Is the USA on track to end the HIV epidemic?

Despite progress in reducing new HIV infections in the USA, publicly available data suggest that new HIV infections continue to occur at an alarming rate. In this Viewpoint, we highlight the regularity with which the existing systems for HIV prevention and treatment delivery in the USA fail and the clearly inequitable effect of the systems' failure among several priority populations of the Ending the HIV Epidemic (EHE) initiative. Existing data cast doubt on whether the current EHE efforts will suffice to achieve its 2030 goal of reducing annual new HIV infections to fewer than 3000. We outline future directions in four priority areas to regain lost ground in pursuit of the 2030 EHE goals: reducing the stigma affecting people living with and most at risk of HIV; broadening the HIV workforce; mitigating harmful social determinants of health; and recommitting and reinvesting in health in the USA more broadly.

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Déclaration de conflit d'intérêts

Declaration of interests VG-R reports grants and personal fees from ViiV Healthcare, outside the submitted work; personal fees from Gilead Sciences, outside the submitted work; and research funding from National Institutes of Health and other federal and philanthropic funders. VG-R serves as a member of the US Presidential Advisory Council on HIV/AIDS; the Centers for Disease Control and Prevention/Health Resources and Services Administration Advisory committee on HIV, viral hepatitis, and sexually trasmitted disease prevention and treatment; the US Department of Health and Human Services panel on antiretroviral guidelines for adults and adolescents; the National Academies of Sciences, Engineering, and Medicine committee on unequal treatment revisited: the current state of racial and ethnic disparities in healthcare; and the committee on the prevention and control of sexually transmitted infections in the USA. VG-R serves on the board of directors of the HIV Medicine Association, the Latino Commission on AIDS, and numerous other health organisations. All other authors declare no competing interests.