New metrics needed to evaluate and combat HIV epidemics in the US

December 17, 2019

A new peer-reviewed commentary published in the January issue of the American Journal of Public Health argues for new metrics to evaluate the public health response to HIV in the United States. The U.S. Department of Health and Human Services (HHS) has announced plans to reduce the number of new HIV infections by 75 percent in the next five years and 90 percent in the next 10 years. "Ending the HIV Epidemic" (EtHE) efforts will focus initially on 48 high burden counties; Washington, DC; San Juan, Puerto Rico; and seven states with substantial rural HIV burdens, before moving on to all U.S. counties.

Dr. Denis Nash, Distinguished Professor of Epidemiology at the CUNY Graduate School of Public Health and Executive Director of the CUNY Institute for Implementation Science in Population Health, notes that because ending the public health threat of HIV requires intensification and more focused targeting of implementation, there is a need for new metrics to inform and evaluate EtHE initiatives. Nash argues that newer metrics should complement the current metrics that focus on new HIV infections, individuals successfully being treated for HIV, and coverage of pre-Exposure Prophylaxis (PrEP), a drug which can prevent HIV infection.

The HHS plan should develop metrics that track the deployment and uptake of specific intervention delivery strategies, which would provide data regarding plan goals. Nash contends that HIV-related health disparities in both implementation outcomes and health outcomes require special attention.

"Given the major disparities in HIV incidence and the potential for these disparities to be further exacerbated through differential access to HIV testing, PrEP, HIV treatment, and treatment adherence support, special attention must be paid to the use of metrics and targets capable of informing action and course corrections aimed at mitigating disparities," Nash says.

Finally, Nash underscores the need for HHS to develop a public facing web-based dashboard system that more rapidly disseminates actionable information based on the new metrics needed to inform the implementation of the HHS plan.

"We have made substantial strides in getting useful data into the hands of those that are in a position to act in support of New York's Ending the Epidemic initiative," he said, referring to New York's Ending the Epidemic Dashboard system. "The national EtHE Plan needs a timely dissemination system like the one we have here in New York in order to accelerate impact and share lessons learned within and across those jurisdictions aiming to end HIV as a local public health threat."
-end-
Funding

This work was supported by funding from the US National Institutes of Health (NIH), including the Einstein, Rockefeller, CUNY Center for AIDS Research (ERC CFAR, P30 AI124414), and the HIV Center for Clinical and Behavioral Studies (P30 MH043520), the New York State Department of Health AIDS Institute, and the CUNY Institute for Implementation Science in Population Health.

For more information, contact:

Denis Nash
denis.nash@sph.cuny.edu
347-331-6554

About the Institute for Implementation Science in Population Health at the City University of New York.

The CUNY Institute for Implementation Science in Population Health (ISPH) was founded on the notion that substantial improvements in population health can be efficiently achieved through better implementation of existing strategies, policies, and interventions across multiple sectors. We study how to translate and scale-up evidence-based interventions and policies within clinical and community settings in order to improve population health and reduce health disparities. CUNY ISPH. Pursing population health gains through better implementation. http://www.cunyisph.org. Follow us on Twitter: @CUNYISPH.

About the CUNY Graduate School of Public Health and Health Policy

The CUNY Graduate School of Public Health and Health Policy (CUNY SPH) is committed to teaching, research and service that creates a healthier New York City and helps promote equitable, efficient and evidence-based solutions to pressing health problems facing cities around the world. For more information, visit sph.cuny.edu.

Citation:

"Designing and Disseminating Metrics to Support Jurisdictional Efforts to End the Public Health Threat Posed by HIV Epidemics," Denis Nash, American Journal of Public Health, 2020;110:53-57. doi: 10.2105/AJPH.2019.305398

CUNY Graduate School of Public Health and Health Policy

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.