Holtgrave David R
New York State Department of Health, Corning Tower, 14 th Floor, Suite 1435, Albany, NY, 12,237, USA.
Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
AIDS Behav. 2025 May 19. doi: 10.1007/s10461-025-04757-0.
News outlets are reporting that CDC's HIV prevention program including its Ending the HIV Epidemic (EHE) efforts are slated to be defunded. One way to estimate the potential impacts of halting HIV prevention in the nation is to use mathematical modeling to provide informed estimates of the epidemiologic and economic impacts of this purported policy shift. We describe here a basic transmission rate model to estimate the HIV-related epidemiologic and economic horizon through 2030 as if funding were untouched and as if it were to be ended. This model is compared to other lenses through which to view the halting of national HIV prevention. Through any employed analytic lens, the result seems similar - ending HIV prevention efforts means the epidemic will get worse, lives will be lost, and not only will money not be saved but the net additional medical costs will rapidly increase. If this worsening of the epidemic comes to pass, the nation will enter the next decade far worse off than it is now, and efforts to get back to the current HIV-related "starting place" will need to be larger, more intensive, and much more expensive. There was a national hope that the ending of the current decade would indeed be the end of the epidemic; but if HIV prevention support is stopped, we would not be able to experience this important and joyous HIV elimination milestone in 2030 but rather be left to witness just how much worse the epidemic may get.
新闻媒体报道称,美国疾病控制与预防中心(CDC)的艾滋病预防项目,包括其“终结艾滋病流行”(EHE)工作,预计将被削减资金。评估在美国停止艾滋病预防工作可能产生的影响的一种方法,是使用数学模型,以便对这一所谓政策转变的流行病学和经济影响提供有依据的估计。我们在此描述一个基本传播率模型,以估计到2030年与艾滋病相关的流行病学和经济前景,假设资金不受影响以及假设资金将被终止的情况。该模型与其他审视美国艾滋病预防工作停止的视角进行了比较。通过任何所采用的分析视角,结果似乎都相似——停止艾滋病预防工作意味着疫情将恶化,会有人丧生,而且不仅不会节省资金,额外的医疗成本净额还将迅速增加。如果疫情的这种恶化成为现实,美国进入下一个十年时的状况将比现在糟糕得多,要恢复到当前与艾滋病相关的“起始点”所需的努力将更大、更密集,且成本更高。曾有一个全国性的希望,即当前这十年的结束确实将是艾滋病流行的终结;但如果艾滋病预防支持被停止,我们将无法在2030年迎来这一重要且令人欣喜的消除艾滋病里程碑,而是只能目睹疫情可能会变得多么糟糕。