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4. Getting to Zero -- Progress Toward Ending HIV Epidemic


In July UNAIDS released a report showing that the Millennium Development Goal of getting 15 million people with HIV worldwide onto antiretroviral therapy (ART) by 2015 -- a goal many once considered impossible -- had been reached 9 months sooner than projected. Other targets have also been achieved or exceeded, as new HIV infections have decreased by 35% and AIDS-related deaths by 41%.

In the U.S., San Francisco's Getting to Zero initiativeaims to make the city the first jurisdiction to eliminate new HIV infections, HIV-related deaths, and HIV stigma and discrimination using a 3-prong strategy of pre-exposure prophylaxis (PrEP), immediate antiretroviral treatment, and retaining HIV-positive people in care. According to the SF Department of Public Health's 2014 HIV Epidemiology annual report, the number of newly diagnosed HIV infections in the city fell by more than 18%, from 371 in 2013 to 302 in 2014 -- the lowest since the start of the epidemic. Deaths due to any cause among people with HIV fell by 15% during the same period, from 209 to 177.

New York State launched a blueprint to end the AIDS epidemic by facilitating PrEP access, identifying people who remain undiagnosed and linking them to health care, and retaining people with HIV in health care to maximize viral suppression.

Coinciding with the 2015 National HIV Prevention Conference in December, the Centers for Disease Control and Prevention (CDC) reported that annual HIV diagnoses in the U.S. fell by 19% overall between 2005 and 2014, which the agency attributed to "dramatic and continuing declines over the decade among several populations including heterosexuals, people who inject drugs, and African Americans."

Among men who have sex with men -- a group that accounts for nearly two-thirds of all new cases -- HIV diagnoses rose by 6% over the decade, before stabilizing in recent years at a less than 1% increase. White gay and bisexual men saw an 18% decline in newly detected infections over the decade, while new diagnoses among black and Latino gay men rose by 22% and 24%, respectively. But new cases have leveled off among young black gay men during the last 5 years: while this group experienced a steep 87% increase over the decade as a whole, the rate declined by 2% between 2010 and 2014.

"[This data] tells us that our prevention strategies are working, but progress is uneven across populations," said Eugene McCray, director of CDC's Division of HIV/AIDS Prevention. "We urgently need to accelerate access to testing, treatment, and new biomedical prevention strategies so that everyone can protect themselves and their partners."

NEXT: 5. Indiana HIV Outbreak Linked to Opioid Injection