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March 8, 2019

HIV in the United States: Getting to Zero Transmissions by 2030

Author Affiliations
  • 1Harvard Global Health Institute, Cambridge, Massachusetts
  • 2Harvard Medical School, Cambridge, Massachusetts
  • 3Harvard School of Public Health, Cambridge, Massachusetts
JAMA. 2019;321(12):1153-1154. doi:10.1001/jama.2019.1817

It has been nearly 4 decades since the Centers for Disease Control and Prevention reported a rare lung infection among 5 previously healthy young men in Los Angeles—what would be the first recorded cases of Pneumocystis carinii pneumonia in men who were discovered to have human immunodeficiency virus (HIV) infection. Since the first cases of AIDS were identified in the United States, the number of people with HIV in the United States has reached an estimated 1.2 million, with nearly 40 000 people receiving a new diagnosis in 2017 alone.1 This infection, which was initially nearly uniformly fatal, has become a chronic disease largely because of the scientific breakthrough of a new group of medications, known as highly active antiretroviral therapy (HAART), which has helped to control the epidemic in the United States and globally. Despite this pivotal advancement, only 60% of the people living with HIV in the United States have achieved viral suppression.1 Additionally, the financial costs of HIV are substantial, especially for the federal government, which spent an estimated $20 billion on HIV care and treatment in fiscal year 2016 alone.2 Even though the human and financial burdens of HIV remain substantial, it is now possible to end transmission of the virus and control the epidemic in the United States within the next 10 years.

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