CDC: Global Reach of ART HIV Therapy Sees 300-Fold Increase

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The federal agency has taken a vital role in support and implementation of the ongoing PEPFAR initiative.

Back in 2004, through the development of the US President’s Emergency Plan for AIDS Relief (PEPFAR), and implementation driven largely by CDC, the United States started providing HIV antiretroviral therapy (ART) worldwide.

This week, CDC announced that by 2022, approximately 20 million persons with HIV worldwide have received PEPFAR-supported ART. This number represents a 300-fold increase from 66,6550 in 2004. It was reported that this accomplishment was 62% CDC-supported.

The results were published in the MMWR’s Vital Signs.

The investigators report that viral suppression loads increased over the last several years across different populations, demonstrating important highlights of the program.

“During 2015–2022, the viral load suppression rate among those receiving testing increased from 80% (1,691,232 persons with viral load suppression of 2,109,749 who received a viral load test) to 95% (14,146,647 of 14,875,130),” they wrote. “During 2017–2022, the viral load suppression rate increased among women, men, persons aged <10, 10–19, and ≥20 years, pregnant women, and breastfeeding women. Males, females, and those aged ≥20 years reached viral load suppression rates of ≥95% in 2022 (Table 1). By 2022, the viral load suppression rate among female sex workers, MSM, transgender persons, and persons who inject drugs reached ≥95%, but among persons in prisons, remained unchanged, at 93%.”

This is especially encouraging as the PEPFAR program has reached across 54 countries and areas of the world that may have had limited to no ART coverage, previously.

The US Department of State leads and coordinates the PEPFAR program. They use a comprehensive government approach for addressing the HIV/AIDS response on an international level. The CDC has played an integral role for PEPFAR, which include 7 US government departments and agencies. CDC is responsible for protecting the public’s health, and the agency continues to invest in the public health workforce development, surveillance, and laboratory capacity with scientific and technical expertise and data-driven approaches to fight the global HIV epidemic.

As evidence of its efforts, CDC receives approximately 50% of the PEPFAR funding for HIV treatment and supports approximately 60% of all individuals receiving ART through the program.

Still, the authors acknowledge there is work left to be done. “Despite increases in viral load suppression rates and health system strengthening investments, variability exists in viral load coverage among some subpopulations (children aged <10 years, males, pregnant women, men who have sex with men [MSM], persons in prisons and other closed settings [persons in prisons], and transgender persons) and in viral load suppression among other subpopulations (pregnant and breastfeeding women, persons in prisons, and persons aged <20 years),” they wrote. “To eliminate HIV as a global public health threat, achievements in HIV services must be sustained and expanded to reach all subpopulations.”

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