A steep drop in the local incidence of new HIV infections accompanied the rollout of a U.S.-funded anti-HIV program in a large East African population, according to a study led by researchers at Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Medicine.
The study, published Nov. 29 in the New England Journal of Medicine, is the first to track a large group of people before, during and after the start of an HIV prevention program and show that the program is likely working on a large scale. The researchers found that as the program began and matured from the early 2000s until 2016, there was a 42 percent decline in the rate of new HIV infections.
The ongoing HIV prevention program — in Uganda’s rural Rakai District on the shore of Lake Victoria — has been funded by the President’s Emergency Plan for AIDS Relief (PEPFAR), set up in 2004 by the George W. Bush administration. The program provides multiple free services, including anti-HIV drugs for infected people, voluntary safe male circumcision, condoms and promotion of risk-reduction sexual practices. These measures are known to reduce HIV transmission and acquisition at an individual level, but their population-wide impact over time in a real-world context has been less clear.
The African region also accounts for almost two-thirds of the global total of new HIV infections, according to the World Health Organization, with 25.6 million people in the region living with HIV in 2016.