionary BLE Multi-Mode Platform for Health Care RTLS Solutions
March 22nd 2024CenTrak, the industry leader in real-time location technology, introduces the groundbreaking BLE Multi-Mode Platform, setting a new standard for Real-Time Location Systems (RTLS) in health care. Discover how this innovative solution enhances location data precision and streamlines operations for health care organizations.