While incidence rates drop, actual numbers of new infections could rise steeply
In 2015, the more than 68 million people tested for HIV with support from the U.S. President’s Emergency Plan for AIDS Relief included 14.7 million pregnant women, the program’s latest report to Congress, released Monday, notes. Among the results of that testing were an estimated 267,000 HIV infections averted among babies who otherwise would have been born with the virus, the report continues.
The number of men in East and Southern Africa who, with PEPFAR support, were medically circumcised to reduce their risks of getting HIV reached 8.9 million, and the number of people living with HIV receiving life-saving antiretroviral treatment that protects their health and prevents transmission of the virus through program support reached 9.5 million.
These are among the hopeful notes of a report that cites advances in HIV prevention and treatment delivery that increases opportunities to provide immediate treatment to people diagnosed with HIV, and to meet the UNAIDS goals to end the global health threat of the virus by 2030. The promise of pre-exposure prophylactic use of antiretroviral treatment — or PrEP — offers new opportunities to avert infections, the report notes, while early treatment of still healthy people living with the virus and improved medicines make possible cost-saving measures that can provide treatment for two people who need it at the previous cost of providing treatment for one. Improved data collection and use, the beginnings of strengthened links with local civil society, and increased emphasis on evidence for programming all are referenced as reasons that the third iteration of PEPFAR, which has evolved from an emergency to a sustainable response to a public health crisis, to a response that controls and ends a public health crisis, can succeed.
But, the report notes, the work ahead will continue to include a Sisyphean challenge if response doesn’t match need, with sub-Saharan Africa home to a growing population of young people nearly a third larger than that at the start of the epidemic. That means, the report notes, that pointing with pride at dropping rates of infections will lose meaning, unless the actual numbers of new infections is dropping as well.