Addressing research priorities for prevention of HIV infection in the United States.
More than half a million Americans became newly infected with human immunodeficiency virus (HIV) in the first decade of the new millennium. The domestic epidemic has had the heaviest impact on men who have sex with men and persons from racial and ethnic minority populations, particularly black persons. For example, black men who have sex with men represent <1% of the US population but 25% of new HIV infections, according to Centers for Disease Control and Prevention estimates published in 2008. Although black and Hispanic women constitute 24% of all US women, they accounted for 82% of HIV infections among women in 2005, according to data from 33 states with confidential name-based reporting. There is a nearly 23-fold higher rate of AIDS diagnoses among black women (45.5 diagnoses per 100,000 women) and a nearly 6-fold higher rate among Hispanic women (11.2 diagnoses per 100,000 women), compared with the rate among white women (2.0 diagnoses per 100,000 women). Investigators from the HIV Prevention Trials Network, a National Institutes of Health-sponsored collaborative clinical trials group, have crafted a domestic research agenda with community input. Two new domestic studies are in progress (2009), and a community-based clinical trial feasibility effort is in development (2010 start date). These studies focus on outreach, testing, and treatment of infected persons as a backbone for prevention of HIV infection. Reaching persons not receiving health messages and services with novel approaches to both prevention and treatment is an essential priority for control of HIV infection in the United States; our research is designed to guide the best approaches and assess the impact of bridging treatment and prevention.
Vermund
Sten H
SH
Institute for Global Health and Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-0242, USA. sten.vermund@vanderbilt.edu
Hodder
Sally L
SL
Justman
Jessica E
JE
Koblin
Beryl A
BA
Mastro
Timothy D
TD
Mayer
Kenneth H
KH
Wheeler
Darrell P
DP
El-Sadr
Wafaa M
WM
D035843:Biomedical Research; D002986:Clinical Trials as Topic; D003140:Communicable Disease Control / Q000379:methods*; D005006:Ethnicity; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D012106:Research; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014930:Women
AIDS. 2003 Feb 14;17(3):321-9
12556685
MMWR Morb Mortal Wkly Rep. 1999 Jan 29;48(3):45-8
9935141
Am J Public Health. 2002 Mar;92(3):388-94
11867317
Public Health Rep. 2001;116 Suppl 1:216-22
11889287
J Infect Dis. 2008 Jul 1;198(1):59-67
18498241
J Acquir Immune Defic Syndr. 2005 Aug 1;39(4):446-53
16010168
Clin Infect Dis. 2002 May 15;34(10):1391-5
11981736
J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Mar 1;20(3):295-9
10077180
Lancet. 2004 Jul 3-9;364(9428):41-50
15234855
Lancet. 2008 Nov 29;372(9653):1881-1893
19012954
J Clin Microbiol. 2008 Jan;46(1):341-5
17977990
Clin Infect Dis. 1998 Apr;26(4):855-64
9564464
Public Health Rep. 2007;122 Suppl 1:16-23
17354523
Lancet. 2008 Jun 21;371(9630):2109-19
18572080
Soc Sci Med. 2009 Feb;68(4):740-8
19070413
JAMA. 2009 Jun 10;301(22):2380-2
19509386
AIDS. 2008 Oct 18;22(16):2179-85
18832881
AIDS. 2007 Jan 30;21(3):377-9
17255749
AIDS Care. 2006;18 Suppl 1:S6-9
16938669
MMWR Morb Mortal Wkly Rep. 2008 Sep 12;57(36):985-9
18784639
South Med J. 1997 Jul;90(7):697-701
9225891
Curr Opin HIV AIDS. 2009 Jul;4(4):266-73
19532063
Am J Public Health. 1999 Sep;89(9):1397-405
10474559
Antivir Ther. 2007;12(6):841-51
17926639
Am J Public Health. 2001 Jun;91(6):922-6
11392935
J Infect Dis. 2004 Sep 1;190(5):879-85
15295691
Lancet. 2009 Jan 3;373(9657):48-57
19038438
MMWR Morb Mortal Wkly Rep. 2008 Oct 3;57(39):1073-6
18830210
J Urban Health. 2000 Sep;77(3):425-37
10976615
AIDS. 2009 Jun 19;23(10):1277-84
19440142
J Acquir Immune Defic Syndr. 2008 Dec 15;49(5):570
19202462
Lancet. 2006 Aug 5;368(9534):531-6
16890841
N Engl J Med. 2000 Mar 30;342(13):921-9
10738050
J Acquir Immune Defic Syndr. 2005 Sep 1;40(1):96-101
16123689
Lancet. 2008 Jul 26;372(9635):314-20
18657710
Public Health Rep. 1996;111 Suppl 1:138-44
8862170