Study: US met perinatal HIV elimination goals in 2019

Key takeaways:

• The U.S. met perinatal elimination goals for the first time in 2019.
• The impact of COVID-19 on elimination efforts remains unknown.

The United States met perinatal HIV elimination goals for the first time in 2019, according to a study led by CDC researchers.

The incidence of perinatal HIV has steadily declined since the early 1990s. In 2012, the CDC published “A Framework for Elimination of Perinatal Transmission of HIV in the United States,” which set a goal of an incidence of less than one case of perinatal HIV per 100,000 live births, and a perinatal transmission rate of less than 1%.

“We have been actively monitoring progress that we make in this field,” Athena P. Kourtis, MD, PhD, MPH, chief of the CDC's HIV research branch and clinical professor of pediatrics at Emory University School of Medicine, told Healio. “We're very happy to note in our publication that these goals were met for the first time in the United States in 2019. So, this is really a major public health success, and it calls for celebration.”

Kourtis said that although she did not suspect “there was anything really special that was happening in 2019” to cause the decline in that year, there has been a “continuous decline” in the number of infants with perinatal HIV in the U.S. since the 1990s.

“This decline has really been very dramatic if you consider the peaks that we saw in the U.S. back in the 90s,” Kourtis said. “There were, you know, 1,700 infants a year with HIV infection, and now we're down to less than 35 infants [per year]. This is really quite an accomplishment.”

In an accompanying commentary, Nahida Chakhtoura, MD, MsGH, of the pregnancy and perinatology branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and Bill G. Kapogiannis, MD, acting NIH director of AIDS research and acting director of the NIH Office of AIDS Research, noted that Black and Hispanic people in the U.S. are more likely to be living with undiagnosed HIV.

“Much work remains to close the science-to-service gaps, as 16% to 30% of pregnant individuals diagnosed at or after delivery resulted in perinatal transmission of HIV,” they wrote. “Important implementation science is needed to uncover individual, health system, and provider level challenges and implement interventions that will improve the delivery and uptake of culturally competent, unbiased, health care among diverse communities.”

Kourtis said the news that a goal was met is cause for celebration, but urged vigilance and said they are examining the effects of the COVID-19 pandemic on elimination efforts.

“It does not mean that our efforts should stop because this is an effort that needs to be maintained,” Kourtis said. “This elimination needs to be maintained constantly, and we need to meet these goals every year, one family at a time.”

References:

Chakhtoura N, et al. Pediatrics. 2023;doi:10.1542/peds.2022-060209.

Lampe MA, et al. Pediatrics. 2023;doi:10.1542/peds.2022-050604.

Nesheim S, et al. Pediatrics. 2012; doi: 10.1542/peds.2012-0194.