Estimated future HIV prevalence, incidence, and potential infections averted in the United States: a multiple scenario analysis.
OBJECTIVE
To estimate the potential future burden of HIV in the United States under different intervention scenarios.


METHODS
We modeled future HIV incidence, prevalence, and infections averted using 2006 estimates of HIV incidence (55,400 new infections per year), prevalence (1,107,000 persons living with HIV), and transmission rate (5.0 per 100 persons living with HIV). We modeled 10-year trends for 3 base-case scenarios (steady incidence, steady transmission rate, declining transmission rate based on the 2000-2006 trend) and 2 intensified HIV intervention scenarios (50% reduction in transmission rate within 10 and 5 years).


RESULTS
Base-case scenarios predicted HIV prevalence increases of 24%-38% in 10 years. Reducing the transmission rate by 50% within 10 years reduces incidence by 40%; prevalence increases 20% to an estimated 1,329,000 persons living with HIV. Halving the transmission rate within 5 years reduces incidence by 46%; prevalence increases 13%, to 1,247,000. Although in year 10 incidence is similar regardless of the intervention time frame, more infections are averted when halving the transmission rate within 5 years.


CONCLUSIONS
HIV prevalence will likely increase creating additional demands for health care services. These analyses are instructive for setting HIV prevention goals for the nation and assessing potential cost savings of intensified HIV prevention efforts.
Hall
H Irene
HI
Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. ixh1@cdc.gov
Green
Timothy A
TA
Wolitski
Richard J
RJ
Holtgrave
David R
DR
Rhodes
Philip
P
Lehman
J Stan
JS
Durden
Teresa
T
Fenton
Kevin A
KA
Mermin
Jonathan H
JH
D005544:Forecasting; D015658:HIV Infections / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D015994:Incidence; D008962:Models, Theoretical; D015995:Prevalence; D040242:Risk Reduction Behavior; D014481:United States / Q000453:epidemiology