During the 2019 State of the Union address, President Trump announced the initiative, Ending the HIV Epidemic: A Plan for America. The goal of this 10-year national initiative is to reduce new HIV infections in the United States to less than 3,000 per year by 2030. If successful, incident HIV infections would be rare, effectively ending the epidemic. The HIV Care Continuum (also known as the HIV Care Cascade or HIV Treatment Cascade) is a model of sequential steps for medical care for individuals living with HIV. The HIV Care Continuum begins with being diagnosed with HIV and progresses to include linkage to HIV care, engagement and retention in HIV care, receipt of antiretroviral medication, and achieving sustained viral suppression. The plan to End the HIV Epidemic seeks to address the HIV Care Continuum to:
- Diagnose all people living with HIV as early as possible after transmission.
- Treat HIV rapidly and effectively to achieve sustained viral suppression.
- Prevent HIV transmission among people at highest risk with Pre-Exposure Prophylaxis (PrEP) and prevention education.
- Respond rapidly to detect and respond to HIV clusters and prevent new HIV infections.
The national strategy also focuses on prioritized geographic locations to target with additional resources; in the first year 48 U.S. counties and seven states (Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma and South Carolina) were identified as priority regions for the plan’s objectives. To achieve the goals outlined in this initiative, the work of psychologists will be crucial to the successful achievement of the targeted health outcomes. For example, psychologists’ expertise in efficacious prevention intervention approaches and knowledge of best practices to support behavior change will be critical to the success of the national strategy.
In this issue of the Psychology and AIDS Exchange Newsletter we have compiled five outstanding articles detailing intervention approaches to optimize outcomes along the HIV Care Continuum. Brown, Mullins and Andrew Ferguson overview PrEP as an HIV prevention strategy among individuals who inject drugs. Tyrel Starks, PhD, and Daniel Sauermilch, PhD, discuss HIV testing approaches, with a focus on couples’ HIV testing and counseling. Sylvie Naar, PhD, overviews the implementation of Motivational Interviewing approaches to end the HIV epidemic among adolescents. Next, Claborn and Kioumarsi detail patient- and systems-level interventions to improve linkage and retention in HIV care. Last, Leo Rennie highlights federal funding and policy issues related to the Ending the Epidemic initiative. The articles included in this newsletter highlight challenges to the success of the End the Epidemic approach and empirically-supported interventions to bolster behavior change needed to improve the HIV Care Continuum and prevent new incident infections.
