January 28, 2015
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New goals set for increased HIV/AIDS diagnosis, treatment by 2020

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In a commentary published in JAMA, leaders of the global AIDS community called for increased efforts to contain the disease by 2020.

“Today, an estimated 13.6 million people worldwide are receiving ART, 700,000 having initiated therapy over the past year alone — remarkable progress by any measure,” wrote Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, and Hilary D. Marston, MD, MPH, also of NIAID. “Although much remains to be done to achieve universal global access to ART for all people with HIV, the global AIDS community has set its sights on new, even more ambitious goals.”

Anthony Fauci

Anthony S. Fauci

Fauci and Marston wrote that the next milestone toward an AIDS-free generation is what they are calling the “90-90-90” target. This reflects the goal that 90% of the people with the virus become aware of their HIV status, 90% of those who have tested positive begin ART, and 90% of those enrolled in the therapy achieve virologic suppression.

To do so will require not only an emphasis on broader programs, they wrote, but also more focused efforts. Among these are strategies that target groups greatly affected by the disease such as black men who have sex with men.

“To reach the 90-90-90 goals in the United States and globally, focus should be on the populations most vulnerable to HIV and should target interventions that are most useful and sustainable for these people,” they wrote. “Infected individuals and health care practitioners must work together to understand the gaps in the continuum of care and the best ways to fill them.”

In addition, Fauci and Marston drew attention to emerging interventions, such as pre-exposure prophylaxis, and patient retention as answers to further reduce the spread of the disease.

“Ultimately, the tailored deployment of these interventions against HIV, along with a robust system of care and treatment to help individuals achieve and maintain virologic suppression, will be essential to attain a world without AIDS,” they wrote. “Even though the United States and the global community are currently far from that goal, with a commitment to scaling up both provision of ART and proven prevention interventions, as well as a strategic focus on the communities and individuals most at risk, important progress can be made in the struggle toward a world without AIDS.”

Disclosure: The researchers report no relevant financial disclosures.