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Is HIV epidemic control by 2030 realistic?
Chris Beyrer1, Georgia D Tomaras2, Huub C Gelderblom3
1Duke Global Health Institute, Duke University, Durham, NC, USA; Duke Center for AIDS Research, Duke University, Durham, NC, USA.
The Lancet. HIV
|June 26, 2024
Summary
New HIV infections remain high globally, hindering efforts to end AIDS by 2030. Current prevention strategies face challenges, emphasizing the need for a scalable HIV vaccine for population-level impact.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- New human immunodeficiency virus (HIV) acquisition rates persist globally, impacting low-, middle-, and high-income countries.
- Despite advancements in treatment and prevention, the scale-up of biomedical interventions has been insufficient to meet the goal of ending AIDS by 2030.
- Challenges include low population coverage of interventions, adherence issues with oral pre-exposure prophylaxis (PrEP), and infections occurring in populations not typically targeted for prevention.
Purpose of the Study:
- To highlight the inadequacy of current HIV prevention strategies in achieving global epidemic control.
- To emphasize the critical need for population-level impact interventions, particularly in generalized epidemics.
- To advocate for continued research and development of effective HIV prevention tools, such as vaccines.
Main Methods:
- This study is a review and analysis of current HIV acquisition rates and prevention strategy effectiveness.
- It synthesizes data on the limitations of existing biomedical interventions, including oral PrEP, long-acting injectables, and monoclonal antibodies.
- The analysis considers the impact of population coverage, adherence, and targeted prevention approaches.
Main Results:
- Current HIV prevention strategies are not being scaled effectively to meet global targets for epidemic control.
- Existing biomedical interventions face significant hurdles, including cost, adherence, and reaching at-risk populations.
- A vaccine or vaccine-like intervention is considered the most probable solution for substantial population-level impact on HIV incidence, especially in generalized epidemics.
Conclusions:
- Global efforts to control the HIV pandemic are insufficient to meet the 2030 goals.
- There is a critical need to acknowledge these shortcomings and advocate for sustained, population-based control strategies.
- The development and widespread implementation of an effective HIV vaccine remain paramount for significantly reducing global HIV incidence.
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